1
|
Pan G, Cui B, Han M, Lin L, Li Y, Wang L, Guo S, Yin Y, Zhan H, Li P. Puerarin inhibits NHE1 activity by interfering with the p38 pathway and attenuates mitochondrial damage induced by myocardial calcium overload in heart failure rats. Acta Biochim Biophys Sin (Shanghai) 2024; 56:270-279. [PMID: 38282474 PMCID: PMC10984851 DOI: 10.3724/abbs.2023269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/11/2023] [Indexed: 01/30/2024] Open
Abstract
Previous studies have shown that puerarin plays a key role in protecting humans and animals from cardiovascular diseases. The exact mechanism of the therapeutic effect of puerarin on various cardiovascular diseases (protective effect on cardiomyocytes) is still unclear. In the present study, we identify the role of puerarin in an animal model of experimental heart failure (HF) and explore its underlying mechanisms. The HF rat model is induced by intraperitoneal injection of adriamycin (ADR), and puerarin is administered intragastrically at low, medium, and high concentrations. We demonstrate that puerarin significantly improves myocardial fibrosis and inflammatory infiltration and, as a result, improves cardiac function in ADR-induced HF rats. Mechanistically, we find for the first time that puerarin inhibits overactivated Na +/H + exchange isoform 1 (NHE1) in HF, which may improve HF by decreasing Na + and Ca 2+ ion concentrations and attenuating mitochondrial damage caused by calcium overload; on the other hand, puerarin inhibits the activation of the p38 pathway in HF, reduces the expressions of TGF-β and proinflammatory cytokines, and suppresses myocardial fibrosis. In conclusion, our results suggest that Puerarin is an effective drug against HF and may play a protective role in the myocardium by inhibiting the activation of p38 and its downstream NHE1.
Collapse
Affiliation(s)
- Guopin Pan
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Baoyue Cui
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
- Nanyang Second General HospitalNanyang473001China
| | - Mingming Han
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Laibiao Lin
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Yinlan Li
- College of PharmacyHeilongjiang University of Chinese MedicineHarbin150040China
| | - Ling Wang
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Shuang Guo
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning437100China
| | - Yaling Yin
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Heqin Zhan
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
| | - Peng Li
- Sino-UK Joint Laboratory of Brain Function and Injury and Department of Physiology and NeurobiologyHenan International Joint Laboratory of Cardiovascular Remodeling and Drug InterventionSchool of Basic Medical SciencesCollege of PharmacyXinxiang Medical UniversityXinxiang453003China
- Hubei Key Laboratory of Diabetes and AngiopathyHubei University of Science and TechnologyXianning437100China
| |
Collapse
|
2
|
Jaquenod De Giusti C, Blanco PG, Lamas PA, Carrizo Velasquez F, Lofeudo JM, Portiansky EL, Alvarez BV. Carbonic anhydrase II/sodium-proton exchanger 1 metabolon complex in cardiomyopathy of ob -/- type 2 diabetic mice. J Mol Cell Cardiol 2019; 136:53-63. [PMID: 31518570 DOI: 10.1016/j.yjmcc.2019.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 07/17/2019] [Indexed: 10/26/2022]
Abstract
Heart failure is the leading cause of death among diabetic people. Cellular and molecular entities leading to diabetic cardiomyopathy are, however, poorly understood. Coupling of cardiac carbonic anhydrase II (CAII) and Na+/H+ exchanger 1 (NHE1) to form a transport metabolon was analyzed in obese type 2 diabetic mice (ob-/-) and control heterozygous littermates (ob+/-). Echocardiography showed elevated systolic interventricular septum thickness and systolic posterior wall thickness in ob-/- mice at 9 and 16 weeks. ob-/- mice showed increased left ventricular (LV) weight/tibia length ratio and increased cardiomyocyte cross sectional area as compared to controls, indicating cardiac hypertrophy. Immunoblot analysis showed increased CAII expression in LV samples of ob-/-vs. ob+/- mice, and augmented Ser703 phosphorylation on NHE1 in ob-/- hearts. Reciprocal co-immunoprecipitation analysis showed strong association of CAII and NHE1 in LV samples of ob-/- mice. NHE1-dependent rate of intracellular pH (pHi) normalization after transient acid loading of isolated cardiomyocytes was higher in ob-/- mice vs. ob+/-. NHE transport activity was also augmented in cultured H9C2 rat cardiomyoblasts treated with high glucose/high palmitate, and it was normalized after CA inhibition. We conclude that the NHE1/CAII metabolon complex is exacerbated in diabetic cardiomyopathy of ob-/- mice, which may lead to perturbation of pHi and [Na+] and [Ca2+] handling in these diseased hearts.
