Pharmacological preconditioning
DOI:
https://doi.org/10.33910/2687-1270-2020-1-1-32-39Keywords:
pharmacological preconditioning, neuroprotection, cardioprotection, translational medicineAbstract
Preconditioning is the use of preventive actions to increase the resistance of individual organs or the body as a whole to damaging factors. There are two main approaches for preconditioning — non-drug, based on the use of physical factors of moderate intensity (hypoxia/ischemia, cold stress or heat-shock, etc.) and drug, called “pharmacological preconditioning”. As the name implies, pharmacological preconditioning is carried out through the preventive use of various pharmacological agents and is now considered as a promising approach to ensure cardio-and neuroprotection. In particular, pre-pharmacological preparation may be convenient for surgical clinical scenarios. Many pharmacological agents offered for preconditioning have already been clinical use for many years, however, for purposes other than preconditioning, e.g. inhalation anesthetics, antibiotics, and opioids. Other groups of substances considered for pharmacological preconditioning are agents of bacterial and endogenous origin: steroid hormones, lipopolysaccharide, deferoxamine, erythromycin, thrombin, and erythropoietin. From a translational point of view, safety profiles of many of these substances are well studied and tested which could facilitate their rapid clinical implementation and application. However, despite the fact that many types of pharmacological preconditioning have proven to be effective and have significant potential in animal model studies, most of them have not yet been studied in a clinical setting. Thus, considering high translational potential of pharmacological preconditioning technologies and marked insufficiency of clinical studies in this area the implementation of these technologies in the clinic can become a breakthrough in preventive medicine. The purpose of this review is to draw the attention of a wide range of researchers and clinicians to this issue in the hope that it will encourage the professional community to actively engage in search for a solution.
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