Measurement of superoxide-derived free radicals in the reperfused heart. Evidence for a free radical mechanism of reperfusion injury

The interaction of 5,5-dimethyl-1-pyrroline-N-oxide with human myeloperoxidase and its potential impact on spin trapping of neutrophil-derived free radicals

Activation of human neutrophils leads to secretion of myeloperoxidase (MPO) with resulting generation of several oxidant species including OCl-. Spin trapping techniques employing 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) are being applied increasingly to the investigation of free radical production by in vitro and in vivo experimental systems which contain neutrophils. Because such knowledge is critical to the interpretation of these data, we examined the impact of MPO and MPO-derived oxidants on DMPO spin adduct formation and stability. Addition of increasing concentrations of OCl- to DMPO yielded a number of EPR-detectable products including DMPO-OH. However, the concentration of OCl- required was in excess of that expected under physiologic conditions. Addition of purified human MPO and H2O2 to DMPO yielded EPR spectra consisting of small DMPO-OH peaks. The addition of MPO and H2O2 to preformed DMPO-OH and DMPO-CH3 resulted in rapid destruction of these spin adducts. Thus MPO/H2O2 appeared to both generate and destroy DMPO spin adducts. Neutrophils stimulated with phorbol myristate acetate or opsonized zymosan generated large DMPO-OOH and DMPO-OH peaks as well as small DMPO-CH3 peaks. Addition of the MPO inhibitor azide to the reaction mixture had no effecting on resulting DMPO-OH or DMPO-CH3 peak amplitudes but increased that of DMPO-OOH. These data suggest that MPO-derived oxidants likely have little impact on the nature of EPR spectra resulting from DMPO spin trapping of free radical species following neutrophil stimulation. Because MPO oxidants did appear to react with DMPO the ability of DMPO to protect a biologic target from in vitro MPO injury was examined. DMPO (greater than 10 mM) significantly decreased MPO/H2O2/Cl- -mediated erythrocyte hemolysis as assessed by 51Cr release. The experimental and/or pharmacologic implications of this observation require further study.

Use of 3,3,5,5-tetramethyl-1-pyrroline-1-oxide spin trap for the continuous flow ESR monitoring of hydroxyl radical generation in the ischemic and reperfused myocardium

A new approach for in vivo spin trapping and quantitation of oxygen-derived free radicals has been developed using a continuous flow high speed ESR detection system. Spin adducts of OH. were detected as 1:1:1:1:1:1 sextets (aN=15.2 G, aH=16.8 G, g=2.0055) in the isolated rat heart when perfused with 3,3,5,5-tetramethyl-1-pyrroline-1-oxide (40 mM) during a 10-min control pretreatment (14 ml/min) followed by 50 min of low-flow ischemia (1 ml/min), 30 min of global ischemia and subsequent reperfusion at 14 ml/min. The ESR signals appeared within 15-20 min of low-flow ischemia and grew moderately during the remaining 30 min at a rate of 2-6 nmoles of spin adduct released per minute. Post-ischemic reperfusion was characterized by a burst of spin adduct formation at 30 s-1 min, corresponding to 51.8 nmoles of spin adduct released between 30 s and 1 min.

Protection by superoxide dismutase from myocardial dysfunction and attenuation of vasodilator reserve after coronary occlusion and reperfusion in dog

