The role of p38 mitogen-activated protein kinase in myocardial ischemia reperfusion injury; relationship to ischemic preconditioning

Myocardial mitogen-activated protein kinases can be activated by ischemia and reperfusion, and they may play important roles in the evolution of ischemic injury. Considerable work has been performed to evaluate the role of different MAPK signaling pathways in ischemia/reperfusion injury. The focus of this review is the p38 MAPK pathway, specifically whether activation of the p38 MAPK signaling pathway is beneficial or detrimental. Different studies have come to conflicting conclusions. This review will examine the literature on the role of p38 MAPK in myocardial ischemia/reperfusion injury, highlight areas of controversy and areas of general agreement, examine possible downstream targets of p38 during acute ischemia, and attempt to draw some conclusions.