Pre-conditioning is an exciting physiological phenomenon that, despite great efforts, has so far resisted translation to mainstream clinical medicine. Many potential triggers (e.g., ischemia of the organ in question or a remote organ, many different drugs) have been investigated, but recent work has implicated activation of mitochondrial aldehyde dehydrogenase (ALDH2) as central to the process. A genetic polymorphism, known as ALDH2*2, is common worldwide (present in up to 40% of Han Chinese people) and produces a functionally different enzyme. The authors used a variety of protocols in the human ischemic forearm model, in participants with both enzyme types, to assess cytoprotection with low-dose sodium nitrite and attempt to further elucidate the role of ALDH2.
Keywords: ALDH2, mitochondrial aldehyde dehydrogenase; Ach, acetylcholine; FBF, forearm blood flow; FBF-R, forearm blood flow ratio; GTN, glyceryl trinitrate; IR, ischemia–reperfusion; RIPC, remote ischemic pre-conditioning; cytoprotection; endothelium; nitric oxide; nitrite; reperfusion injury.