- Department of Cardiothoracic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, P. R. China;
Abstract： Ischemia postconditioning is a new concept based on ischemic preconditioning. It has become a hot topic in protection of ischemic-reperfusion injury because of its effective protection, relative ease of application, and postconditioning. However, its precise mechanisms and most effective application methods are still unclear. This review covers recent progress in the understanding, developments (in remote postconditioning and pharmacological postconditioning), applications to the protection of heart, lung, liver, kidney, and brain, mechanisms and appropriate protocol of ischemic post-conditioning.
Citation： LIU Hongduan,LIU Liming.. Progress in Ischemic Postconditioning： A Review. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 309-313. doi: Copy
| 1. | ischemia： a delay of lethal cell injury in ischemic myocardium. |
| 2. | Circulation, 1986, 74(5)： 1124-1136. |
| 3. | ?2 高峰, Yan WL, Geng YJ, 等. “缺氧后处理”对大鼠缺氧-复氧心室肌细胞的保护作用. 心功能杂志, 1999, 11(4)：241-242. |
| 4. | ?3 Zhao ZQ, Corvera JS, Halkos ME, et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion： comparison with ischemic preconditioning. Am J Physiol Heart Circ Physiol, 2003, 285(2)： H579 - H588. |
| 5. | ?4 Kerendi F, Kin H, Halkos ME, et al. Remote postconditioning.Brief renal ischemia and reperfusion applied before coronary artery reperfusion reduces myocardial infarct size via endogenous activation of adenosine receptors. Basic Res Cardiol, 2005, 100(5)：404-412. |
| 6. | ?5 Ren C, Yan Z, Wei D, et al. Limb remote ischemic postconditioning protects against focal ischemia in rats. Brain Res, 2009, 1288：88-94. |
| 7. | ?6 Jin ZX, Zhou JJ, Xin M, et al. Postconditioning the human heart with adenosine in heart valve replacement surgery. Ann Thorac Surg, 2007, 83(6)：2066-2072. |
| 8. | ?7 Ke JJ, Yu FX, Rao Y, et al. Adenosine postconditioning protects against myocardial ischemia-reperfusion injury though modulate production of TNF-α and prevents activation of transcription factor NF-kappaB. Mol Biol Rep, 2011, 38(1)：531-538. |
| 9. | ?8 Redel A, Stumpner J, Tischer-Zeitz T, et al. Comparison of isoflurane-, sevoflurane-, and desflurane-induced pre- and postconditioning. |
| 10. | against myocardial infarction in mice in vivo. Exp Biol Med. |
| 11. | (Maywood), 2009, 234(10)：1186-1191. |
| 12. | ?9 Yao YT, Fang NX, Shi CX, et al. Sevoflurane postconditioning protects isolated rat hearts against ischemia-reperfusion injury. Chin Med J(Engl), 2010, 123(10)：1320-1328. |
| 13. | ischemia/reperfusion injury in rat liver transplantation. |
| 14. | Hepatogastroenterology, 2010, 57(101)：875-881. |
| 15. | 收稿日期：2011-05-08. |
| 16. | ?Murry CE, Jennings RB, Reimer KA. Preconditioning with. |
| 17. | Li Y, Xia AZ, Xing SH. Protective effect of edaravone against renal ischemia/reperfusion injury and compared with ischemic postconditioning in rats. Acta pharmaceutica Sinica, 2010, 45(7)：840-848. |
| 18. | Du DS, Ma XB, Zhang JF, et al. The protective effect of capsaicin receptor-mediated genistein postconditioning on gastric ischemia-reperfusion injury in rats. Dig Dis Sci, 2010, 55 (11)：3070- 3077. |
| 19. | Yang XM, Proctor JB, Cui L, et al. Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways. J Am Coll Cardiol, 2004, 44(5)：1103-1110. |
| 20. | Staat P, Rioufol G, Piot C, et al. Postconditioning the human heart . Circulation, 2005, 112(14)：2143-2148. |
| 21. | Lee DS, Steinbaugh GE, Quarrie R, et al. Ischemic postconditioning does not provide cardioprotection from long-term ischemic injury in isolated male or female rat hearts. J Surg Res, 2010, 64(2)：175-181. |
