Remote ischemic conditioning (RIC) has well-established cardioprotective effects in preclinical studies and promising results in preclinical stroke research. Effective translation from preclinical studies to clinical trials has yet to be accomplished, perhaps because of the use of multiple applications of RIC (e.g., pre-, per-, or post-conditioning) in preclinical studies by both invasive and non-invasive protocols, some of which not clinically applicable. Our systematic review conformed to PRISMA guidelines and addressed differences in clinically relevant RIC applications and outcomes between preclinical and clinical studies. We retrieved a total of 30 studies (8 human; 22 animal) that met the inclusion criteria of testing clinically relevant procedures; namely, non-invasive and per- or post-conditioning protocols. Per-conditioning was applied in 6 animal and 3 human studies, post-conditioning was applied in 16 animal and 5 human studies, and both conditioning methods were applied in 2 animal studies. Application of RIC varied between human and animal studies regarding initiation, duration, repetition, and number of limbs included. Study designs did not systematically apply blinding, randomization, or placebo controls. On only a few occasions did preclinical studies include animals with clinically relevant comorbidities. Clinical trials were challenged by not completing the intended number of RIC cycles or addressing this deficit in the data analysis. Consistency and transferability of methods used for positive animal studies and subsequent human studies are essential for the optimal translation of results. Consensus on preclinical and clinical RIC procedures should be reached for a full understanding of the possible beneficial effects of RIC treatment in stroke.

中文翻译：

---

缺血性卒中远程缺血调节的转化挑战——系统评价

远程缺血调理 (RIC) 在临床前研究中具有公认的心脏保护作用，在临床前卒中研究中具有可喜的结果。从临床前研究到临床试验的有效转化尚未完成，这可能是因为通过侵入性和非侵入性方案在临床前研究中使用了 RIC 的多种应用（例如，预处理、预处理或后处理），其中一些在临床上不适用。我们的系统评价符合 PRISMA 指南，并解决了临床前和临床研究之间临床相关 RIC 应用和结果的差异。我们检索了 30 项研究（8 项人类；22 项动物）符合临床相关程序测试的纳入标准；即，非侵入性和预或后处理协议。在 6 项动物研究和 3 项人体研究中应用了预调节，在 16 项动物和 5 项人体研究中应用了后调节，两种调节方法都应用于 2 项动物研究。RIC 在人类和动物研究中的应用在起始、持续时间、重复和包括的肢体数量方面有所不同。研究设计没有系统地应用盲法、随机化或安慰剂对照。仅在少数情况下，临床前研究包括具有临床相关合并症的动物。临床试验因未完成预期数量的 RIC 周期或解决数据分析中的这一缺陷而受到挑战。用于阳性动物研究和随后的人体研究的方法的一致性和可转移性对于结果的最佳转化至关重要。