The evolving concept of physiological ischemia training vs. ischemia preconditioning

• Published in: Journal of biomedical research Vol. 29; no. 6; pp. 445 - 450
• Main Authors: Ni, Jun, Lu, Hongjian, Lu, Xiao, Jiang, Minghui, Peng, Qingyun, Ren, Caili, Xiang, Jie, Mei, Chengyao, Li, Jianan
• Format: Journal Article
• Language: English
• Published: China Editorial Department of Journal of Biomedical Research 01.01.2015
• Subjects: Review; 心脏病患者; 生理性; 缺血再灌注损伤; 缺血性心脏病; 缺血预适应; 血管内皮生长因子; 血管生成; 训练; physiological ischemia training; angiogenesis; ischemia preconditioning; vascular endothelial growth factor
• ISSN: 1674-8301
• DOI: 10.7555/JBR.29.20140142

Ischemic heart diseases are the leading cause of death with increasing numbers of patients worldwide. Despite advances in revascularization techniques, angiogenic therapies remain highly attractive. Physiological ischemia train- ing, which is first proposed in our laboratory, refers to reversible ischemia training of normal skeletal muscles by using a tourniquet or isometric contraction to cause physiologic ischemia for about 4 weeks for the sake of triggering mole- cular and cellular mechanisms to promote angiogenesis and formation of collateral vessels and protect remote ische- mia areas. Physiological ischemia training therapy augments angiogenesis in the ischemic myocardium by inducing differential expression of proteins involved in energy metabolism, cell migration, protein folding, and generation. It upregulates the expressions of vascular endothelial growth factor, and induces angiogenesis, protects the myocardium when infarction occurs by increasing circulating endothelial progenitor cells and enhancing their migration, which is in accordance with physical training in heart disease rehabilitation. These findings may lead to a new approach of ther- apeutic angiogenesis for patients with ischemic heart diseases. On the basis of the promising results in animal studies, studies were also conducted in patients with coronary artery disease without any adverse effect in vivo, indicating that physiological ischemia training therapy is a safe, effective and non-invasive angiogenic approach for cardiovascular rehabilitation. Preconditioning is considered to be the most protective intervention against myocardial ischemia-reper- fusion injury to date. Physiological ischemia training is different from preconditioning. This review summarizes the preclinical and clinical data of physiological ischemia training and its difference from preconditioning.