Previous studies indicate impairment of coronary arterial ring relaxation and loss of coronary vasodilator reserve after coronary artery occlusion and reperfusion. These changes are mediated in part through loss of endothelium-derived relaxing factor (EDRF) and/or myocardial neutrophil accumulation. To examine if superoxide dismutase (SOD), a scavenger of superoxide radicals, would modify the diminished coronary vasodilator reserve after temporary coronary occlusion in the intact animal, open-chest mongrel dogs were subjected to 1 hour of circumflex (Cx) coronary artery occlusion followed by 1 hour of reperfusion and treated with saline or SOD. Before Cx occlusion, coronary blood flow increased, and vascular resistance decreased (both p less than 0.01) in response to EDRF-dependent vasodilator acetylcholine as well as EDRF-independent vasodilator nitroglycerin. After Cx reperfusion, resting Cx coronary blood flow and vascular resistance were similar to the preocclusion values. In the saline-treated animals, there was evidence of myocardial dysfunction, which was measured by segmental shortening (-6 +/- 2% vs. 10 +/- 2%). Furthermore, increase in Cx coronary blood flow and reduction in vascular resistance in response to both vasodilators were significantly (p less than 0.01) impaired; these occurrences suggested loss of coronary vasodilator reserve. Myocardial histology showed extensive capillary plugging by neutrophils in the Cx-supplied myocardium. Myocardial myeloperoxidase activity, an index of neutrophil infiltration, was also increased in the Cx compared with the left anterior descending coronary artery region (p less than 0.02). Treatment of dogs with SOD, started at the end of Cx occlusion and continued during reperfusion, exerted significant (p less than 0.01) protective effect against reperfusion-induced attenuation of coronary vasodilator reserve in response to both acetylcholine and nitroglycerin. Loss of myocardial function (segmental shortening 5 +/- 1% vs. 10 +/- 1%) was less than in the saline-treated animals (p less than 0.01). Cx region-myocardial neutrophil accumulation and myeloperoxidase activity were also less (p less than 0.02) in the SOD-treated than in the saline-treated dogs. These observations suggest that coronary reperfusion impairs coronary vasodilator reserve in intact dogs. This impairment can be modified by treatment of animals with SOD before reperfusion. Capillary plugging by neutrophils may contribute to the altered coronary vasodilator reserve observed in the immediate postreperfusion period, and SOD modifies this reperfusion-induced impairment.

Deleterious effects of oxygen radicals in ischemia/reperfusion. Resolved and unresolved issues

Oxygen free radicals are known to be generated during periods of ischemia followed by reperfusion. There is still some controversy, however, concerning the use of electron paramagnetic resonance spectroscopy to accurately detect and identify the free radical species that are formed. There is no doubt that oxygen radicals are deleterious to the myocardium; free radicals cause left ventricular dysfunction and structural damage to myocytes and endothelial cells in both in vitro and in vivo preparations. Potential sources of these cytotoxic oxygen species include the xanthine oxidase pathway, activated neutrophils, mitochondria, and arachidonate metabolism, yet the crucial source of free radicals in the setting of ischemia and reperfusion is unresolved. There is little doubt that oxygen radicals play a role in the phenomenon of stunned myocardium induced by brief periods of ischemia followed by reperfusion; numerous studies have consistently observed that pretreatment with free radical scavengers and antioxidants enhances contractile function of stunned, postischemic tissue. Whether oxygen free radical scavengers administered only during reperfusion enhance recovery of stunned myocardium in models of brief ischemia remains to be determined. In models of prolonged ischemia (2 hours) followed by reperfusion, we have not observed a beneficial effect of scavengers on stunned myocardium. The issue of whether oxygen free radical scavengers are capable of reducing so-called irreversible or lethal reperfusion injury remains, in our opinion, unresolved. Although some studies have observed that agents such as superoxide dismutase and catalase reduce infarct size in ischemia and reperfusion models, many others have reported negative results. Additional studies will be needed to resolve this ongoing controversy. Oxygen free radicals may also contribute to reperfusion-induced arrhythmias in rodent heart preparations; however, less data are available in other animal models. The concept of reperfusion injury should not be considered a deterrent to reperfusion for the treatment of acute myocardial infarcts in the clinical setting. Thrombolytic therapy reduces myocardial infarct size, enhances recovery of left ventricular function, and improves survival. Whether incremental beneficial effects on these parameters will be obtained when oxygen radical-scavenging agents are used as adjuvant therapy to thrombolysis in patients remains to be determined.

