Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies
Abstract
:1. Introduction
2. Pathophysiology of IRI
2.1. Ischemic Period: Hypoxic Injury and Preparation for Reperfusion
2.2. Reperfusion Injury: the Superlative Damage
2.3. The Ever-Evolving Role of Mitochondria in IRI
2.4. G-Proteins and Endothelium Interplay in IRI
3. Systemic Susceptibility to IRI
4. Therapeutics: the Pharmacological Approach
4.1. Representative Pharmacological Targets
4.2. Pharmacological Targeting of the RISK Pathway
4.3. Pharmacological Targeting of the SAFE Pathway
4.4. Pharmacological Targeting of the cGMP/PKG Pathway
4.5. Pharmacological Targeting of the Mitochondria
4.6. Engaging Multiple Pathways
4.7. Alternative Mechanisms of Protection
4.8. Hyperbaric Oxygen Therapy
5. Conclusions and Perspectives
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Ultrastructural Alteration | Reversible Injury | Irreversible Injury |
---|---|---|
Plasma membrane | formation of bubbles, reduction, and distortion of microvilli, appearance of myelin figures and loosening of intracellular bonds | evident discontinuity of plasma membranes and organelles |
Mitochondrial | edema, rarefaction, and appearance of amorphous densities rich in phospholipids | dilatation of mitochondria with formation of amorphous densities, intracytoplasmic myelin figures and cotton-like material (denatured proteins) |
Nuclear | disintegration of granular and fibrillar elements | karyolysis (DNase activity), pyknosis (shrinking of the nucleus and increased basophilia), karyorrhexis (nuclear fragmentation) |
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Soares, R.O.S.; Losada, D.M.; Jordani, M.C.; Évora, P.; Castro-e-Silva, O. Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies. Int. J. Mol. Sci. 2019, 20, 5034. https://doi.org/10.3390/ijms20205034
Soares ROS, Losada DM, Jordani MC, Évora P, Castro-e-Silva O. Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies. International Journal of Molecular Sciences. 2019; 20(20):5034. https://doi.org/10.3390/ijms20205034
Chicago/Turabian StyleSoares, Ricardo O. S., Daniele M. Losada, Maria C. Jordani, Paulo Évora, and Orlando Castro-e-Silva. 2019. "Ischemia/Reperfusion Injury Revisited: An Overview of the Latest Pharmacological Strategies" International Journal of Molecular Sciences 20, no. 20: 5034. https://doi.org/10.3390/ijms20205034