Collapse
Affiliation(s)
- Carolina Jaquenod De Giusti
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120, 1900 La Plata, Argentina; Established Investigators of CONICET, Argentina
| | - Paula G Blanco
- Servicio de Cardiología, Facultad de Ciencias Veterinarias, UNLP, Argentina; Established Investigators of CONICET, Argentina
| | - Paula A Lamas
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120, 1900 La Plata, Argentina
| | - Fernanda Carrizo Velasquez
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120, 1900 La Plata, Argentina
| | - Juan M Lofeudo
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120, 1900 La Plata, Argentina
| | - Enrique L Portiansky
- Laboratorio de Análisis de Imágenes, Facultad de Ciencias Veterinarias, UNLP, Argentina; Established Investigators of CONICET, Argentina
| | - Bernardo V Alvarez
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120, 1900 La Plata, Argentina; Established Investigators of CONICET, Argentina.
| |
Collapse
|
3
|
Ciocci Pardo A, Díaz RG, González Arbeláez LF, Pérez NG, Swenson ER, Mosca SM, Alvarez BV. Benzolamide perpetuates acidic conditions during reperfusion and reduces myocardial ischemia-reperfusion injury. J Appl Physiol (1985) 2017; 125:340-352. [PMID: 29357509 DOI: 10.1152/japplphysiol.00957.2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
During ischemia, increased anaerobic glycolysis results in intracellular acidosis. Activation of alkalinizing transport mechanisms associated with carbonic anhydrases (CAs) leads to myocardial intracellular Ca2+ increase. We characterize the effects of inhibition of CA with benzolamide (BZ) during cardiac ischemia-reperfusion (I/R). Langendorff-perfused isolated rat hearts were subjected to 30 min of global ischemia and 60 min of reperfusion. Other hearts were treated with BZ (5 μM) during the initial 10 min of reperfusion or perfused with acid solution (AR, pH 6.4) during the first 3 min of reperfusion. p38MAPK, a kinase linked to membrane transporters and involved in cardioprotection, was examined in hearts treated with BZ in presence of the p38MAPK inhibitor SB202190 (10 μM). Infarct size (IZ) and myocardial function were assessed, and phosphorylated forms of p38MAPK, Akt, and PKCε were evaluated by immunoblotting. We determined the rate of intracellular pH (pHi) normalization after transient acid loading in the absence and presence of BZ or BZ + SB202190 in heart papillary muscles (HPMs). Mitochondrial membrane potential (ΔΨm), Ca2+ retention capacity and Ca2+-mediated swelling after I/R were also measured. BZ, similarly to AR, reduced IZ, improved postischemic recovery of myocardial contractility, increased phosphorylation of Akt, PKCε, and p38MAPK, and normalized ΔΨm and Ca2+ homeostasis, effects abolished after p38MAPK inhibition. In HPMs, BZ slowed pHi recovery, an effect that was restored after p38MAPK inhibition. We conclude that prolongation of acidic conditions during reperfusion by BZ could be responsible for the cardioprotective benefits of reduced infarction and better myocontractile function, through p38MAPK-dependent pathways. NEW & NOTEWORTHY Carbonic anhydrase inhibition by benzolamide (BZ) maintains acidity, decreases infarct size, and improves postischemic myocardial dysfunction in ischemia-reperfusion (I/R) hearts. Protection afforded by BZ mimicked the beneficial effects elicited by an acidic solution (AR). Increased phosphorylation of p38MAPK occurs in I/R hearts reperfused with BZ or with AR. Mitochondria from I/R hearts possess abnormal Ca2+ handling and a more depolarized membrane potential compared with control hearts, and these changes were restored by treatment with BZ or AR.
