CIRBP and ischemia: At the same time, CIRP induces MAPK/ERK1/2 cascade pathway and NF-κB pathway, activates Bcl-2 and Bcl-xl to induce anti-apoptosis and inhibits Bax and Bad-activated caspase-9 apoptosis.133 However, the accumulation of CIRP during ischemia may result in its massive release into the extracellular domain during reperfusion.