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Ischemic postconditioning: mechanisms, comorbidities, and clinical application

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Abstract

Since ischemic heart disease (IHD) is a major cause of mortality and heart failure, novel therapeutic strategies are expected to improve the clinical outcomes of patients with acute myocardial infarction. Brief episodes of ischemia/reperfusion performed at the onset of reperfusion can reduce infarct size; a phenomenon termed “ischemic postconditioning.” Extensive research has determined that different autacoids (e.g., adenosine, bradykinin, opioid, etc.) and cytokines, their respective receptors, kinase signaling pathways, and mitochondrial modulation are involved in ischemic conditioning. Modification of these factors by pharmacological agents mimics the cardioprotection by ischemic postconditioning. Here, the potential mechanisms of ischemic postconditioning, the presence of comorbidities, and the possible extrapolation to the clinical setting are reviewed. In the near future, large, multicentered, randomized, placebo-controlled, clinical trials will be required to determine whether pharmacological and/or ischemic postconditioning can improve the clinical outcomes of patients with IHD.

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Acknowledgments

This work was supported by the University of Buenos Aires Grant (UBACYT B069), National Agency of Scientific and Technological Promotion (05/PICT13069; 06/PICT01071).

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Authors and Affiliations

  1. Department of Pathology, School of Medicine, Institute of Cardiovascular Physiopathology, University of Buenos Aires, JE Uriburu 950 – 2nd Floor, C1114AAD, Buenos Aires, Argentina

    Bruno Buchholz, Martín Donato, Verónica D’Annunzio & Ricardo J. Gelpi

  2. Institute of Biochemistry and Molecular Medicine (IBIMOL), University of Buenos Aires - CONICET, Buenos Aires, Argentina

    Bruno Buchholz, Martín Donato, Verónica D’Annunzio & Ricardo J. Gelpi

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  1. Bruno Buchholz
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  2. Martín Donato
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  3. Verónica D’Annunzio
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Correspondence to Ricardo J. Gelpi.

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Bruno Buchholz and Martín Donato have contributed equally to this manuscript.

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Buchholz, B., Donato, M., D’Annunzio, V. et al. Ischemic postconditioning: mechanisms, comorbidities, and clinical application. Mol Cell Biochem 392, 1–12 (2014). https://doi.org/10.1007/s11010-014-2014-6

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