肢体缺血预处理对大鼠缺血再灌注海马HSP70表达的影响

热休克蛋白(heat shock proteins70,HSP70),是一种应激蛋白。研究显示,大鼠大脑中动脉阻断后,HSP70蛋白仅出现在梗死灶周围神经元,即在缺血半影区大量表达。在短暂缺血后死亡的海马CA1区锥体细胞中HSP70蓄积甚少,存活的齿状回颗粒细胞中有明显的HSP70积累。以上表明HSP70可能对脑缺血后神经细胞具有保护作用。我们以前研究结果证实肢体缺血预处理(limb ischemic preconditioning,LIP)可减轻脑缺血再灌注损伤。本实验运用免疫组化技术观察脑缺血再灌注前给予LIP海马HSP70的表达情况,探讨HSP70在LIP抗脑缺血再灌注损伤中的作用。…     

酸敏感离子通道2a对缺血预处理诱导大鼠海马缺血耐受的作用

目的探讨脑缺血时的组织病理学变化及酸敏感离子通道2a（ASIC2a）在缺血预处理诱导的脑缺血模型耐受中的作用。方法取成年雄性SD大鼠160只,随机分为假手术组、预缺血组、缺血组、缺血预处理组共4组。行焦油紫染色观察各组大鼠海马CAI区存活神经元密度,TUNEL染色观察大鼠海马CA1区神经元凋亡情况,RT—PCR和Western blotting检测ASIC2a在大鼠海马CAl区mRNA和蛋白表达情况。结果缺血预处理能够显著减少大鼠海马CA1区锥体神经元的死亡和凋亡,PC＋Isch组和Isch组相比具有显著性差异（P〈0．01）。全脑缺血能够上调ASIC2a在大鼠海马CA1区mRNA和蛋白表达,在24h达到高峰,而缺血预处理进一步上调ASIC2a表达,呈进行性上升,在24h和72h时相点,PC＋Isch组和Isch组相比具有显著性差异（P〈0．01）。结论在脑缺血耐受中,缺血预处理对第二次致死性缺血表现出保护作用。在这个过程中,大鼠海马CA1区ASIC2a基因和蛋白表达上调发挥了重要的保护作用。     

大鼠局灶缺血预处理诱导的脑缺血耐受中热休克蛋白70的表达及其意义

目的　研究局灶脑缺血预处理对热休克蛋白 70 (HSP70 )表达和脑缺血耐受的影响。方法　SD大鼠随机分为 3组 :预缺血组、假手术组及对照组 ,前两组分别在 2小时大脑中动脉缺血 (MCAO)前 3天给予10分钟的预缺血或假手术 ,MCAO后 2 4小时处死 ,对照组给予两次相隔 3天的假手术 ,比较各组梗死体积及HSP70的表达。结果　预缺血组梗死体积较假手术组减少 5 2 5 4 % (P <0 0 1) ,HSP70表达高于假手术组及对照组 (P <0 0 1)。结论　 10分钟大脑中动脉预缺血可有效诱导缺血耐受 ,增加HSP70表达。HSP70表达上调可能是局灶性脑缺血耐受产生的分子机制之一     

热耐受对鼠脑海马缺血后细胞凋亡的保护☆

】　目的　观察热耐受对鼠脑海马缺血再灌流后细胞凋亡的保护作用，并探讨迟发神经元死亡(DND)与细胞凋亡的关系。方法　大鼠前脑缺血10 min，以及在缺血前反复3次高热处理，应用TUNEL技术检测海马缺血区凋亡细胞，并用免疫组化法检测该区HSP70表达水平。结果　缺血再灌流后，细胞凋亡在DND形态学改变前出现。热耐受后可显著减轻缺血损害导致的细胞凋亡。结论　细胞凋亡是DND的死亡方式之一，热耐受诱导的HSP70表达增强是其保护细胞、减少凋亡的主要机制。     

