Remote ischemic conditioning (RIC) represents an innovative and attractive neuroprotective approach in
brain ischemia. The purpose of this intervention is to activate endogenous tolerance mechanisms by inflicting a subliminal
ischemia injury to the limbs, or to another "remote" region, leading to a protective systemic response against ischemic
brain injury. Among the multiple candidates that have been proposed as putative mediators of the protective effect generated by the subthreshold peripheral ischemic insult, it has been hypothesized that
microRNAs may play a vital role in the
infarct-sparing effect of RIC. The effect of
miRNAs can be exploited at different levels: (1) as transducers of protective messages to the brain or (2) as effectors of brain protection. The purpose of the present review is to summarize the most recent evidence supporting the involvement of
microRNAs in brain protection elicited by remote conditioning, highlighting potential and pitfalls in their exploitation as diagnostic and therapeutic tools. The understanding of these processes could help provide light on the molecular pathways involved in brain protection for the future development of
miRNA-based
theranostic agents in
stroke.