Reperfusion injury future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anjan K. Chakrabarti, M.D. [2]Shivam Singla, M.D.[3]
Overview
A lot of studies done in the past three decades helped a lot in understanding the molecular mechanisms associated with Ischemia-reperfusion injury. Also, these studies helped in evaluating various strategies to decrease the incidence and severity associated with Ischemia-reperfusion injury. Existing therapies for Ischemia-reperfusion injury can be divided into Pharmacological and non-pharmacological interventions. A lot of promising studies and clinical trials are still under the pipeline. Till the date, the most encouraging results are associated with ischemic preconditioning and postconditioning, adenosine, and exenatide. A lot of studies have demonstrated the combined effect of pharmacological and nonpharmacological approach as together to be used as a multifactorial approach to improve the clinical outcomes.
Future or Investigational Therapies
While there has been significant progress made in understanding repercussion injury, from molecular mechanisms to bedside clinical interventional, there are several areas that warrant further study. Some of these topics were outlined by the 2010 National Heart, Lung, and Blood Institute Workshop on Cardioprotection[1], and include:
- Identifying the molecular and subcellular mechanisms responsible for postconditioning, remote conditioning, and preconditioning.
- Determining whether the protective mechanism triggered by remote conditioning is humoral, neural, or both.
- Investigating whether age, obesity, and diabetes mellitus may attenuate the beneficial effects of cardioprotective strategies.
- Developing additional pharmacological strategies that mimic, synergize, or augment the protection exerted by conditioning protocols in conjunction with repercussion[2].
- Establishing a cardioprotective clinical trial network concurrent with the existing and complementary preclinical network (CAESAR) to test promising cardioprotective agents and strategies in patients in the setting of both acute myocardial infarction and cardiac surgery.
References
- ↑ Schwartz Longacre L, Kloner RA, Arai AE, Baines CP, Bolli R, Braunwald E; et al. (2011). "New horizons in cardioprotection: recommendations from the 2010 national heart, lung, and blood institute workshop". Circulation. 124 (10): 1172–9. doi:10.1161/CIRCULATIONAHA.111.032698. PMID 21900096.
- ↑ Chi HJ, Chen ML, Yang XC, Lin XM, Sun H, Zhao WS, Qi D, Dong JL, Cai J (2017). "Progress in Therapies for Myocardial Ischemia Reperfusion Injury". Curr Drug Targets. 18 (15): 1712–1721. doi:10.2174/1389450117666160401120308. PMID 27033199.