缺血预处理后Fas蛋白表达与迟发性神经元凋亡的关系初步探讨

目的动态观察缺血预处理后大鼠大脑皮层和海马CA1区神经元凋亡与Fas蛋白表达变化情况,初步探讨缺血预处理后Fas蛋白表达与迟发性神经元凋亡的关系。方法四血管阻断法复制全脑缺血模型,动物随机分为非缺血对照组、预处理对照组、缺血预处理组和缺血组。采用尼氏和TUNEL染色法观察皮层及海马CA1区神经元存活数和凋亡细胞数,免疫组化方法检测Fas蛋白在缺血预处理后表达变化情况。结果缺血组缺血6h在皮质及海马CA1区Fas阳性表达细胞计数升高,12h达高峰;缺血预处理组缺血12h阳性细胞计数升高,24h达高峰。缺血组缺血6h出现凋亡细胞,48h凋亡细胞数达到高峰;缺血预处理组凋亡细胞数较缺血组明显减少。缺血组缺血7d神经元数明显减少,12周时神经元大量减少;缺血预处理组缺血7d时神经元数无明显变化,但12周时神经元同样大量减少。结论全脑缺血可能通过诱导Fas蛋白的表达增多,启动细胞凋亡,导致缺血后神经元凋亡的发生;缺血预处理虽可延缓缺血后神经元的凋亡,但无法提供真正的长时期的神经元保护作用,其有限的保护作用可能是通过延缓Fas蛋白的表达而减缓了神经元凋亡的进程。     

吗啡预处理与脑缺血再灌注损伤后细胞凋亡：抑制效应的途径？

[摘要] 背景：大量研究已经证明凋亡是脑缺血再灌注损伤后神经元损伤的重要形式,且这一过程可以人为干预以改善预后。药物预处理对缺血再灌注损伤后神经元凋亡的影响是脑缺血研究的热点。吗啡是临床常用药,几项研究显示其对某种形式的脑损伤有保护作用,但吗啡预处理对脑缺血再灌注损伤后神经元凋亡的影响尚未见报道。 目的: 探讨吗啡预处理对大鼠全脑缺血再灌注损伤后神经元凋亡及相关基因表达的影响。 设计、时间及地点：2008年6月-2009年8月在青岛大学医学院脑血管病研究所完成分子生物学水平的随机对照实验。 材料：神经元凋亡及免疫组化检测试剂盒均由武汉博士德公司提供 方法: 健康雄性成年Wistar大鼠72只,随机分成4组：假手术组;脑缺血/再灌注组;吗啡预处理1mg/kg组;吗啡预处理7mg/kg组,18只/组。依再灌注时间不同,各组又分为再灌注1d、3d、7d 三个亚组,6只/亚组。以Pusinelli方法为标准建立四动脉阻断法全脑缺血模型,假手术组仅暴露第一颈椎双侧翼孔和双侧颈总动脉而不烧灼,不夹闭动脉;脑缺血组缺血前60min腹腔注射生理盐水2mg/kg;吗啡预处理1mg/kg组及吗啡预处理7mg/kg组分别在脑缺血前60min腹腔内注射吗啡1mg/kg及7mg/kg。在脑缺血8分钟后恢复血流,再灌注1d、3d、7d后断头取脑制作石蜡切片。 主要观察指标： HE染色观察海马CA1区组织病理学改变,TUNEL法检测海马CA1区神经元凋亡,免疫组化检测海马CA1区Casepase-3蛋白表达。 结果：HE染色：假手术组海马CA1区神经元结构正常;脑缺血组则出现大量的肿胀、核固缩及胞浆空泡样变异常细胞并神经元数量显著减少;吗啡预处理组细胞肿胀、核皱缩及细胞缺失的病理学改变显著轻于脑缺血再灌注组。凋亡细胞计数：与假手术组比较,缺血组和吗啡预处理组海马CA1区神经元凋亡数明显增加(P<0.01) ;与缺血再灌注组比较, 吗啡预处理组神经元的凋亡数明显减少(P<0.01);与吗啡预处理1mg/kg组比较,吗啡预处理7mg/kg组神经元凋亡数显著降低(P< 0.05 或P< 0.01)。Casepase-3蛋白表达：缺血组和吗啡预处理组Casepase-3表达明显高于假手术组(P<0.01);吗啡预处理组Casepase-3表达显著低于缺血再灌注组(P<0.01);吗啡预处理7mg/kg组Casepase-3表达明显低于吗啡预处理1mg/kg组(P< 0.05 )。应用吗啡后,在1d、3d、7d三个时点,神经元凋亡的减少趋势与Casepase-3降低的趋势一致。 结论： 吗啡预处理可减轻缺血性脑损伤,提高脑缺血耐受性,且大剂量吗啡效果优于小剂量;吗啡抗凋亡作用机制与Casepase-3密切有关。     

