Remote Ischemic Conditioning (pre, per, and post) as an Emerging Strategy of Neuroprotection in Ischemic Stroke PDF Download

Author: Francisco Purroy
Publisher: Frontiers Media SA
ISBN: 2889765911
Category : Medical
Languages : en
Pages : 109

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Author: Angela Dykes
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Remote ischemic conditioning (RIC) is a noninvasive procedure where blood flow to a limb is repetitively reduced, sometimes called an "exercise memetic". RIC delivered before (pre-RIC) or after (post-RIC) stroke is reportedly neuroprotective in preclinical stroke models. A review of the preclinical RIC literature revealed that studies almost exclusively use male subjects and a single stroke model (MCAO) that produces a large injury (~34% of hemisphere). To improve clinical translation, efficacy should be demonstrated in multiple stroke models and both sexes. Furthermore, the restorative potential of RIC (delivered past the neuroprotection window) to improve stroke recovery remains to be investigated. In male and female Sprague-Dawley rats (n=129) a standardized session (5min inflation, 5min deflation, 4 repetitions) of RIC was delivered using a pressurized cuff on the hindlimb. RIC was either delivered once 18h before, once 4hr acutely after or daily for 28 days beginning day 5 after endothelin-1 (ET-1) stroke. Infarct volumes were assessed 24hrs after stroke using MRI. To determine if RIC efficacy varied across stroke size, a hierarchical cluster analysis was used to divide rats into subgroups based on stroke size (small/large). RIC was effective in ET-1 which produced smaller strokes ("small":5.2%, "large":18.0% of hemisphere) than MCAO (~34%). This is more comparable to injury sizes seen clinically (4.5-14.0%). "Small" (42±4mm3) strokes were reduced by 39% (p=0.010, d=0.29) and "large" (146±8mm3) strokes were reduced by and 35% (p

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Languages : en
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Novel and innovative approaches are essential in developing new treatments and improving clinical outcomes in ischemic stroke patient. Remote ischemic conditioning (RIC) is a series of mechanical interruptions in blood flow of a distal organ, following end organ reperfusion, shown to significantly reduce infarct size through inhibition of oxidation and inflammation. Ischemia/reperfusion is what ultimately leads to the irreversible brain damage and clinical picture seen in stroke patients. There have been reports about the potential of RIC in acute ischemic stroke; however, the focus here is a comprehensive look at the differences in the three types of RIC (remote pre-, per-, and postconditioning). There are some limited uses of preconditioning in acute ischemic stroke due to the unpredictability of the ischemic event; however, it does provide the identification of biomarkers for clinical studies. Remote limb per- and postconditioning offer a more promising treatment during patient care as they can be harnessed during or after the initial ischemic insult. Though further research is needed, it is imperative to discuss the relevance of preclinical data in understanding the methods and mechanisms involved in RIC. This understanding will facilitate translation to a clinically feasible paradigm for use in the hospital setting. As an attractive low-cost, low-risk, and easily-operated therapy, the application of remote ischemic conditioning can be applied to cerebral ischemia in the clinics. When carrying out experimental studies, such detailed mechanisms of action and potential biomarkers should be integrated into clinical trial designs to ensure proper translation and ultimately therapeutic efficacy.

Author: Kristina Dupont Hougaard
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Author: Steven C. Cramer
Publisher: Cambridge University Press
ISBN: 1139490656
Category : Medical
Languages : en
Pages : 307

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Increasing evidence identifies the possibility of restoring function to the damaged brain via exogenous therapies. One major target for these advances is stroke, where most patients can be left with significant disability. Treatments have the potential to improve the victim's quality of life significantly and reduce the time and expense of rehabilitation. Brain Repair After Stroke reviews the biology of spontaneous brain repair after stroke in animal models and in humans. Detailed chapters cover the many forms of therapy being explored to promote brain repair and consider clinical trial issues in this context. This book provides a summary of the neurobiology of innate and treatment-induced repair mechanisms after hypoxia and reviews the state of the art for human therapeutics in relation to promoting behavioral recovery after stroke. Essential reading for stroke physicians, neurologists, rehabilitation physicians and neuropsychologists.

Author: Bernhard Schaller
Publisher: Nova Publishers
ISBN: 9781604562286
Category : Cerebral anoxia
Languages : en
Pages : 116

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Endogenous neuoprotection is a phenomenon where a brief episode of ischemia renders the brain resistant against a subsequent longer-asting ischemia event. Experimentally, the author was able to model hypoxic preconditioning in animal model. Increasing knowledge of this endogenous neuroprotectin by ischemic tolerance may help to minimize neuronal damage following ischemic stroke and hypoxic encephalopathy. This book is, therefore, the first overview of this important topic and will certainly influence further investigations in clinical and neuroscience research.

