“Remote” myokine protects from pulmonary ischemia/reperfusion injury by a surprising “proximal” control mechanism

The concept of remote ischemic preconditioning (RIPC) was first conceived more than quarter of a century ago in the context of myocardial ischemia/reperfusion (I/R) injury. It was originally based on the principle of “intra”-myocardial protection, i.e., to reduce myocardial I/R damage by subjecting the heart to cycles of “sub-lethal” myocardial I/R prior to prolonged coronary artery occlusion, which however was clinically restricted to elective cardiac surgery settings (1).