秋水仙碱联合环磷酰胺增强大鼠脑缺血耐受的作用及其对热休克蛋白70表达的影响

目的　观察环磷酰胺联合秋水仙碱对预缺血诱导的脑缺血耐受及热休克蛋白 70 (HSP70 )表达的影响。方法　SD大鼠随机分为药物、预缺血及假手术 3个组 ,分别在 2小时大脑中动脉缺血 (MCAO)前 3天给予 10分钟的预处理、药物加预处理或假手术 ,MCAO后 2 4小时处死 ,比较各组神经功能评分、梗死体积及HSP70的表达。结果　药物组神经功能缺损减轻和梗死体积缩小较预缺血组更为明显 ,HSP70表达亦高于其余两组 (P <0 0 1)。结论　环磷酰胺联合秋水仙碱可增强预缺血诱导的脑缺血耐受作用 ,上调HSP70表达 ,二者具有叠加效应。     

小檗碱对大鼠脑缺血后MCP-1表达的影响

目的探讨小檗碱处理对大鼠脑缺血后单核细胞趋化蛋白-1（MCP-1）表达的影响及小檗碱对脑缺血的神经保护作用。方法建立大鼠短暂性全脑缺血模型，采用尼氏体亚甲蓝染色观察脑缺血后大鼠脑海马CA1区神经元存活情况；采用免疫荧光染色方法检测脑缺血后大鼠缺血脑组织中MCP-1的表达情况。结果（1）与假手术组比较，脑缺血组大鼠脑海马CA1区神经元明显缺失，而小檗碱处理组大鼠脑海马CA1区神经元存活数明显多于缺血对照组；（2）与假手术组比较，脑缺血组大鼠脑缺血区MCP-1表达显著增多，而小檗碱处理显著降低了大鼠脑缺血区MCP-1的阳性表达。结论脑缺血引起MCP-1表达上调，提示MCP-1可能参与脑缺血损伤。小檗碱可抑制缺血脑组织MCP-1的表达，推测其可能经此途径减轻脑缺血的炎症反应而发挥一定的神经保护作用。     

预缺血诱导大鼠CA1神经元中蛋白伴侣hsp70的表达并抑制蛋白聚集物的形成

目的 研究预缺血对蛋白伴侣hsp70表达和蛋白聚集物形成的影响,探讨其可能的脑保护机制.方法 采用大鼠双侧颈总动脉暂时夹闭法建立全脑缺血模型.大鼠分为3min缺血组,10min缺血组以及预缺血组.苏木素-伊红染色,光镜下随机计数分析预缺血后海马CA1区死亡神经元数量变化.免疫组织化学及激光扫描共聚焦显微镜法观察蛋白伴侣hsp70在CAI区神经元内的分布.差速离心分离细胞浆、细胞核及蛋白聚集物.蛋白印迹法检测不同缺血状态下海马CA1神经元内蛋白聚集物含量的变化,以及胞浆、胞核及蛋白聚集物内蛋白伴侣hsp70含量的变化.结果 组织学检查显示预缺血能够显著减少海马CA1区神经元死亡数量.预缺血诱导海马CA1区神经元内蛋白伴侣hsp70在再灌注后24h表达.预缺血处理后,海马CA1区神经元内蛋白聚集物显著减少.预缺血诱导的蛋白伴侣hsp70与再缺血形成的异常蛋白结合在一起并防止其聚集.结论 预缺血可能通过诱导蛋白伴侣hsp70的表达和抑制再缺血后蛋白聚集物的形成,减少再缺血引起的神经元死亡.     

脑缺血预处理对缺血再灌注损伤的保护作用

目的　观察缺血预处理对脑缺血再灌注损伤的保护作用。方法　采用四血管阻断法对实验鼠分组进行全脑缺血预处理及缺血后再灌注, 半定量法观察海马区神经元受损情况。结果　实验组四血管阻断３ 分钟（ 预处理） 后海马区神经元受损与对照组无显著差异;３ 天间隔６ 分钟全脑缺血再灌注组神经元受损较其他组明显减轻。结论　缺血预处理对脑缺血再灌注损伤保护作用与全脑缺血预处理时间, 后续全脑缺血再灌注损伤时间及两者间的时间间隔有关。     

Induction of 27-kDa heat shock protein following cerebral ischemia in a rat model of ischemic tolerance

