The evolving concept of physiological ischemia training vs. ischemia preconditioning

作     者：Jun Ni Hongjian Lu Xiao Lu Minghui Jiang Qingyun Peng Caili Ren Jie Xiang Chengyao Mei Jianan Li 

作者机构：Department of Rehabilitation Medicinethe Affiliated Hospital of Nantong University The Second People's HospitalNantong Department of Rehabilitation Medicinethe First Affiliated Hospital of Nanjing Medical University Department of Cardiologythe Affiliated Hospital of Nantong University 

出 版 物：《The Journal of Biomedical Research》 (生物医学研究杂志（英文版）)

年 卷 期：2015年第29卷第6期

页      面：445-450页

核心收录：

学科分类：1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100215[医学-康复医学与理疗学] 10[医学] 

基　　金：supported by grants from Nantong City(No.BK2014040 to Jun Ni and No.HS2012057 to Hongjian Lu) Chinese National Science Fund of China(No.81070181 to Xiao Lu) 

主　　题：physiological ischemia training ischemia preconditioning angiogenesis vascular endothelial growth factor 

摘      要：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.