Collapse
Affiliation(s)
- Alejandro Ciocci Pardo
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| | - Romina G Díaz
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| | - Luisa F González Arbeláez
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| | - Néstor G Pérez
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| | - Erik R Swenson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Department of Veterans Affairs Puget Sound Health Care System , Seattle, Washington
| | - Susana M Mosca
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| | - Bernardo V Alvarez
- Centro de Investigaciones Cardiovasculares CIC-CONICET, Facultad de Ciencias Médicas, Universidad Nacional de La Plata , La Plata , Argentina
| |
Collapse
|
4
|
Kane AE, Howlett SE. Novel cardioprotection strategies for the aged heart: evidence from pre-clinical studies. Clin Exp Pharmacol Physiol 2017; 43:1251-1260. [PMID: 27626269 DOI: 10.1111/1440-1681.12668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 11/30/2022]
Abstract
The incidence of cardiovascular disease is rising as the population ages. This has led to an increase in the need to perform cardiac surgery in older patients. However, aged hearts are particularly susceptible to reperfusion injury following periods of myocardial ischaemia that occur during cardiac surgery. Indeed, older adults experience myocardial dysfunction and reduced survival post-surgery compared to younger people and certain groups, including older women and frail older adults, are at particular risk. This highlights the need to design cardioprotective strategies specifically for the ageing heart. Cardioprotection during surgery is often accomplished by perfusing the heart with chemical arresting agents, known as cardioplegic solutions. New protective strategies have been developed and tested in animal models, where cardioplegic solutions have been modified by changing their temperature, chemical components and/or the frequency of delivery. In addition, drugs designed to activate cardioprotective mechanisms or to inhibit mechanisms involved in injury have been added to improve the efficacy of these solutions. However, most experimental studies have developed and optimized cardioplegic solutions in hearts from younger male animals. This review discusses pre-clinical models used to optimize cardioplegic solutions, with an emphasis on the few studies that have used hearts from older animals. Pharmacologic agents that have been shown to enhance the benefits of cardioplegia in younger hearts and could, in theory, protect vulnerable older hearts are also considered. We emphasize the need to conduct studies in frail older animals of both sexes to facilitate translation of laboratory-based observations to the clinic.
Collapse
Affiliation(s)
- Alice E Kane
- Department of Pharmacology, Dalhousie University, NS, B3H 4R2, Canada
| | - Susan E Howlett
- Department of Pharmacology, Dalhousie University, NS, B3H 4R2, Canada.,Department of Medicine (Geriatric Medicine), Dalhousie University, Halifax, NS, B3H 4R2, Canada.,Institute of Cardiovascular Sciences, University of Manchester, Manchester, UK
| |
Collapse
|
5
|
Vargas LA, Pinilla OA, Díaz RG, Sepúlveda DE, Swenson ER, Pérez NG, Álvarez BV. Carbonic anhydrase inhibitors reduce cardiac dysfunction after sustained coronary artery ligation in rats. Cardiovasc Pathol 2016; 25:468-477. [PMID: 27614168 DOI: 10.1016/j.carpath.2016.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Two potent carbonic anhydrase (CA) inhibitors with widely differing membrane permeability, poorly diffusible benzolamide (BZ), and highly diffusible ethoxzolamide (ETZ) were assessed to determine whether they can reduce cardiac dysfunction in rats subjected to coronary artery ligation (CAL)-induced myocardial infarction. METHODS AND RESULTS Rats with evidence of heart failure (HF) at 32 weeks following a permanent left anterior coronary artery occlusion were treated with placebo, BZ, or ETZ (4 mg kgday-1) for 4 weeks at which time left ventricular function and structure were evaluated. Lung weight/body weight (LW/BW) ratio increased in CAL rats by 17±1% vs. control, suggesting pulmonary edema. There was a trend for BZ and ETZ to ameliorate the increase in LW/BW by almost 50% (9±5% and 9±8%, respectively, versus CAL) (P=.16, NS). Echocardiographic assessment showed decreased left ventricular midwall shortening in HF rats, 21±1% vs. control 32±1%, which was improved by BZ to 29±1% and ETZ to 27±1%, and reduced endocardial shortening in HF rats 38±3% vs. control 62±1%, partially restored by BZ and ETZ to ~50%. Expression of the hypoxia-inducible membrane-associated CAIX isoform increased by ~60% in HF rat hearts, and this effect was blocked by ETZ. CONCLUSIONS We conclude that CAL-induced myocardial interstitial fibrosis and associated decline in left ventricular function were diminished with BZ or ETZ treatment. The reductions in cardiac remodeling in HF with both ETZ and BZ CA inhibitors suggest that inhibition of a membrane-bound CA appears to be the critical site for this protection.