Preconditioning the brain with sublethal cerebral ischemia induces tolerance to subsequent lethal periods of ischemia (ischemic tolerance). The purpose of this study is to investigate the role of low-molecular weight stress proteins, 27-kDa heat shock protein (HSP27) and αB crystallin, in ischemic tolerance. We measured the content of these proteins with enzyme immunoassay in the rat hippocampus and cerebral cortex following 6 min of ischemia with and without preconditioning with 3 min of ischemia and 3 days of reperfusion. We also visualized the localization of HSP27 immunohistochemically in comparison with that of HSP70. A 3-min period of ischemia caused a 2.4-fold increase in HSP27 content in the hippocampus after 3 days. Immunohistochemical localization of HSP27 was found in glial cells in all subregions of the hippocampus, whereas HSP70 immunostaining was seen only in CA1 pyramidal neurons. HSP27 content in the hippocampus decreased 2 h after 6 min of ischemia. HSP27 content progressively increased in the unpreconditioned hippocampus after 1 and 3 days, but returned to preischemic levels in the preconditioned hippocampus. HSP27 and HSP70 immunostaining was seen in CA1 pyramidal neurons after 1 day both with and without preconditioning. After 3 and 7 days, an intense HSP27 staining was observed in reactive glial cells in the CA1 without preconditioning, whereas the staining decreased in the preconditioned hippocampus. HSP70 staining was seen only in neurons at these time points. We observed no significant changes in HSP27 content in the cerebral cortex although neurons in the third and fifth layers were immunostained after 1 and 3 days. We observed no alterations in αB crystallin content after ischemia both in the hippocampus and the cortex. The present study demonstrated that cerebral ischemia induces HSP27 expression but not αB crystallin. Both HSP27 and HSP70 induction had a good temporal correlation with the induction of ischemic tolerance. However, different sites of action were suggested because the localization and cell types of HSP27 induction were quite different from those of HSP70 induction. The result suggests that it is unlikely that HSP27 is directly involved in the protection afforded by ischemic preconditioning.     

Ischemic preconditioning attenuates of ischemia-induced degradation of spectrin and tau: implications for ischemic tolerance

Global ischemia selectively induces CA1 neuronal death in the hippocampus. Pretreatment with non-lethal ischemia (i.e. ischemic preconditioning) prevents CA1 neuronal death induced by lethal ischemia. While ischemic tolerance is a well-known phenomenon, the underlying molecular mechanisms are not fully understood. Cytoskeletal proteins including α-spectrin, tau, and microtubule-associated protein 2 (MAP-2) are indispensable for the maintenance of neuronal homeostasis. Here, we report the effects of ischemic preconditioning on the ischemia-induced degradation of cytoskeletal proteins α-spectrin, tau, and MAP-2 in the rat CA1 region. We found that most neurons of the CA1 region had died after 5 min of ischemia. However, exposing the brain to 3 min of ischemic preconditioning 3 days earlier significantly reduced the number of neuronal death. A significant degradation of α-spectrin and tau, but not of MAP-2, was found in the CA1 region after 5 min of ischemia. Ischemic preconditioning attenuated the ischemia-induced massive degradation of α-spectrin and tau. Our results suggest that the attenuation of ischemia-induced degradation of α-spectrin and tau by ischemic preconditioning may be associated with the neuroprotective mechanism of the ischemic tolerance.     

'Ischemic tolerance' phenomenon detected in various brain regions.

We investigated the effects of mild and non-lethal ischemic insult on neuronal death following subsequent lethal ischemic stress in various brain regions, using a gerbil model of bilateral cerebral ischemia. Single 10-min ischemia consistently caused neuronal damage in the hippocampal CA1, CA2, CA3 and CA4, layer III/IV of the cerebral cortex, dorsolateral part of the caudoputamen and ventrolateral part of the thalamus. On the other hand, in double ischemia groups, 2-min ischemic insult 2 days before 10-min ischemia exhibited significant protection in the CA1 and CA3 of the hippocampus, the cerebral cortex, the caudoputamen and the thalamus. Five-min ischemic insult 2 days before 10-min ischemia also showed protective effect in the same areas as those of 2-min ischemia except for the CA1 region of the hippocampus, while 1-min ischemic insult exhibited no protective effect in any brain regions. In the immunoblot analysis, both 2- and 5-min ischemia caused increased synthesis of heat shock protein 72 (HSP 72) in the hippocampus, but 1-min ischemia did not. The present study demonstrated that the 'ischemic tolerance' phenomenon was widely found in the brain and also suggested that ischemic treatment severe enough to cause HSP 72 synthesis might be needed for induction of 'ischemic tolerance'.     

