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Review
. 2022 Jul-Sep;12(3):73-76.
doi: 10.4103/2045-9912.330689.

Current research progress of isoflurane in cerebral ischemia/reperfusion injury: a narrative review

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Review

Current research progress of isoflurane in cerebral ischemia/reperfusion injury: a narrative review

Shu-Jun Chen et al. Med Gas Res. 2022 Jul-Sep.

Abstract

Cerebral ischemia/reperfusion injury is an important factor leading to poor prognosis in ischemic stroke patients. Therefore, it is particularly important to find effective remedial measures to promote the health of patients to return to society. Isoflurane is a safe and reliable anesthetic gas with a long history of clinical application. In recent years, its protection function to human body has been widely recognized, and nowadays isoflurane for cerebral protection has been widely studied, and the stable effect of isoflurane has satisfied many researchers. Basic studies have shown that isoflurane's protection of brain tissue after ischemia/reperfusion involves a variety of signaling pathways and effector molecules. Even though many signaling pathways have been described, more and more studies focus on exploring their mechanisms of action, in order to provide strong evidence for clinical application. This could prompt the introduction of isoflurane therapy to clinical patients as soon as possible. In this paper, several confirmed signaling pathways will be reviewed to find possible strategies for clinical treatment.

Keywords: angiogenesis; cerebral ischemia/reperfusion injury; isoflurane; middle cerebral artery occlusion; vascular endothelial growth factor.

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Conflict of interest statement

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Figures

Figure 1
Figure 1
Mechanism of ISO in cerebral I/R injury. Note: After ISO treatment, Shh/Gli and TGF-β2/Smad3 pathway can promote the production of cytokines such as VEGF and CD34, promoting angiogenesis, and restoring blood supply and oxygen to the brain. On the other side, ISO could reduce the death of cells in anoxic area and protect brain tissue by inhibiting MAPKKK, MAPKK, JNK. I/R: Ischemia/reperfusion; ISO: isoflurane; JNK: c-Jun N-terminal kinase; MAPKK: mitogen-activated protein kinase kinase; MAPKKK: mitogen activated protein kinase kinase kinase; Shh: sonic hedgehog; Smad3: mothers against decapentaplegic homolog 3; TGF-β2: transforming growth factor-β2; VEGF: vascular endothelial growth factor.

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