Investigations on the influence of copper succinate on the production of superoxide anion radicals by bovine small intestinal mucosa cells

The effect of an experimental ischemia lasting for 45 minutes and a subsequent period of reperfusion of equal length on the activity of xanthine oxidase (XO) and microsomal NADPH-cytochrome P450 reductase (NADPH-CR) were investigated in the small intestinal mucosa of male neonatal calves of the breed German "Schwarzbunte". The activity of the NADPH-CR was determined by chemiluminescence. The activity of XO decreased during ischemia, but rose to values above the control level following reperfusion. 5 mg of Cu2(succinate)2 (CuSu) administered either intraarterially or intraluminally during reperfusion prevented the rise in XO. Formation of malondialdehyde decreased in the presence of CuSu. The NADPH-CR likewise showed subnormal activity values during ischemia, but also remained at a low level during reperfusion. The activity of this enzyme was further lowered by local intraarterial or intraluminal administration of 5 mg of CuSu and by 120 mg of CuSu administered intravenously during the reperfusion. These results are discussed with regard to the superoxide anion radical induced tissue lesions observed during reperfusion.

Free-radical formation by mitomycin C and its novel analogs in cardiac microsomes and the perfused rat heart

Using a spin-trapping technique, we have examined free-radical formation by mitomycin C and its analogs, BMY 25282 and BMY 25067, in rat cardiac microsomes and isolated perfused rat hearts. All three drugs stimulated 2--4-fold OH radical formation in cardiac microsomes which was inhibited by SOD and catalase. Superoxide anion radical was also detected in the presence of diethylenetetraaminopentaacetic acid. Addition of DMSO yielded methyl radicals, thus indicating the production of free OH under these conditions. Similar stimulation of OH formation (2--3-fold) in the perfusates from rat hearts was detected with all three drugs. Perfusion with catalase (550 U/ml) completely suppressed the OH signal both in the presence and absence of the drugs, thus suggesting the intermediacy of hydrogen peroxide. However, BMY 25067-induced OH formation was more sensitive to inhibition by superoxide dismutase (SOD) and the iron chelator ICRF-187. Perfusion with DMSO produced methyl radicals at the expense of OH in the presence of all three drugs. SOD and catalase inhibited DMPO-OH signals, indicating that most of the OH formation was extracellular in this setting. While mitomycin C and BMY 25067 (up to 10 microM) did not affect the heart rate, perfusion with 10 microM BMY 25282 caused acute arrhythmia and cardiac standstill within 20 min. An initial surge in OH formation (2-fold) accompanied this cardiotoxic effect. Both the arrhythmia and the free radical signal were partially blocked by SOD, catalase and ICRF-187, indicating that iron-dependent oxygen radical formation from BMY-25282 (and possibly other compounds) is involved, in part, in inducing toxic manifestations in the rat heart and possibly in clinic.

Sensitivity to oxidants of mitochondrial and sarcoplasmic reticular calcium uptake in saponin-treated cardiac myocytes

Calcium transport functions of mitochondria and sarcoplasmic reticulum (SR) were studied without prior extraction using isolated rat heart myocytes permeabilized with saponin. Calcium uptake by SR was rapid and its affinity was high in comparison to calcium uptake by mitochondria, which had a higher capacity. The sensitivity of uptake to two oxidants, H2O2 and HOCl (hypochlorous acid), depended on the cytosolic calcium concentration; when this was similar to the concentration in diastole (180 nM), HOCl inhibited calcium uptake by mitochondria and SR, whereas when the calcium concentration was 750 nM, mitochondrial calcium uptake showed relatively high resistance, although SR uptake was still markedly inhibited by HOCl. Calcium uptake of both mitochondria and SR was less sensitive to the action of H2O2 than to HOCl, and the H2O2 effect was less dependent on the cytosolic calcium concentration. Therefore, HOCl, when produced by activated leukocytes and supplied to the heart cells, may seriously impair the excitation-contraction coupling function of SR, whereas H2O2, possibly generated directly by mitochondria or generated from superoxide anions, may be tolerated relatively well by heart SR and mitochondria.

