Moving towards preconditioning for neurological disorders: are we ready for clinical trials?

The large volume of preclinical investigations begets the question of whether to proceed with clinical trials in preconditioning for neurological disorders, particularly for treatment of human cerebral ischemia. This important question was discussed during the 2nd Translational Preconditioning Meeting held at the University of Miami. While recommendations for proceeding to clinical trials have been devised in other fields of stroke therapy, such as neuroprotection, no such guidelines exist for preconditioning. During the discussion, the general opinion was to proceed with clinical preconditioning trials, with the understanding that initial trials be exploratory in nature and focus on the development of biomarkers, assessing the elicitability of the preconditioning response.