Preventive strategies to mitigate the deleterious effects of ischemia reperfusion injury. Focus on 'Acute hot water immersion is protective against impaired vascular function following forearm is.chemia-reperfusion in young healthy humans'

摘要

ischemia occurs when arterial blood flow is insufficient to meet the metabolic demands of the target tissue, resulting in a series of coordinated molecular, cellular, tissue-specific, and systemic events that cause tissue damage. Paradoxically, reperfusion that occurs following ischemia can exacerbate tissue injury and necrosis. The detrimental effects of reperfusion injury were first observed more than 50 years ago, when researchers found that reperfusion appeared to accelerate the development of necrosis in hearts subjected to coronary liga-tion (9). More recently, the dramatic effects of ischemia-reperfusion (I/R) have been highlighted in a study that suggested that reperfusion injury can account for up to 50% of myocardial infarct size (17). I/R leads to a cascade of events, resulting in an increase in oxidative and nitrosative stress, inflammation, and endothelial dysfunction. Common settings in which I/R occur include thrombolytic therapy, angioplasty, organ transplant, and major trauma/shock. Consequently, much research has sought to identify therapeutic strategies to minimize this component of tissue injury. Currently, postischemic strategies are used, including mild therapeutic hypothermia, which has been reported to benefit patients following cardiac arrest (17). However, novel strategies to prevent and/or mitigate the effects of I/R injury are necessary, as the incidence of ischemic events is increasing.