| 22. | Kin H, Zhao ZQ, Sun HY, et al. Postconditioning attenuates myocardial ischemia-reperfusion injury by inhibiting events in the early minutes of reperfusion. Cardiovasc Res, 2004, 62(1)：74-85. |
| 23. | Ma X, Zhang X, Li C, et al. Effect of postconditioning on coronary blood flow velocity and endothelial function and LV recovery after myocardial infarction. J Interv Cardiol, 2006, 19(5)：367-375. |
| 24. | Luo W, Li B, Chen R, et al. Effect of ischemic postconditioning in adult valve replacement. Eur J Cardiothorac Surg, 2008, 33(2)：203-208. |
| 25. | 王珏, 高琴, 孙国铨, 等. δ-阿片受体在缺血后处理心肌保护中的作用. 中国应用生理学杂志, 2008 , 24(2)：184-189. |
| 26. | Mykytenko J, Reeves JG, Kin H, et al. Persistent beneficial effect of postconditioning against infarct size： role of mitochondrial K(ATP) channels during reperfusion. Basic Res Cardiol, 2008, 103(5)：472-484. |
| 27. | 张健发, 马依彤, 杨毅宁, 等. 再灌注损伤抢救激酶对小鼠缺血后适应心肌再灌注损伤中的减轻作用. 中华心血管病杂志, 2008, 36(2)：161-166. |
| 28. | 李晓梅, 马依彤, 杨毅宁,等. 肥厚心肌缺血后适应时细胞外信号调节激酶的保护作用.中华医学杂志, 2009, 89(12)：846-850. |
| 29. | Lønborg J, Kelbaek H, Vejlstrup N, et al. Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance. Circ Cardiovasc Interv, 2010, 3(1)：34-41. |
| 30. | Sun H, Guo T, Liu L, et al. Ischemic postconditioning inhibits apoptosis after acute myocardial infarction in pigs. Heart Surg Forum, 2010, 13(5)：E305-E310. |
| 31. | Kloner RA, Dow J, Bhandari A. Postconditioning markedly attenuates ventricular arrhythmias after ischemia-reperfusion. J Cardiovasc Pharmacol Ther, 2006, 11(1)：55-63. |
| 32. | Sasaki H, Shimizu M, Ogawa K, et al. Brief ischemia-reperfusion performed after prolonged ischemia (ischemic postconditioning) can terminate reperfusion arrhythmias with no reduction of cardiac function in rats. Int Heart J, 2007, 48(2)：205-213. |
| 33. | Lin XM, Zhang ZY, Wang LF, et al. Attenuation of tumor necrosis factor-alpha elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction. Chin Med J (Engl), 2010, 123(14)：1833-1839. |
| 34. | Pinheiro BB, Fiorelli AI, Gomes OM, et al. Cardiac effects of postconditioning depend critically on the duration of reperfusion and reocclusion episodes. Heart Surg Forum, 2010, 13(1)：E52- E56. |
| 35. | Wang G, Zhang S, Joggerst SJ, et al. Effects of the number and interval of balloon inflations during primary PCI on the extent of myocardial injury in patients with STEMI： does postconditioning exist in real-world practice? J Invasive Cardiol, 2009, 21(9)：451-455. |
| 36. | Xia ZY, Gao J, Ancharaz AK. Protective effect of ischemic postconditioning on lung ischemia-reperfusion injury in rats and the role of heme oxygenase-1. Chin J Traumatol(Engl), 2009 , 12(3)：162-166. |
| 37. | Liu KX, Li YS, Huang WQ, et al. Immediate but not delayed postconditioning during reperfusion attenuates acute lung injury induced by intestinal ischemia/reperfusion in rats： comparison with ischemic preconditioning. J Surg Res, 2009, 157(1)：e55-e62. |
| 38. | 鲁建军, 姚达, 秦存伟, 等. 缺血后处理对犬肺移植术后早期炎症反应的影响.中山大学学报（医学科学版）, 2009, 30 (5)： 547-550. |
| 39. | Zeng Z, Huang HF, Chen MQ, et al. Postconditioning prevents. |
| 40. | Jiang B, Liu X, Chen H, et al. Ischemic postconditioning attenuates renal ischemic/reperfusion injury in mongrel dogs. Urology, 2010, 76(6)：1519：e1-e7. |
| 41. | ?Yuan Y,Guo Q,Ye Z,et al.Ischemic postconditioning protects brain from ischemia/reperfusion injury by attenuating endoplasmic reticulum stress-induced apoptosis through PI3K-Akt pathway . Brain Res,2011,1367：85-93. |
