Title:Endogenous Cardioprotective Agents: Role in Pre and Postconditioning
Volume: 16
Issue: 8
Author(s): Claudia Penna, Riccarda Granata, Carlo Gabriele Tocchetti, Maria Pia Gallo, Giuseppe Alloatti and Pasquale Pagliaro
Affiliation:
Keywords:
Cardioprotection, chromogranin A derivatives, exosomes, Ghrelin-associated peptides, GPCR activators, growth
factors, ischemia/reperfusion, tyrosine kinase receptor activators.
Abstract: Cardiovascular diseases (CVD) are the leading cause of death, chronic illness and disability
in Western countries. The most common cause of CVD derives from the harmful effects of acute myocardial
ischemia and subsequent reperfusion injury. Cardioprotection against acute ischemia/
reperfusion injury is made possible by the "conditioning protocols." Conditioning is obtained by
applying a few periods of brief ischemia and reperfusion in the event of prolonged (index) ischemia that may cause myocardial
infarction. Whilst the conditioning stimulus is applied before the index ischemia in ischemic pre-conditioning, it is
applied after the event in post-conditioning. Pre and post- conditioning stimuli can be applied in a different/remote organ
(remote pre- and post-conditioning); in this case conditioning stimulus can also be applied during the index event, in the
so called remote per-conditioning. All these endogenous cardioprotective strategies recruit endogenous cytoprotective
agents and factors that elicit specific cardioprotective pathways. Here, we discuss many of these cardioprotective factors
compared to literature and highlight their main characteristics and mechanisms of action. Enphasis is given to endogenous
cardioprotective agents acting or not on surface receptors, including chromogranin A derivatives, ghrelin-associated peptides,
growth factors and cytokines, and to microvesicles and exosomes. Moreover the cardioprotective effects of
gasotransmitters nitric oxide, hydrogen sulphide and carbon monoxide are reviewed. The possible clinical translation of
these knowledge for future successful therapies is briefly and critically discussed.
