Determination of significant parameters in remote ischemic postconditioning for ischemic stroke in experimental models: A systematic review and meta‐analysis study. (27th July 2022)

• Record Type: Journal Article
• Authors: Liu, Kezhou; Cai, Zhengting; Zhang, Quanwei; He, Jiatong; Cheng, Yinuo; Wei, Shaonong; Yin, Mengjie
• Is Part Of: CNS neuroscience & therapeutics. Volume 28:Number 10(2022)
• Page Start: 1492
• Page End: 1508
• Publication Date: 2022-07-27
• Subjects: experimental models -- ischemia -- meta‐analysis -- remote ischemic postconditioning -- stroke; Neuropharmacology -- Periodicals; Central nervous system -- Diseases -- Effect of drugs on -- Periodicals; 612.8
• DOI: 10.1111/cns.13925
• Languages: English
• ISSNs: 1755-5930

Abstract

Abstract: Objectives: To systematically review studies using remote ischemia postconditioning (RIPostC) for ischemic stroke in experimental models and obtain factors that significantly influence treatment outcomes. Materials and Methods: Peer‐reviewed studies were identified and selected based on the eligibility criteria, followed by extraction of data on potentially influential factors related to model preparation, postconditioning, and measure time based on outcome measures including infarct size, neurological scales, and cell tests with autophagy, apoptosis, normal‐neuron, and damaged‐neuron counting. Then, all data were preprocessed, grouped, and meta‐analyzed with the indicator of the standardized mean difference. Results: Fifty‐seven studies with 224 experiments (91 for infarct size, 92 for neurological scales, and 41 for cell‐level tests) were included. There was little statistical difference between different model preparations, treated body parts, number of treatments, and sides. And treatment effect was generally a positive correlation with the duration of conditioning time to stroke onset with exceptions at some time points. Based on infarct size, the number of cycles per treatment, duration of occlusion, and release per cycle showed significant differences. Combined with the effect sizes by other measures, the occlusion/release duration of 8–10 min per cycle is better than 5 min, and three cycles per treatment were most frequently used with good effects. Effect also varied when measuring at different times, showing statistical differences in infarct size and most neurological scales. RIPostC is confirmed as an effective therapeutic intervention for ischemic stroke, while the RIPostC‐mediated autophagy level being activated or inhibited remained conflicting. Conclusions: Conditioning time, number of cycles per treatment, duration of occlusion, and release per cycle were found to influence the treatment effects of RIPostC significantly. More studies on the relevant influential factors and autophagy mechanisms are warranted. Abstract : Studies on remote ischemia postconditioning (RIPostC) for ischemic stroke have been conducted in experimental models for over a decade, but lacking a systematic review makes it unclear which combination of conditioning parameters achieves better efficacy and which measures better reflect treatment effect and disease progression. Our study focused on the therapeutic effect of RIPostC on acute ischemic stroke based on experimental models, using meta‐analysis to quantitatively assess as many potential influencing factors as possible by various outcome measures.