Ischemic preconditioning (IPC) is the strongest endogenous myocardial protective mechanism, but up to now, its specific mechanisms have not been completely understood. The Notch network regulates multiple cellular processes, including cell fate determination, development, differentiation, proliferation, apoptosis, and regeneration. Recent loss-of-function studies have shown that the Notch1 receptor controls the response to injury in the adult heart by limiting myocyte hypertrophy, enhancing myocyte survival, promoting precursor proliferation and reducing interstitial fibrosis. Notch signaling also plays a regulatory role in adult cardiac injury and in protection of myocardial function after ischemia. The Notch pathway cross-talks with the PI3K/Akt and NF-κB signaling pathways, both of which are well-known factors involved in IPC-induced myocardial protection. We therefore hypothesize that Notch signaling may play a regulatory role in myocardial protection during ischemic preconditioning and hope to find new drug targets to attain the same beneficial effects of Notch signaling without ischemic insults.
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