Table 1.
Summary of representative studies on postconditioning for ischemic stroke treatment.
Ischemia models/time period | Species | Sex | Age or body weight | Treatment time point after reperfusion | Treatment Periods | Cycle | Molecular mechanisms | Outcomes | Ref |
---|---|---|---|---|---|---|---|---|---|
MCAO 60 min | C57BL6 mice | Male | 23–26g | 10 min | 10 min I | 1 | Inhibited Leucocyte infiltration, microglial activation, NF-κB, MMP-9, proteasome activity; Increased HSP70.BDNF, VEGF | Reduced Infarct size, BBB damage, brain edema; Improved motor function, neurogenesis, angiogenesis | (Doeppner et al., 2017) |
MCAO 45 min | C57BL6 mice | Male | 4–4.5 months | 2 min | 15s I/30s R | 3 | Inhibited miR-1/−12, let-7f; Increased miR-19a | Improved motor and cognitive function | (Miao et al., 2016) |
MCAO 120 min | Wistar rats | Male | 7–8 weeks | Immediately | 30s R/30s I | 3 | Reduced protein carbonyl derivatives, advanced oxidation protein products, hydrogen peroxide; Increased SOD, CAT, proteasome activity | Reduced infarct size | (Li et al., 2012) |
MCAO | Wistar rats | Male | 200–250g | 30 min | 10s I/30s R | 5 | Decreased ROS | Reduced infarct size, brain edema | (Rezazadeh et al., 2013) |
30s I/30s R | 5 | Reduced infarct size | |||||||
60s I/60s R | 5 | Reduced infarct size | |||||||
MCAO 2 hours | Wistar rats | Male | 7–8 weeks | Immediately | 30s R/30s I | 3 | Increased IκBα, decreased p-IκBα, NF-κB, p- NF-κB, Caspase-3, Noxa, Bim and Bax | Reduced infarct size, apoptosis, improved neurological outcome | (Liang et al.; 2014) |
MCAO 100min | 5D rats | Male | 10 min | 10 min I | 1 | Not studied | Reduced infarct size, improved neurological outcomes, neurogenesis, and angiogenesis | (Esposito et al., 2015) | |
MCAO 100min | 5D rats | Male | 320–340g | 10 min | 10 min I | 1 | Increased VEGF | Reduced Infarct size; Improved neurological outcome; microglial polarization | (Esposito et al., 2018) |
MCAO 60 min | SD rats | Male | 250–280g | Immediately | 30s R/30s I | 6 | Increased HSP70, bcl-2, SOD activity; Decreased caspase-3/9, MDA, inhibited cytochrome C and bax translocation | Reduced infarct size, and cell apoptosis; improved neurological outcomes | (Xing et al., 2008a) |
MCAO 2,3, 4, 4.5, 6 hours | SD rats | Male | 7–8 weeks | Immediately | 10s I/10s R | 5 | Inhibited IL-1β, TLR2/4, IRAK4 | Reduced infarct size and cell apoptosis | (Wang et al., 2014) |
MCAO 90 min | SD rats | Male | 7–8 weeks 270–300g | Immediately or 3 h | 10s I/10s R | 10 | Increased BDNF, p-CREB, | Reduced infarct size, brain edema, cell Hpoptosis, and stabilized cerebral blood flow | (Wu et al., 2015) |
MCAO 120 min | SD rats | Male | 250–280g | Immediately | 30s R/30s I | 3 | Preserved claudin-5, occludin | Reduced infarct size, protected neurovascular unit, improved neurological outcome | (Han et al., 2014) |
MCAO 120 min | SD rats | Female | 2–3 months 210–230g | Immediately | 10s R/10s I | 6 | Increased acid-sensing ion channel 2a | Protected neurons of hippocampal CA1 region | (Duanmu et al,, 2015) |
MCAO 120 min | SD rats | Male | 250–280g | Immediately | 30s R/30s I | 3 | Inhibited AQP4 | Reduced infarct size and brain edema | (Han et al., 2015) |