| 42. | Sun K, Liu ZS, Sun Q. Role of mitochondria in cell apoptosis during hepatic ischemia-reperfusion injury and protective effect of ischemic postconditioning. World J Gastroenterol, 2004, 10(13)：1934-1938. |
| 43. | 宋文英, 董海龙, 陈琼, 等. 缺血后处理上调内源性抗氧化物酶活性诱导兔脊髓保护效应. 中华医学杂志, 2008, 88(33)：2355-2359. |
| 44. | Yun Y, Duan WG, Chen P, et al. Ischemic postconditioning modified renal oxidative stress and lipid peroxidation caused by ischemic reperfusion injury in rats. Transplant Proc, 2009, 41(9)：3597-3602. |
| 45. | Abas F, Alkan T, Goren B, et al. Neuroprotective effects of postconditioning on lipid peroxidation and apoptosis after focal cerebral ischemia/reperfusion injury in rats. Turk Neurosurg, 2010 , 20(1)：1-8. |
| 46. | Park JW, Kang JW, Jeon WJ, et al. Postconditioning protects skeletal muscle from ischemia-reperfusion injury. Microsurgery, 2010, 30(3)：223-229. |
| 47. | Wang W, Tang T, Zhang P, et al. Postconditioning attenuates renal ischemia-reperfusion injury by preventing DAF down-regulation. J Urol, 2010, 183(6)：2424-2431. |
| 48. | Ferencz A, Takács I, Horváth S, et al. Examination of protective effect of ischemic postconditioning after small bowel autotransplantation. Transplant Proc, 2010, 42(6)：2287-2289. |
| 49. | Kin H, Zatta AJ, Lofye MT, et al. Postconditioning reduces infarct size via adenosine receptor activation by endogenous adenosine. Cardiovasc Res, 2005, 67(1)：124-133. |
| 50. | You L, Li L, Xu Q, et al. Postconditioning reduces infarct size and cardiac myocyte apoptosis via the opioid receptor and JAK-STAT signaling pathway. Mol Biol Rep, 2011, 38(1)：437-443. |
| 51. | Yang XM, Proctor JB, Cui L, et al. Multiple,brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways. J Am Coll Cardiol, 2004, 44(5)：1103-1110. |
| 52. | Penna C, Mancardi D, Rastaldo R, et al. Intermittent activation of bradykinin B2 receptors and mitochondrial KATP channels trigger cardiac postconditioning through redox signaling. Cardiovasc Res, 2007, 75(1)：168-177. |
| 53. | Yong QC, Lee SW, Foo CS, et al. Endogenous hydrogen sulphide mediates the cardioprotection induced by ischemic postconditioning. Am J Physiol Heart Circ Physiol, 2008, 295(3)：H1330-H1340. |
- 1. ischemia： a delay of lethal cell injury in ischemic myocardium.
- 2. Circulation, 1986, 74(5)： 1124-1136.
- 3. ?2 高峰, Yan WL, Geng YJ, 等. “缺氧后处理”对大鼠缺氧-复氧心室肌细胞的保护作用. 心功能杂志, 1999, 11(4)：241-242.
- 4. ?3 Zhao ZQ, Corvera JS, Halkos ME, et al. Inhibition of myocardial injury by ischemic postconditioning during reperfusion： comparison with ischemic preconditioning. Am J Physiol Heart Circ Physiol, 2003, 285(2)： H579 - H588.
- 5. ?4 Kerendi F, Kin H, Halkos ME, et al. Remote postconditioning.Brief renal ischemia and reperfusion applied before coronary artery reperfusion reduces myocardial infarct size via endogenous activation of adenosine receptors. Basic Res Cardiol, 2005, 100(5)：404-412.
- 6. ?5 Ren C, Yan Z, Wei D, et al. Limb remote ischemic postconditioning protects against focal ischemia in rats. Brain Res, 2009, 1288：88-94.
- 7. ?6 Jin ZX, Zhou JJ, Xin M, et al. Postconditioning the human heart with adenosine in heart valve replacement surgery. Ann Thorac Surg, 2007, 83(6)：2066-2072.
- 8. ?7 Ke JJ, Yu FX, Rao Y, et al. Adenosine postconditioning protects against myocardial ischemia-reperfusion injury though modulate production of TNF-α and prevents activation of transcription factor NF-kappaB. Mol Biol Rep, 2011, 38(1)：531-538.
- 9. ?8 Redel A, Stumpner J, Tischer-Zeitz T, et al. Comparison of isoflurane-, sevoflurane-, and desflurane-induced pre- and postconditioning.
- 10. against myocardial infarction in mice in vivo. Exp Biol Med.