Ischemia-induced changes in myocardial paramagnetic metabolites: implications for intracellular oxy-radical generation

Evidence to identify the cellular sources of oxy-radical generation in myocardium has been of an indirect nature. We have used low-temperature ESR spectroscopy to identify and characterize ischemia-induced changes in myocardial paramagnetic metabolites. Iron-sulfur proteins associated with the NADH or succinate dehydrogenases of the mitochondrial electron-transport chain were progressively reduced with the onset and development of ischemia. This study provides direct evidence for ischemia-induced changes in an intracellular source of superoxide radical generation that may contribute to oxy-radical production during reperfusion.

Stimulated human neutrophils damage cardiac sarcoplasmic reticulum function by generation of oxidants

An important aspect of myocardial injury is the role of neutrophils in post-ischemic damage to the heart. Stimulated neutrophils initiate a series of reactions that produce toxic oxidizing agents. Superoxide rapidly dismutases to H2O2 and neutrophils contain myeloperoxidase which catalyzes the oxidation of Cl- by H2O2 to yield hypochlorous acid (HOCl). The highly reactive HOCl combines non-enzymatically with nitrogenous compounds to generate long-lived, non-radical oxidants, monochloramine and taurine N-monochloramine. We investigated the role of oxygen radicals and long-lived oxidants on cardiac sarcoplasmic reticulum function, which plays a major role in the regulation of intracellular Ca2+ and thereby in the generation of force. Incubation of sarcoplasmic reticulum with phorbol myristate acetate (PMA)-stimulated neutrophils (4 x 10(6) cells/ml) significantly decreased calcium uptake rate (0.85 +/- 0.11 to 0.11 +/- 0.06 mumol/min per mg) and Ca2+-ATPase activity (1.67 +/- 0.08 to 0.46 +/- 0.10 mumol/min per mg). Inclusion of myeloperoxidase inhibitors (cyanide, sodium azide and 3-amino-1,2,4-triazole), catalase, superoxide dismutase plus catalase, and alpha-tocopherol significantly protected (P less than 0.01) calcium uptake rates and Ca2+-ATPase activity of sarcoplasmic reticulum. Superoxide dismutase (10 microgram/ml) alone or deferoxamine (1 mM) had no protective effect in this system. The maximum inhibition of sarcoplasmic reticulum function was observed with (3-4) x 10(6) cells/ml in 4-6 min. HOCl and NH2Cl inhibited calcium uptake rate and Ca2+-ATPase activity of sarcoplasmic reticulum in a dose-dependent manner (2-20 microM), whereas H2O2 damaged sarcoplasmic reticulum at concentrations ranging from 5 to 25 mM. HOCl (20 microM) inhibited 80-90% of Ca2+-uptake rate and Ca2+-ATPase activity and L-methionine (0.1-1 mM) provided complete protection. We conclude that stimulated neutrophils damage cardiac sarcoplasmic function by generation of myeloperoxidase-catalyzed oxidants.

Thiobarbituric acid-reactive malondialdehyde formation during superoxide-dependent, iron-catalyzed lipid peroxidation: influence of peroxidation conditions