‘Ischemic tolerance’ phenomenon detected in various brain regions

We investigated the effects of mild and non-lethal ischemic insult on neuronal death following subsequent lethal ischemic stress in various brain regions, using a gerbil model of bilateral cerebral ischemia. Single 10-min ischemia consistently caused neuronal damage in the hippocampal CA1, CA2, CA3 and CA4, layer III/IV of the cerebral cortex, dorsolateral part of the caudoputamen and ventrolateral part of the thalamus. On the other hand, in double ischemia groups, 2-min ischemic insult 2 days before 10-min ischemia exhibited significant protection in the CA1 and CA3 of the hippocampus, the cerebral cortex, the caudoputamen and the thalamus. Five-min ischemic insult 2 days before 10-min ischemia also showed protective effect in the same areas as those of 2-min ischemia except for the CA1 region of the hippocampus, while 1-min ischemic insult exhibited no protective effect in any brain regions. In the immunoblot analysis, both 2- and 5-min ischemia caused increased synthesis of heat shock protein 72 (HSP 72) in the hippocampus, but 1-min ischemia did not. The present study demonstrated that the ‘ischemic tolerance’ phenomenon was widely found in the brain and also suggested that ischemic treatment severe enough to cause HSP 72 synthesis might be needed for induction of ‘ischemic tolerance’.     

Activation of p38 MAPK participates in brain ischemic tolerance induced by limb ischemic preconditioning by up-regulating HSP 70

This study investigates whether activation of p38 MAPK by the up-regulation of HSP 70 participates in the induction of brain ischemic tolerance by limb ischemic preconditioning (LIP). Western blot and immunohistochemical assays indicated that p38 MAPK activation occurred earlier than HSP 70 induction in the CA1 region of the hippocampus after LIP. P-p38 MAPK expression was up-regulated at 6 h and reached its peak 12 h after LIP, while HSP 70 expression was not significantly increased until 1 day and peaked 2 days after LIP. Neuropathological evaluation by thionin staining showed that quercetin (4 ml/kg, 50 mg/kg, intraperitoneal injection), an inhibitor of HSP 70, blocked the protective effect of LIP against delayed neuronal death that is normally induced by lethal brain ischemic insult, indicating that HSP 70 participates in the induction of brain ischemic tolerance by LIP. Furthermore, SB 203580, an inhibitor of HSP 70, inhibited HSP 70 activation in the CA1 region of the hippocampus induced by LIP either with or without the presence of subsequent brain ischemic insult. Based on the above results, it can be concluded that activation of p38 MAPK participates in the brain ischemic tolerance induced by LIP at least partly by the up-regulation of HSP 70 expression.     

Ischemic preconditioning: a long term survival study using behavioural and histological endpoints

In this study we sought to determine if ischemic preconditioning provided long term behavioral and histological protection. A second goal was to see if ischemic preconditioning conveys its protective effect on CA1 neurons by altering post-ischemic brain temperature. While preconditioning episodes of short duration ischemia (i.e. 1.5 min) provided significant histological protection of CA1 pyramidal cells against a subsequent severe ischemic insult (i.e. 5 min), this did not result in complete behavioural protection. Preconditioned ischemic animals initially displayed habituation deficits in an open field test that were comparable to untreated ischemic gerbils. A significant decline in CA1 preservation in preconditioned animals was observed when survival time was extended from 10 (81% protection) to 30 (53% protection) days. In addition, protection was not observed in the subiculum and CA2 sector of the hippocampus where consistent damage was observed in 21/22 gerbils. Ischemic preconditioning did not markedly affect post-ischemic brain temperature suggesting that the observed protection was not due to a reduction in temperature during or after the severe ischemic insult. The lack of functional protection within the first 10 days after ischemia, along with the decline of cellular preservation over time, suggests that this paradigm may not provide permanent protection.     