Author: Paul A. Lapchak
Publisher: Springer
ISBN: 3319453459
Category : Medical
Languages : en
Pages : 795

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A critical and comprehensive look at current state-of-the-art scientific and translational research being conducted internationally, in academia and industry, to address new ways to provide effective treatment to victims of ischemic and hemorrhagic stroke and other ischemic diseases. Currently stroke can be successfully treated through the administration of a thrombolytic, but the therapeutic window is short and many patients are not able to receive treatment. Only about 30% of patients are "cured" by available treatments. In 5 sections, the proposed volume will explore historical and novel neuroprotection mechanisms and targets, new and combination therapies, as well as clinical trial design for some of the recent bench-side research.

Author: Tomas A. Salerno
Publisher: John Wiley & Sons
ISBN: 1405178434
Category : Medical
Languages : en
Pages : 344

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Myocardial protection is regarded as one of the most important, yet also most controversial aspects of cardiac surgery. There has been considerable improvement in myocardial protection strategies over recent years, utilising a variety of new approaches to treat cardiac diseases, and this text is intended to embrace the state of the art in this field. The book summarises the state of knowledge on all aspects of myocardial protection, including the latest in the treatment of cardiac diseases, robotics, pediatric surgery and the treatment of cardiac failure. Robotic surgery, valvular surgery, pediatric surgery and coronary surgery are all covered by renowned experts, producing a comprehensive, forward-looking view of the field of myocardial protection. This book should function to update physicians and surgeons interested in the field of cardiac surgery on the current state of knowledge on myocardial protection.

Author: Ulrich Dirnagl
Publisher: Humana Press
ISBN: 9781607617495
Category : Medical
Languages : en
Pages : 0

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In view of the numerous failures of clinical trials aimed at improving stroke therapy, the role and potential benefit of experimentally modeling focal cerebral ischemia in rodents has been debated. When methods of systematic review and metaanalyis are applied, however, it turns out that experimental models actually faithfully predicted the negative outcomes of clinical trials. In addition, thrombolysis and neuroprotection by hypothermia, first described in animal models, are key examples of treatment modalities that have made it successfully into clinical practice. In Rodent Models of Stroke, an international consortium of authors aims at critically addressing the issues on a very practical level, from choosing the model and outcome measures, designing the experiment, conducting and analyzing it, to reporting it in a scientific publication. The structure and content of the book reflect both the authors’ longstanding expertise in experimental and clinical stroke research and their roles in training the scientific community in the tools of the trade. As a volume in the successful Neuromethods series, the chapters provide authoritative reviews of the most commonly used, well-honed approaches in the field today. Stimulating and easy-to-use, Rodent Models of Stroke will help its readers understand the limitations and the opportunities of modeling stroke in rodents and enable them to conduct experiments which will not only improve our understanding of the pathophysiology of this devastating disorder but also serve as the basis for developing new highly effective treatments.

Author: Deepak L. Bhatt
Publisher: Imperial College Press
ISBN: 1860948529
Category : Medical
Languages : en
Pages : 235

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Platelets in Cardiovascular Disease provides an in-depth and current coverage of relevant platelet biology and antiplatelet therapy that is in clinical use today and potentially for the future. The book provides a succinct overview of the critical role of platelets in cardiovascular medicine. Cardiovascular disease is the leading cause of mortality worldwide, and recent research has found that the platelet is central to the genesis of heart attacks and stroke as well as many of the complications of angioplasty and bypass surgery. An explosion of knowledge of the biology of platelets has established their important role in the formation of blood clots and, perhaps more intriguingly, their role as inflammatory cells. This growth in information has been paralleled by the development of several drugs that can interfere with platelet action and thereby improve patient outcomes. Indeed, several antiplatelet drugs already in development may ultimately lead to marked advances in both the treatment and prevention of cardiovascular disease. Drawing upon a panel of international experts, Platelets in Cardiovascular Disease delivers a concise yet thorough review of the major developments in antiplatelet therapy. Practicing clinicians as well as those involved in the development of new antithrombotic therapies will find the book interesting and useful. Sample Chapter(s). Chapter 1: Platelet Biology the Role of Platelets in Hemostasis, Thrombosis and Inflammation (274 KB). Contents: Platelet Biology: The Role of Platelets in Hemostasis, Thrombosis and Inflammation (R C Becker); Thromboxane Antagonists (B R Dulin & S R Steinhubl); Glycoprotein IIb/IIIa Inhibitors (S J Lehman et al.); ADP Receptor Antagonists (J Karha & C P Cannon); Monitoring Antiplatelet Therapy (P Harrison & A D Michelson); Platelet Genomics (B K Jefferson et al.); Future Strategies for the Development of Antiplatelet Drugs (R A Harrington). Readership: Physicians: cardiologists, vascular medicine specialists, hematologists; physicians in training: fellows, residents, interns; pharmacists; pharmaceutical industry: scientists, sales representatives.