A systematic study of the influence of biological lipid peroxidation conditions on lipid hydroperoxide decomposition to thiobarbituric acid-reactive malondialdehyde is presented. A superoxide-dependent, iron-catalyzed peroxidation system was employed with xanthine oxidase plus hypoxanthine plus ferric iron-adenosine diphosphate complex as free radical generator. Purified cardiac membrane phospholipid (as liposomes) was the peroxidative target, and 15-hydroperoxy-eicosatetraenoic acid was used as a standard lipid hydroperoxide. Exposure of myocardial phospholipid to free radical generator at physiological pH (7.4) and temperature (37 degrees C) was found to support not only phospholipid peroxidation, but also rapid lipid hydroperoxide breakdown and consequent malondialdehyde formation during peroxidation. Under lipid peroxidation conditions, oxidative injury to the phospholipid polyunsaturated fatty acids required superoxide radical and ferric iron-adenosine diphosphate complex, whereas 37 degrees C temperature and trace iron were sufficient for lipid hydroperoxide decomposition to malondialdehyde. Harsh thiobarbituric acid-test conditions following peroxidation were not mandatory for either lipid hydroperoxide breakdown or thiobarbituric acid-reactive malondialdehyde formation. However, hydroperoxide decomposition that had begun in the peroxidation reaction could be completed during a subsequent thiobarbituric acid test in which no lipid autoxidation took place. Iron was more critical than heat in promoting the observed hydroperoxide decomposition to malondialdehyde during the lipid peroxidation reaction at 37 degrees C and pH 7.4. These data demonstrate that the radical generator, at physiological pH and temperature, serves a dual role as both initiator of membrane phospholipid peroxidation and promotor of lipid peroxide breakdown and thiobarbituric acid-reactive malondialdehyde formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Spin trapping evidence for radical generation by isolated hearts and cultured heart cells

The spin trap 5,5-dimethyl-1-pyrroline-1-oxide (DMPO) has been applied to monitor the generation of free oxy-radicals in samples derived from isolated hearts and heart cells. .OH was trapped in the effluent of isolated hearts in the early phase of reperfusion following an ischemia time of only 10 min. Radical detection was possible even when the cardioactive DMPO was added to the effluent after draining off the heart, demonstrating that the short-lived .OH was generated by components released from the affected heart. These results support the hypothesis that radicals are of relevance for reperfusion injury. By omitting antioxidants commonly used for incubation media of cultured cells, it was possible for the first time to demonstrate the formation of .OH in the incubation solution of cardiac cells.

Propranolol as xanthine oxidase inhibitor: implications for antioxidant activity

Propranolol is the beta-blocker most widely used in the management of cardiovascular disorders. It has been proposed that propranolol may act as a "chain-breaking" antioxidant. We have directly examined the ability of propranolol to inhibit superoxide-dependent, iron-promoted cardiac membrane phospholipid peroxidation, with xanthine oxidase (XOD) as a physiologically-recognized, enzymatic superoxide generator. Our results demonstrate that propranolol not only protects cardiac-membrane lipid from peroxidative damage, but also acts as a simple, reversible XOD inhibitor, noncompetitive with xanthine substrate. Propranolol, at effective antiperoxidant and XOD-inhibitory concentrations, cannot scavenge superoxide radical. The antiperoxidative profile of propranolol resembles that of the known XOD inhibitor allopurinol, although allopurinol, a tight-binding substrate-analog competitive with xanthine, inhibits XOD in a manner mechanistically very different from that of propranolol. Furthermore, the antiperoxidative profiles of both propranolol and allopurinol do not resemble those of chain-breaking antioxidants such as alpha-tocopherol. These data, along with the tendency of propranolol to concentrate in myocardial membranes and cytosol, suggest that the observed antioxidant action of propranolol, as a consequence of XOD inhibition, could play a pharmacologic role in propranolol's cardioprotective effects.

Cytotoxic effect of phenazine methosulphate on the isolated frog heart

1. Perfusion of isolated frog hearts with phenazine methosulphate (PMS) at 0.3-1.0 mM caused a fall in amplitude and frequency of beat, and finally a cessation of contractile activity, together with widespread ultrastructural damage. 2. Sarcolemma blebs were a characteristic feature of the damage. 3. No protection was provided by mannitol (10-100 mM), superoxide dismutase, catalase or a pHo of 6.6. 4. Potassium ferricyanide (1-6 mM), an artificial electron acceptor, also caused ultrastructural damage. 5. Comparisons are made with the oxygen paradox of mammalian heart, and the possible role of Ca2+ fluxes and oxygen radicals in muscle damage are discussed.