MCAO 120 min | SD Rat | Male | 250–300g | Immediately | 30s R/30s I | 3 | Not studied | Reduced infarct size | (Taskapilioglu et al., 2009) |
MCAO | Rat | Male | Inhibited positive cell cycle regulators and ERK/CREB and GSK- 3β/CREB | (Zhao et al., 2013) | |||||
MCAO 60 min | SD Rats | Male | 250–230g | Immediately | 30s R/30s I | 6 | Inhibited MPO, MDA, IL-1β, TNF-α, ICAM-1 | Reduced infarct size, cell necrosis and apoptosis, leucocyte infiltration and oxidative stress | (Xing et al., 2008b) |
MCAO 100 min | SD rats | Male | 250–300g | 2 min | 2 min I/2 min R | 5 | Increased p-AKT, p-ERK, p-p38 | No protection on infarct volume | (Pignataro et al., 2008) |
5 min | 5 min I/5 min R | 3 | Reduced infarct size | ||||||
10 min | 10 min I | 1 | Reduced infarct size | ||||||
30 min | 10 min I | 1 | No protection | ||||||
Thrombotic ischemia | Tree shrews | Male | 120–150g | 4 h after ischemia | 5 min I/5 min R | 3 | Inhibited MIPO, TLR4; Increased TLR4 at 72 hours | Reduced neuron death | (Feng et al., 2011) |
Distal MCAO plus BCCA 30 min | SD rats | Male | 350–400g | Immediately or 3 h | 30s R/10s I | 3 | Decreased CHOP, caspase-12; Increased GRP7E, | Reduced infarct size and neuronal apoptosis | (Yuan et al., 2011) |
Permanent distal (MCAO) plus CCAO 30 min | 5D rats | Male | 350–390g | Immediately | 30s R/10s I | 3 | Mot mentioned | Reduced brain infarct volume | (Gao et al,, 2008a) |
30s R/10s I | 10 | No protection | |||||||
10s R/10s I | 3 | No protection | |||||||
10s R/10s I | 10 | Reduced infarct size | |||||||
3 min | 10s I/10s R | 10 | No protection | ||||||
Permanent distal (MCAO) plus CCAO 30 min | SD rats | Male | 350–450g | Immediately | 30s R/10s I | 3 | Inhibited superoxide | Reduced infarct size and cell apoptosis | (Zhao et al., 2006) |
Permanent distal MCAO plus bilateral CCAO 30 min | SD rats; T-cell-deficient rats | Male | 230–250g | Immediately | 30s R/10s I | 3 | Increased p-Akt, Akt1/2/3, p-mTOR, mTOR, pS6K, S6K, p4EPB1, 4EPB1, GAP43 | Reduced infarct size and improved neurological outcomes | (Xie et al., 2013) |
SD rats | Male | 350–390g | Immediately | 30s R/10s I | 3 | Increased p-Akt, p-GSK3β, p-β-catenin, p-JNK, p-ERK1/2, δPKC, εPKC | Long-term reduction of brain damage and improved neurological outcomes | (Gao et al., 2008b) | |
SD rats | Male | 270–330g | 30 min | 10s I/10s R | 10 | Reduced infarct size | (Ren et al., 2008) | ||
30 min | 30s I/30s R | 3 | Reduced infarct size | ||||||
3h | 10s I/10s R | 10 | No protection | ||||||
3h | 30s I/30s R | 3 | Reduced infarct size | ||||||
BCAO 10 min | Swiss mice | Male | 25 ± 2g | Immediately | 10s R/10s I | 3 | PI3K | Improved memory and motor coordination | (Rehni and Singh, 2007) |
BCAO 12 min | Swiss mice | Male | 20 ± 5g | Immediately | 10s R/10s I | 3 | Increased nitrite/nitrate, GSH, eNOS; Inhibited AChE activity, TBRS | Reduced infarct size, improved memory and motor coordination | (Gulati et al., 2014) |
BCAO 12 min | Swiss mice | Male | 22 ± 5g | Immediately | 10s R/10s I | 3 | Increased nitrite/nitrate, GSH; Inhibited AChE activity, TBARS | Reduced infarct size, improved memory and motor coordination | (Gulati and Singh, 2014) |
