Advances in organ protection: ischemic preconditioning and erythropoietin as protective strategies.

Abstract

Background: Ischemic preconditioning (IPC) and erythropoietin (EPO) are known for their protective effects against organ damage caused by ischemia, ischemia-reperfusion (I/R), and certain drugs. This review aims to summarize the literature on IPC and EPO, focusing on their mechanisms and exploring their relationship in organ protection.

Methods: A comprehensive search of PubMed databases was conducted using keywords, such as IPC, EPO, ischemia-reperfusion, and organ protection. Articles were screened for relevance to IPC or EPO-mediated organ protection, excluding studies on hypoxic preconditioning and pharmacological preconditioning.

Results: IPC and EPO have demonstrated protective effects across various organs, including kidneys, liver, heart, small intestine, retina, stomach, pancreas, and nervous system. They exert their effects through anti-apoptotic, anti-oxidative stress, and anti-inflammatory mechanisms involving distinct signaling pathways. Evidence suggests a potential interaction between IPC and EPO, with IPC potentially elevating serum EPO levels and EPO enhancing the protective effects of IPC, particularly in the heart via the JAK-STAT pathway.

Conclusions: IPC and EPO hold promise as therapeutic strategies for mitigating organ damage in ischemic conditions. Further research is needed to elucidate their interaction in organ protection given the current limitations in evidence. Nonetheless, their individual mechanisms and clinical applications underscore their potential utility in clinical settings.