尽管最近取得了进展,缺血性心脏病构成了持续的全球挑战,驱动显著的发病率和死亡率。对治疗解决方案的追求导致了诸如缺血预处理等策略的出现,后处理,和远程调理以掩护心脏免受心肌缺血/再灌注毁伤(MIRI)。这些缺血调理方法,之前应用,之后,或者离受影响的器官一定距离,激发未来的治疗策略,包括药理调理。气体发射器,包括一氧化氮,硫化氢,二氧化硫,还有一氧化碳,在生理和病理过程中发挥关键作用,表现出共同的特征,如平滑肌松弛,抗凋亡作用,和抗炎特性。尽管高浓度存在潜在风险,生理水平的气体传递剂诱导血管舒张和促进心脏保护作用。惰性气体,特别是氩气,氦气,还有氙气,通过减少细胞死亡表现出器官保护特性,尽可能减小梗死面积,并增强缺血后器官的功能恢复。惰性气体的保护作用似乎取决于它们对控制细胞存活的分子途径的调节,导致促凋亡和抗凋亡作用。在惰性气体中,氦和氙在心脏保护领域特别有前途。本概述综合了我们目前对气体发射器和惰性气体在MIRI和心脏保护方面所起作用的理解。此外,我们强调了未来潜在的发展,包括利用惰性气体和气体发射器供体分子来推进心脏保护策略。
Despite recent progress, ischemic heart disease poses a persistent global challenge, driving significant morbidity and mortality. The pursuit of therapeutic solutions has led to the emergence of strategies such as ischemic preconditioning, postconditioning, and remote conditioning to shield the heart from myocardial ischemia/reperfusion injury (MIRI). These ischemic conditioning approaches, applied before, after, or at a distance from the affected organ, inspire future therapeutic strategies, including pharmacological conditioning. Gasotransmitters, comprising nitric oxide, hydrogen sulfide, sulfur dioxide, and carbon monoxide, play pivotal roles in physiological and pathological processes, exhibiting shared features such as smooth muscle relaxation, antiapoptotic effects, and anti-inflammatory properties. Despite potential risks at high concentrations, physiological levels of gasotransmitters induce vasorelaxation and promote cardioprotective effects. Noble gases, notably argon, helium, and xenon, exhibit organ-protective properties by reducing cell death, minimizing infarct size, and enhancing functional recovery in post-ischemic organs. The protective role of noble gases appears to hinge on their modulation of molecular pathways governing cell survival, leading to both pro- and antiapoptotic effects. Among noble gases, helium and xenon emerge as particularly promising in the field of cardioprotection. This overview synthesizes our current understanding of the roles played by gasotransmitters and noble gases in the context of MIRI and cardioprotection. In addition, we underscore potential future developments involving the utilization of noble gases and gasotransmitter donor molecules in advancing cardioprotective strategies.