Ischemic tolerance: mechanism of neuroprotective effect and clinical applications

Abstract

Ischemic tolerance is endogenous neuroprotective phenomenon induced by sublethal ischemia. Ischemic preconditioning (IPC) is the first discovered phenomenon of ischemic tolerance. The phenomenon induced by non-lethal ischemia before the lethal ischemic event is widely seen in many species and various organs. IPC shows strong neuroprotective effect in animal models of ischemia, however it is difficult to perform IPC before the ischemic event occur. After that, some other neuroprotective procedures called ischemic postconditioning, remote ischemic preconditioning and remote ischemic postconditioning were discovered. Because these methods can overcome the problem of IPC, these discoveries had great impact on clinical approach of stroke treatment. Ischemic tolerance is safe and promising technique for treating stroke, and understanding the mechanism of neuroprotection and finding the potential biomarker for classifying the responder is essential.