The humoral pathway mediating the cardioprotective effect of remote ischemic preconditioning has been demonstrated in various models: ischemia-reperfusion of the fore- and hindlimbs and liver and occlusion-reperfusion of the mesenteric and renal arteries. This review assesses humoral components in the formation and realization of the cardioprotective actions of remote ischemic preconditioning of the heart. Endogenous agonists of opioid receptors, arachidonic acid derivatives (prostanoids), agonists of cannabinoid and vanilloid receptors, calcitonin gene-related peptide, leukotrienes, and microRNA are all regarded as humoral components. Adenosine, which also has a role in mediating the cardioprotective effects of remote ischemic preconditioning, is regarded as a mediator between the humoral factor and cardiomyocytes. Knowledge of the role of humoral factors in mediating cardioprotection may be useful for developing methods and therapeutic agents to increase the resistance of the myocardium to ischemic-reperfusion damage.
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