- 11. (Maywood), 2009, 234(10)：1186-1191.
- 12. ?9 Yao YT, Fang NX, Shi CX, et al. Sevoflurane postconditioning protects isolated rat hearts against ischemia-reperfusion injury. Chin Med J(Engl), 2010, 123(10)：1320-1328.
- 13. ischemia/reperfusion injury in rat liver transplantation.
- 14. Hepatogastroenterology, 2010, 57(101)：875-881.
- 15. 收稿日期：2011-05-08.
- 16. ?Murry CE, Jennings RB, Reimer KA. Preconditioning with.
- 17. Li Y, Xia AZ, Xing SH. Protective effect of edaravone against renal ischemia/reperfusion injury and compared with ischemic postconditioning in rats. Acta pharmaceutica Sinica, 2010, 45(7)：840-848.
- 18. Du DS, Ma XB, Zhang JF, et al. The protective effect of capsaicin receptor-mediated genistein postconditioning on gastric ischemia-reperfusion injury in rats. Dig Dis Sci, 2010, 55 (11)：3070- 3077.
- 19. Yang XM, Proctor JB, Cui L, et al. Multiple, brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways. J Am Coll Cardiol, 2004, 44(5)：1103-1110.
- 20. Staat P, Rioufol G, Piot C, et al. Postconditioning the human heart . Circulation, 2005, 112(14)：2143-2148.
- 21. Lee DS, Steinbaugh GE, Quarrie R, et al. Ischemic postconditioning does not provide cardioprotection from long-term ischemic injury in isolated male or female rat hearts. J Surg Res, 2010, 64(2)：175-181.
- 22. Kin H, Zhao ZQ, Sun HY, et al. Postconditioning attenuates myocardial ischemia-reperfusion injury by inhibiting events in the early minutes of reperfusion. Cardiovasc Res, 2004, 62(1)：74-85.
- 23. Ma X, Zhang X, Li C, et al. Effect of postconditioning on coronary blood flow velocity and endothelial function and LV recovery after myocardial infarction. J Interv Cardiol, 2006, 19(5)：367-375.
- 24. Luo W, Li B, Chen R, et al. Effect of ischemic postconditioning in adult valve replacement. Eur J Cardiothorac Surg, 2008, 33(2)：203-208.
- 25. 王珏, 高琴, 孙国铨, 等. δ-阿片受体在缺血后处理心肌保护中的作用. 中国应用生理学杂志, 2008 , 24(2)：184-189.
- 26. Mykytenko J, Reeves JG, Kin H, et al. Persistent beneficial effect of postconditioning against infarct size： role of mitochondrial K(ATP) channels during reperfusion. Basic Res Cardiol, 2008, 103(5)：472-484.
- 27. 张健发, 马依彤, 杨毅宁, 等. 再灌注损伤抢救激酶对小鼠缺血后适应心肌再灌注损伤中的减轻作用. 中华心血管病杂志, 2008, 36(2)：161-166.
- 28. 李晓梅, 马依彤, 杨毅宁,等. 肥厚心肌缺血后适应时细胞外信号调节激酶的保护作用.中华医学杂志, 2009, 89(12)：846-850.
- 29. Lønborg J, Kelbaek H, Vejlstrup N, et al. Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance. Circ Cardiovasc Interv, 2010, 3(1)：34-41.
- 30. Sun H, Guo T, Liu L, et al. Ischemic postconditioning inhibits apoptosis after acute myocardial infarction in pigs. Heart Surg Forum, 2010, 13(5)：E305-E310.
- 31. Kloner RA, Dow J, Bhandari A. Postconditioning markedly attenuates ventricular arrhythmias after ischemia-reperfusion. J Cardiovasc Pharmacol Ther, 2006, 11(1)：55-63.
- 32. Sasaki H, Shimizu M, Ogawa K, et al. Brief ischemia-reperfusion performed after prolonged ischemia (ischemic postconditioning) can terminate reperfusion arrhythmias with no reduction of cardiac function in rats. Int Heart J, 2007, 48(2)：205-213.
- 33. Lin XM, Zhang ZY, Wang LF, et al. Attenuation of tumor necrosis factor-alpha elevation and improved heart function by postconditioning for 60 seconds in patients with acute myocardial infarction. Chin Med J (Engl), 2010, 123(14)：1833-1839.
- 34. Pinheiro BB, Fiorelli AI, Gomes OM, et al. Cardiac effects of postconditioning depend critically on the duration of reperfusion and reocclusion episodes. Heart Surg Forum, 2010, 13(1)：E52- E56.
