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Should the STAIR Criteria Be Modified for Preconditioning Studies?

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Abstract

Diverse preconditioning (PC) stimuli protect against a wide variety of neuronal insults in animal models, engendering enthusiasm that PC could be used to protect the brain clinically. Candidate clinical applications include cardiac and vascular surgery, after subarachnoid hemorrhage, and prior to conditions in which acute neuronal injury is anticipated. However, disappointments in clinical validation of multiple neuroprotectants suggest potential problems translating animal data into successful human therapies. Thus, despite strong promise of preclinical PC studies, caution should be maintained in translating these findings into clinical applications. The Stroke Therapy Academic Industry Roundtable working group and the National institute of Neurological Diseases and Stroke proposed working guidelines to improve the utility of preclinical studies that form the foundation of therapies for neurological disease. Here, we review the applicability of these consensus criteria to preconditioning studies and discuss additional considerations for PC studies. We propose that special attention should be paid to several areas, including (1) safety and dosage of PC treatments, (2) meticulously matching preclinical modeling to the human condition to be tested, and (3) timing of both the initiation and discontinuation of the PC stimulus relative to injury ictus.

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Acknowledgments

This work was supported by the National Institutes of Health grants NS054724 (MMW), NS039866 (GX), and NS34709 (RFK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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The authors declare that they have no conflict of interest.

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  1. Department of Neurology, University of Michigan, 7629 Med Sci II, 1137 Catherine Street, Box 5622, Ann Arbor, MI, 48109-5622, USA

    Michael M. Wang

  2. Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA

    Michael M. Wang & Richard F. Keep

  3. Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA

    Guohua Xi & Richard F. Keep

  4. Neurology Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Michael M. Wang

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Wang, M.M., Xi, G. & Keep, R.F. Should the STAIR Criteria Be Modified for Preconditioning Studies?. Transl. Stroke Res. 4, 3–14 (2013). https://doi.org/10.1007/s12975-012-0219-0

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