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Biological Networks in Ischemic Tolerance — Rethinking the Approach to Clinical Conditioning

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Abstract

The adaptive response (conditioning) to environmental stressors evokes evolutionarily conserved programs in uni- and multicellular organisms that result in increased fitness and resistance to stressor induced injury. Although the concept of conditioning has been around for a while, its translation into clinical therapies targeting neurovascular diseases has only recently begun. The slow pace of clinical adoption might be partially explained by our poor understanding of underpinning mechanisms and of the complex responses of the organism to the stressor. At the 2nd Translational Preconditioning Meeting, participants engaged in an intense discussion addressing whether the time has come to more aggressively implement clinical conditioning protocols in the treatment of cerebrovascular diseases or whether it would be better to wait until preclinical data would help to minimize clinical empiricism. This review addresses the complex involvement of biological networks in establishing ischemic tolerance at the organism level using two clinically promising conditioning modalities, namely remote ischemic preconditioning, and per- or post-conditioning, as examples.

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Acknowledgments

This work was supported by NIH grant NS081179 (to JA) and by the Intramural Research Program of the NIH, NINDS (JH).

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The authors declare that they have no conflict of interest.

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  1. Brain and Mind Research Institute, Weill Cornell Medical College, 407 East 61 Street, RR303, New York, NY, 10065, USA

    Josef Anrather

  2. Stroke Branch, NINDS, NIH, 10 Center Drive MSC 1401, Building 10/Room 5B02, Bethesda, MD, 20892-1401, USA

    John M. Hallenbeck

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Anrather, J., Hallenbeck, J.M. Biological Networks in Ischemic Tolerance — Rethinking the Approach to Clinical Conditioning. Transl. Stroke Res. 4, 114–129 (2013). https://doi.org/10.1007/s12975-012-0244-z

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