Cardiac membrane vitamin E and malondialdehyde levels in heart muscle of normotensive and spontaneously-hypertensive rats

The vitamin E (alpha-tocopherol) and free and bound malondialdehyde (MDA) in ventricular heart muscle and myocardial membrane from Wistar-Kyoto (W/K) normotensive and spontaneously hypertensive (SH) rats have been measured directly by high performance liquid chromatography (HPLC). Thiobarbituric acid-reactive substance (TBA-RS) in the myocardium and heart-muscle membrane of the two strains was also quantified by a colorimetric TBA test. It was found that SH-rat myocardium and myocardial membrane contained more than 3-fold less alpha-tocopherol than did heart muscle and cardiac membrane of the normotensive rat. Coincident with this relative vitamin E deficiency were several-fold greater amounts of MDA and TBA-RS in SH-rat myocardium and myocardial membrane. Most (87%) of the MDA in SH-rat heart muscle, but only 40% in W/K-rat heart muscle, was free (i.e., unbound). These results offer direct evidence that SH-rat myocardium is vitamin E-deficient and highly peroxidative, relative to cardiac muscle of the normotensive W/K parent strain. The lower vitamin E content of SH-rat myocardium is particularly striking, because SH-rat myocardial membrane was found to contain approximately 35% more phospholipid than myocardial membrane in the W/K rat. Although the amounts of myocardial TBA-RS are greater in the SH strain, they do not reflect the actual MDA profiles of the heart muscles or the heart membranes and cannot be used as a quantitative index of cardiac oxidative-injury status due to non-MDA TBA-RS in both strains.

Cytotoxic effect of oxygen on the skeletal muscle of mouse diaphragm

Incubation of the isolated mouse diaphragm with a high rate of oxygenation (10 ml s-1, 95% O2 + 5% CO2) causes a characteristic cellular damage with widely-separated myofibrils and swollen sarcotubular system within 10 min. This damage was ameliorated by inhibitors of the hydroxyl radical (.OH), desferrioxamine, dimethyl thiourea and 120 mM mannitol, and by incubation at 8 degrees C. It was not prevented either by inhibitors of the pathway leading to sarcolemma damage (nordihydroguaiaretic acid, alpha-tocopherol, butylated hydroxytoluene) nor by agents and treatments that inhibit the oxygen paradox of cardiac muscle (glucose, omission of extracellular calcium, incubation at 30 degrees C, superoxide dismutase and catalase). Nevertheless there are similarities between these two types of damage triggered by O2 and the possibility that in both an NAD(P)H oxidase is stimulated and cytotoxic oxygen radicals are generated is discussed.

Effect of oxygen-derived free radicals and oxidants on the degradation in vitro of membrane phospholipids

The abilities of chemically generated hydroxyl radical (OH.), superoxide anion (O.-) and hydrogen peroxide (H2O2) to degrade rat myocardial membrane phospholipids previously labeled with [1-14C]arachidonic acid were studied. HO. and H2O2, but not O2.-, caused the degradation of phosphatidylcholine (PC), phosphatidylethanolamine (PE), and phosphatidylinositol (PI). With OH. and H2O2, the loss of radiolabel in PC was accompanied by an increase in the radiolabel of lysophosphatidylcholine (LPC), but not in that of free fatty acid (FFA). These results suggest the hydrolysis of 1-oxygen ester bond of PC by HO. and that H2O2 and that HO. and H2O2, but not O.-, are detrimental to the structure and function of membrane phospholipids. However, since microM amounts of HO. and mM amounts of H2O2 were necessary to affect the membrane phospholipids, it is likely that in the reperfused myocardium only HO., but not H2O2, may directly cause the breakdown of membrane phospholipids.

