Ischemic Preconditioning and Clinical Scenarios

Srinivasan V. Narayanan; Kunjan R. Dave; Miguel A. Perez-Pinzon


Curr Opin Neurol. 2013;26(1):1-7. 

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As previously mentioned, use of rodent models may hinder translating IPC into clinical practice. Rodents lack similar brain architecture and their white matter and grey matter ratios are quite different from humans.[71] Additionally, the typical age of rodents used in IPC studies does not correlate with the age of the typical patient[72] who would necessitate IPC treatment (i.e., elderly patients at risk for cardiovascular or cerebrovascular disease), which poses a dilemma as evidence suggests that the ability to induce IPC diminishes with age.[73] In addition, rigorous exploration of IPC-mediated mechanisms may enable better understanding of a particular method or mimetic of IPC and ease of clinical translation. Rodent models also explore IPC using a reproducible, controlled ischemic insult, while cardiac arrest and stroke occur unpredictably with varying degrees of lethality in human patients.[74] Thus, future work is necessary to elucidate the mechanisms of IPC-induced neuroprotection moving into animal models that are closer to the real clinical scenarios as suggested by the STAIR criteria.[75]