- 35. Wang G, Zhang S, Joggerst SJ, et al. Effects of the number and interval of balloon inflations during primary PCI on the extent of myocardial injury in patients with STEMI： does postconditioning exist in real-world practice? J Invasive Cardiol, 2009, 21(9)：451-455.
- 36. Xia ZY, Gao J, Ancharaz AK. Protective effect of ischemic postconditioning on lung ischemia-reperfusion injury in rats and the role of heme oxygenase-1. Chin J Traumatol(Engl), 2009 , 12(3)：162-166.
- 37. Liu KX, Li YS, Huang WQ, et al. Immediate but not delayed postconditioning during reperfusion attenuates acute lung injury induced by intestinal ischemia/reperfusion in rats： comparison with ischemic preconditioning. J Surg Res, 2009, 157(1)：e55-e62.
- 38. 鲁建军, 姚达, 秦存伟, 等. 缺血后处理对犬肺移植术后早期炎症反应的影响.中山大学学报（医学科学版）, 2009, 30 (5)： 547-550.
- 39. Zeng Z, Huang HF, Chen MQ, et al. Postconditioning prevents.
- 40. Jiang B, Liu X, Chen H, et al. Ischemic postconditioning attenuates renal ischemic/reperfusion injury in mongrel dogs. Urology, 2010, 76(6)：1519：e1-e7.
- 41. ?Yuan Y,Guo Q,Ye Z,et al.Ischemic postconditioning protects brain from ischemia/reperfusion injury by attenuating endoplasmic reticulum stress-induced apoptosis through PI3K-Akt pathway . Brain Res,2011,1367：85-93.
- 42. Sun K, Liu ZS, Sun Q. Role of mitochondria in cell apoptosis during hepatic ischemia-reperfusion injury and protective effect of ischemic postconditioning. World J Gastroenterol, 2004, 10(13)：1934-1938.
- 43. 宋文英, 董海龙, 陈琼, 等. 缺血后处理上调内源性抗氧化物酶活性诱导兔脊髓保护效应. 中华医学杂志, 2008, 88(33)：2355-2359.
- 44. Yun Y, Duan WG, Chen P, et al. Ischemic postconditioning modified renal oxidative stress and lipid peroxidation caused by ischemic reperfusion injury in rats. Transplant Proc, 2009, 41(9)：3597-3602.
- 45. Abas F, Alkan T, Goren B, et al. Neuroprotective effects of postconditioning on lipid peroxidation and apoptosis after focal cerebral ischemia/reperfusion injury in rats. Turk Neurosurg, 2010 , 20(1)：1-8.
- 46. Park JW, Kang JW, Jeon WJ, et al. Postconditioning protects skeletal muscle from ischemia-reperfusion injury. Microsurgery, 2010, 30(3)：223-229.
- 47. Wang W, Tang T, Zhang P, et al. Postconditioning attenuates renal ischemia-reperfusion injury by preventing DAF down-regulation. J Urol, 2010, 183(6)：2424-2431.
- 48. Ferencz A, Takács I, Horváth S, et al. Examination of protective effect of ischemic postconditioning after small bowel autotransplantation. Transplant Proc, 2010, 42(6)：2287-2289.
- 49. Kin H, Zatta AJ, Lofye MT, et al. Postconditioning reduces infarct size via adenosine receptor activation by endogenous adenosine. Cardiovasc Res, 2005, 67(1)：124-133.
- 50. You L, Li L, Xu Q, et al. Postconditioning reduces infarct size and cardiac myocyte apoptosis via the opioid receptor and JAK-STAT signaling pathway. Mol Biol Rep, 2011, 38(1)：437-443.
- 51. Yang XM, Proctor JB, Cui L, et al. Multiple,brief coronary occlusions during early reperfusion protect rabbit hearts by targeting cell signaling pathways. J Am Coll Cardiol, 2004, 44(5)：1103-1110.
- 52. Penna C, Mancardi D, Rastaldo R, et al. Intermittent activation of bradykinin B2 receptors and mitochondrial KATP channels trigger cardiac postconditioning through redox signaling. Cardiovasc Res, 2007, 75(1)：168-177.
- 53. Yong QC, Lee SW, Foo CS, et al. Endogenous hydrogen sulphide mediates the cardioprotection induced by ischemic postconditioning. Am J Physiol Heart Circ Physiol, 2008, 295(3)：H1330-H1340.