Induction of NADPH-diaphorase activity in the hippocampus in a rat model of cerebral ischemia and ischemic tolerance

Preconditioning of the brain with sublethal ischemia induces tolerance to subsequent lethal periods of ischemia (ischemic tolerance). In this study, we used NADPH-diaphorase histochemistry to investigate the postischemic changes of nitric oxide synthase (NOS) in the hippocampus in a rat model of cerebral ischemia and ischemic tolerance. Forebrain ischemia was induced by 4-vessel occlusion for 3 min as an ischemic preconditioning. Three days after the preconditioning or sham operation, second ischemia was induced for 6 min. A transient increase in NADPH-diaphorase activity, beginning after 2 h and maximal after 1 day, was observed in CA1 pyramidal neurons of rats subjected to 3 min of preconditioning ischemia as well as 6 min of subsequent ischemia both with and without preconditioning. In addition, expression of NADPH-diaphorase activity was seen in reactive glial cells in the damaged CA1 region of animals subjected to 6 min of ischemia without preconditioning. Thus, direct involvement of increased NADPH-diaphorase activity in ischemic tolerance was not suggested because the increased NADPH-diaphorase activity preceded the induction of ischemic tolerance which takes place 1–7 days after preconditioning. However, the present findings suggest that the induction of neuronal NADPH-diaphorase activity occurs in response to cerebral ischemia.     

Characterization of spinal HSP72 induction and development of ischemic tolerance after spinal ischemia in rats

Induction of heat shock protein (HSP72) has been implicated in the development of ischemic tolerance in several tissue organs including brain and spinal cord. In the present study, using an aortic balloon occlusion model in rats, we characterized the effect of transient noninjurious (3 or 6 min) or injurious intervals (10 min) of spinal ischemia followed by 4-72 h of reflow on spinal expression of HSP72 and GFAP protein. In a separate group of animals, the effect of ischemic preconditioning (3 or 6 min) on the recovery of function after injurious interval of spinal ischemia (10 min) was studied. After 3 min of ischemia, there was a modest increase in HSP72 protein immunoreactivity in the dorsal horn neurons at 12 h after reperfusion. After 6 min of ischemia, a more robust and wide spread HSP72 protein expression in both dorsal and ventral horn neurons was detected. The peak of the expression was seen at 24 h after ischemia. At the same time point, a significant increase in spinal tissue GFAP expression was measured with Western blots and corresponded morphologically with the presence of activated astrocytes in spinal segments that had been treated similarly. After 10 min of ischemia and 24 h of reflow, a significant increase in spinal neuronal HSP72 expression in perinecrotic regions was seen. Behaviorally, 3 min preconditioning ischemia led to the development of a biphasic ischemic tolerance (the first at 30 min and the second at 24 h after preconditioning) and was expressed as a significantly better recovery of motor function after exposure to a second 10-min interval of spinal ischemia. After 6 min ischemic preconditioning, a more robust ischemic tolerance at 24 h after preconditioning then seen after 3-min preconditioning was detected. These data indicate that 3 min of spinal ischemia represents a threshold for spinal neuronal HSP72 induction, however, a longer sublethal interval (6 min) of preconditioning ischemia is required for a potent neuronal HSP72 induction. More robust neurological protection, seen after 6 min of preconditioning ischemia, also indicates that HSP72 expression in spinal interneurons seen at 24 h after preconditioning may represent an important variable in modulating ischemic tolerance observed during this time frame.     

'Ischemic tolerance' phenomenon found in the brain

We investigated the possibility that neuronal cells given a mild ischemic treatment sufficient to perturb the cellular metabolism acquired tolerance to a subsequent, and what would be lethal, ischemic stress in vivo. Cerebral ischemia was produced in the gerbils by occlusion of both common carotids for 5 min, which consistently resulted in delayed neuronal death in the CA1 region of the hippocampus. Minor 2-min ischemia in this model depletes high-energy phosphate compounds and perturbs the protein synthesis, but never causes neuronal necrosis, and therefore was chosen as mild ischemic treatment. Single 2-min ischemia 1 day or 2 days before 5 min ischemia exhibited only partial protective effects against delayed neuronal death. However, two 2-min ischemic treatments at 1 day intervals 2 days before 5 min ischemia exhibited drastically complete protection against neuronal death. The duration and intervals of ischemic treatment, enough to perturb cellular metabolism and cause protein synthesis, were needed respectively, because neither 1-min ischemia nor 2-min ischemia received twice at short intervals exhibited protective effects. This 'ischemic tolerance' phenomenon induced by ischemic stress--which is unquestionably important--and frequent stress in clinical medicine, is intriguing and may open a new approach to investigate the pathophysiology of ischemic neuronal damage.