Direct detection of radical production in the ischaemic and reperfused myocardium: current status

Electron spin resonance (e.s.r.) spectroscopy, which is a specific method for directly detecting free radicals in biological systems, has now been used in a number of studies to examine free radical generation in both ischaemic and reperfused myocardial tissue. This review critically assesses the information which has been obtained to date with particular reference to the elucidation of the nature and source of the radicals observed in these studies.

Concepts related to the study of reactive oxygen and cardiac reperfusion injury

The phenomenon of reperfusion injury remains poorly defined. Questions remain about whether injury occurs in addition to that produced by hypoxia or ischemia, or whether the observed changes simply reflect the unmasking of an underlying injury. Various pathological processes which occur upon the return of oxygen to hypoxic and ischemic heart tissue have been quantitated to assess the extent of reperfusion injury, yet it is not known if they reflect identical or different processes. In addition, the mechanism(s) responsible for these diverse changes may not be the same in the various model systems used to study reperfusion injury. Although reactive oxygen species clearly are formed at reperfusion, conclusive evidence that they are producing injury, particularly during the first seconds, is not available. Several sources of these reactive oxygen species have been proposed but none have been clearly linked with injury in several species or model systems. As research in the field of reperfusion injury continues, it is imperative for scientists to clearly define the system they are using so that studies examining mechanisms of cell lysis at reperfusion are not confused with those assessing the occurrence and mechanisms of damage in addition to that produced by oxygen deprivation.

Evaluation of free radical and lipid peroxide formation during global ischemia and reperfusion in isolated perfused rat heart

Free radical species have been implicated as important agents involved in myocardial ischemic and reperfusion injuries. In our study, formation of free radicals was measured directly with electron paramagnetic resonance spectroscopy before ischemia, during 10 minutes of global ischemia, and 20 seconds after reperfusion in the rat heart. We also investigated the formation of thiobarbituric acid-reactive material as index of lipoperoxidation induced by free radicals and measured arrhythmias. Production of free radicals takes place during ischemia since the signal intensity with a g value of 2.004 attributed to free radical species was increased by 50% after 10 minutes of global ischemia. In hearts reperfused with oxygenated perfusate for 20 seconds, the signal doubled. These experiments supply evidence that free radicals are generated in isolated rat heart during a short period of global ischemia and reperfusion. However, this increase was not associated with a concomitant increase of lipid peroxides in the myocardium nor with the development of reperfusion arrhythmias.

Protection of cardiac membrane phospholipid against oxidative injury by calcium antagonists

Calcium antagonists representative of the four major chemical classes were assessed for their abilities to prevent peroxidation of rat heart membrane lipids through xanthine oxidase-dependent, superoxide-driven, iron-promoted oxygen radical chemistry. The dihydropyridines nifedipine and nitrendipine did not affect peroxidation, even at a concentration (500 microM) approaching their solubility limit. The benzothiazepine diltiazem did protect the cardiac lipids against oxidative injury, but at high micromolar concentrations: 50% inhibition of peroxidation (antiperoxidant IC50) required 510 microM diltiazem. The phenylalkylamines verapamil and gallopamil (D-600) were likewise weak antiperoxidants (approximately 35% inhibition of peroxidation at 500 microM). In contrast, two other alkylamines, bepridil and prenylamine, were very effective membrane lipid protectants with respective antiperoxidant IC50 values of 55 and 75 microM. The diphenylpiperazines flunarizine (IC50 = 190 microM) and cinnarizine (IC50 = 180 microM) displayed moderate antiperoxidant activity. No Ca2+ antagonist inhibited xanthine oxidase under conditions whereby 10 microM allopurinol inhibited enzyme activity by 50%. The effects of the Ca2+ antagonist-antiperoxidants on the kinetics of cardiac membrane lipid peroxidation indicate that they inhibit peroxidation by intercepting oxy- and/or lipid free radical intermediates. These data raise the possibility that antiperoxidant action may contribute to the spectrum of pharmacologic and therapeutic activities of certain Ca2+ antagonists.