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Protection of organs other than the heart by remote ischemic conditioning

Candilio, Luciano; Malik, Abdul; Hausenloy, Derek J.

Journal of Cardiovascular Medicine: March 2013 - Volume 14 - Issue 3 - p 193–205
doi: 10.2459/JCM.0b013e328359dd7b
Guest Editor: Gerd Heusch

Organ or tissue dysfunction due to acute ischemiareperfusion injury (IRI) is the leading cause of death and disability worldwide. Acute IRI induces cell injury and death in a wide variety of organs and tissues in a large number of different clinical settings. One novel therapeutic noninvasive intervention, capable of conferring multiorgan protection against acute IRI, is ‘remote ischemic conditioning’ (RIC). This describes an endogenous protective response to acute IRI, which is triggered by the application of one or more brief cycles of nonlethal ischemia and reperfusion to one particular organ or tissue. Originally discovered as a therapeutic strategy for protecting the myocardium against acute IRI, it has been subsequently demonstrated that RIC may confer protection against acute IRI in a number of different noncardiac organs and tissues including the kidneys, lungs, liver, skin flaps, ovaries, intestine, stomach and pancreas. The discovery that RIC can be induced noninvasively by applying the RIC stimulus to the skeletal tissue of the upper or lower limb has facilitated its application to a number of clinical settings in which organs and tissues are at high risk of acute IRI. In this article, we review the experimental studies that have investigated RIC in organs and tissues other than the heart, and we explore the therapeutic potential of RIC in preventing organ and tissue dysfunction induced by acute IRI.

The Hatter Cardiovascular Institute, University College London, London, UK

*L.C. and A.M. contributed equally to the writing of this article and are joint first authors.

Correspondence to Dr Derek J. Hausenloy, The Hatter Cardiovascular Institute, University College London, 67 Chenies Mews, London WC1E 6HX, UK E-mail:

Received 4 August, 2012

Revised 14 August, 2012

Accepted 29 August, 2012

© 2013 Italian Federation of Cardiology. All rights reserved.