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10.1053/j.ajkd.2015.06.026

http://scihub22266oqcxt.onion/10.1053/j.ajkd.2015.06.026
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C4623948!4623948!26271146
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suck abstract from ncbi


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pmid26271146      Am+J+Kidney+Dis 2015 ; 66 (5): 846-56
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  • Remote Ischemic Preconditioning for Kidney Protection: GSK3?-Centric Insights Into the Mechanism of Action #MMPMID26271146
  • Liu Z; Gong R
  • Am J Kidney Dis 2015[Nov]; 66 (5): 846-56 PMID26271146show ga
  • Preventing acute kidney injury (AKI) in high-risk patients following medical interventions is a paramount challenge for clinical practice. Recent data from animal experiments and clinical trials indicate that remote ischemic preconditioning (IPC), represented by limb IPC, confers a protective action on the kidney. IPC is effective in reducing the risk of AKI following cardiovascular interventions and the use of iodinated radiocontrast media. Nevertheless, the underlying mechanisms for this protective effect remain elusive. A protective signal is conveyed from the remote site undergoing IPC, like the limb, to target organs, like the kidney, via multiple potential communication pathways, which may involve a humoral, neuronal, and systemic mechanisms. Diverse transmitting pathways trigger a variety of signaling cascades, including the reperfusion injury salvage kinase and survivor activating factor enhancement pathways, all of which converge on glycogen synthase kinase (GSK)3?. Inhibition of GSK3? subsequent to IPC reinforces the Nrf2-mediated antioxidant defense, diminishes the NF?B-dependent pro-inflammatory response, and exerts prosurvival effects ensuing from the desensitized mitochondria permeability transition. Thus, therapeutic targeting of GSK3? by IPC or by pharmacologic preconditioning with existing FDA-approved drugs having GSK3? inhibitory activities might represent a pragmatic and cost-effective adjuvant strategy for kidney protection and prophylaxis against AKI.
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