BCAO 17 min | Swiss mice | Either sex | 25 ± 2g | Immediately | 10s R/10s I | 3 | Involved CCR2 | Reduced infarct size, improved memory and motor corrdiantion | (Rehni and Singh, 2012) |
4-VO 10 min | SD rats | Male | 200–220g | Immediately | 10s R/10s I | e | Inhibited caspase-3/6/9, bax; Increase bcl-2 | Protected hippocampal neurons and inhibited apoptosis | (Ding et al., 2012) |
4-VO 10 min | SD rats | Male | 200–220 g | Immediately | 10s R/10s I | 6 | Inhibited caspase-3/6/9, bax; Increase bcl-2 | Protected hippocampal neurons and inhibited apoptosis | (Ding et al., 2012) |
4-VO 10 min | SD rats | Male | 260–320g | Immediately | 15s R/15s I | 3 | Inhibited Cytochrome C translocation | Promoted neuron survival, spatial learning and memory; improved the disturbance of CBF | (Wang et al., 2008) |
30s R/30s I | 3 | Inhibited Cytochrome C translocation | Promoted neuron survival, spatial learning and memory; improved the disturbance of CBF | ||||||
60s R/15s I | 3 | None | None | ||||||
45 s | 15s I/15s R | 3 | Inhibited Cytochrome C translocation | Promoted neuron survival, spatial learning and memory; improved the disturbance of CBF | |||||
4-VO 10 min | SD rats | Male | 220–250g | Immediately | 10s R/10s I | 6 | Inhibited caspase-3; increased Bcl-2 | Reduced hippocampal neuron apoptosis | (Zhang et al., 2012) |
4-VO 15 min | SD rats | Male | 220–300g | 10 min | 3 min I | 1 | Stabilized VDAC1/2/3 expression and calcium homeostasis | Protected hippocampal neurons | (Yao et al., 2018) |
4-VO 15 min | SD rats | Male | 250–300g | 10 min | 3 mini | 1 | Inhibited GluK2-PSD-95-MLK3-MKK7-JNK3 | Protected hippocampal CA1 pyramidal neurons | (Liu et al., 2013) |
4-VO 15 min | Wistar rats | Male | 250–300g | Immediately | 30s R/15s I | 3 | Not studied | Reduced neuron apoptosis and neurodegeneration | (Xiang et al., 2018) |
4-VO 10 min | Wistar rats | Male | 250–300g | 2 days | 5 min I | 1 | Increased SOD and CAT activity | Reduced neuronal degeneration | (Danielisova et al., 2006) |
4-VO 10 min | Wistar Rats | Male | 250–350g | 2 days | 4 min or 6 min I | 1 | Increased MnSOD | Not studied | (Nemethova et al., 2008) |
4-VO 8, 10, 12 min | Wistar rats | Not mentioned | 250–350g | 2 days | 5, 6 min I | 1 | Not mentioned | Promoted survival of CA1 neurons, cortex and striatum neurons | (Burda et al., 2006) |
I, Ischemia; R, Reperfusion; 4-VO, four vessel occlusion; AQP4, Aquaporin 4; BCAO, bilateral carotid artery occlusion; BDNF, Brain-derived neurotrophic factor; CAT, Catalase; CCR2, C-C chemokine receptor type 2; CHOP, C/EBP-homologous protein; GAP43, Growth Associated Protein 43; Gluk2, Glutamatergic kainate receptor subunit 2; GSH, Glutathione; HSP70, heat shock protein 70; IRAK4, Interleukin-1 receptor-associated kinase 4; JNK3, c-Jun N-terminal kinase 3; MCAO, middle cerebral artery occlusion; MDA, Malondialdehyde; MLK3, Mixed-lineage protein kinase 3; MMP-9, Matrix metallopeptidase 9; MPO, Myeloperoxidase; mTOR, mammalian target of rapamycin; PSD-95, postsynaptic density protein 95; ROS, Reactive oxygen species; SOD, Superoxide dismutase; TBARS, Tihobarbituric acid reactive species; TLR4, Toll-like receptor 4; VDAC, Voltage-dependent anion channel; VEGF, Vascular endothelial growth factor