Journal of Vascular Medicine & Surgery

Abstract

Role of Fibrinogen in the Attenuation of the Ischemic Reperfusion Injury and in Remote Ischemic Preconditioning

Mohamed SA Mohamed

Background: Ischemic reperfusion injury (IRI) is a common hazard involved in many human diseases, such as cerebral stroke, heart infarction, solid organ transplant dysfunction or failure, and vascular diseases. Understanding the molecular bases of this injury is essential for the prevention and control of these life-threatening conditions. Ischemic and remote ischemic preconditioning techniques (IPC and RIPC, respectively) have increasing importance in the clinical practice to protect against the IRI, however, the exact mechanisms of these techniques are not fully understood, which renders their clinical application query. Possible effectors: Nitric oxide (NO) has been reported by multiple studies to be an important mediator of the protective effects of those techniques. While the physiological concentrations of NO and fibrinogen is known to antagonize each other, the circulating levels of both effectors increase in response to RIPC. Hypothesis: While NO has potential anti-inflammatory effects, non-soluble fibrinogen plays a pro-inflammatory effects. However, the soluble fibrinogen (sFB) may have the potential to act synergistically rather than antagonistically with NO towards the attenuation of the IRI. Conclusion: While FB is a risk factor for cardiovascular and inflammatory diseases that is also able to decrease the efflux of NO, and increase the NO oxidative metabolites and S-nitroglutathione, the increased sFB during the acute phase reaction might have other protective aspects that should be carefully investigated.