Collapse
Affiliation(s)
- Lorena A Vargas
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Buenos Aires, Argentina
| | - Oscar A Pinilla
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Buenos Aires, Argentina
| | - Romina G Díaz
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Buenos Aires, Argentina
| | - Diana E Sepúlveda
- Departamento de Patología, Universidad Favaloro, C1078AAJ Ciudad Autónoma de Buenos Aires, Argentina
| | - Erik R Swenson
- Department of Medicine, Pulmonary and Critical Care Medicine, VA Puget Sound Health Care System, University of Washington, Seattle, WA 98108, USA
| | - Néstor G Pérez
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Buenos Aires, Argentina
| | - Bernardo V Álvarez
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 1900 La Plata, Buenos Aires, Argentina.
| |
Collapse
|
6
|
Interaction of sodium bicarbonate and Na+/H+ exchanger inhibition in the treatment of acute metabolic acidosis in pigs. Crit Care Med 2015; 43:e160-9. [PMID: 25785519 DOI: 10.1097/ccm.0000000000000962] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Administration of NaHCO3 does not improve cellular function or reduce the mortality of acute lactic acidosis. This might be related to aggravation of intracellular acidosis, but it could also be due to activation of Na+/H+ exchanger with a deleterious increment in intracellular calcium ([Ca2+]i). This study examined the impact of coadministration of NaHCO3 and a selective inhibitor of Na+/H+ exchanger, sabiporide on cardiovascular function, changes in proinflammatory cytokines, and organ function in a model of acute lactic acidosis produced by hemorrhagic hypotension followed by infusion of lactic acid. DESIGN Experimental, prospective study. SETTING Medical Center research laboratory. SUBJECTS Male Yorkshire pigs. INTERVENTIONS Anesthetized pigs were subjected to hypovolemia for 30 minutes and followed by DL-lactic acid infusion, and then either saline or sodium bicarbonate was infused. MEASUREMENTS AND MAIN RESULTS Hypovolemia followed by a DL-lactic acid infusion resulted in severe acidemia with a blood pH~6.8. Administration of NaHCO3 did not improve cardiovascular performance or decrease the levels of proinflammatory responses, whereas administration of sabiporide prior to acid or NaHCO3 infusion improved cardiopulmonary performance and blood oxygenation, reduced nuclear factor-κB activation, neutrophil accumulation, and proinflammatory cytokine production, and attenuated organ injury. Exposure of rat cardiac myocytes to a pH of 7.2 led to a marked increase of [Ca2+]i, and release of lactate dehydrogenase from cells which were further augmented after increase in external pH by addition of NaHCO3. Both the increase in [Ca2+]i and release of lactate dehydrogenase were attenuated in the presence of sabiporide. CONCLUSIONS Coadministration of Na/H exchanger inhibitor with sodium bicarbonate improves cardiovascular performances, reduces proinflammatory responses, and attenuates organ injury. This improvement in these variables appears to be related to prevention of a rise in intracellular calcium occurring after both exposures to acid and bicarbonate.
Collapse
|
7
|
Lin X, Lee D, Wu D. Sabiporide improves cardiovascular function and attenuates organ injury from severe sepsis. J Surg Res 2014; 188:231-7. [DOI: 10.1016/j.jss.2013.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/02/2013] [Accepted: 12/06/2013] [Indexed: 10/25/2022]
|
8
|
Alvarez BV, Villa-Abrille MC. Mitochondrial NHE1: a newly identified target to prevent heart disease. Front Physiol 2013; 4:152. [PMID: 23825461 PMCID: PMC3695379 DOI: 10.3389/fphys.2013.00152] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/09/2013] [Indexed: 11/23/2022] Open
Abstract
Mitochondrial damage has been associated with early steps of cardiac dysfunction in heart subjected to ischemic stress, oxidative stress and hypertrophy. A common feature for the mitochondrial deterioration is the loss of the mitochondrial membrane potential (ΔΨ m) with the concomitant irreversible opening of the mitochondrial permeability transition pore (MPTP) which follows the mitochondrial Ca2+ overload, and the subsequent mitochondrial swelling. We have recently characterized the expression of the Na+/H+ exchanger 1 (mNHE1) in mitochondrial membranes. This surprising observation provided a unique target for the prevention of the Ca2+-induced MPTP opening, based on the inhibition of the NHE1 m. In this line, inhibition of NHE1 m activity and/or reduction of NHE1 m expression decreased the Ca2+-induced mitochondrial swelling and the release of reactive oxygen species (ROS) in isolated cardiac mitochondria and preserved the ΔΨ m in isolated cardiomyocytes. Mitochondrial NHE1 thus represents a novel target to prevent cardiac disease, opening new avenues for future research.
Collapse
Affiliation(s)
- Bernardo V Alvarez
- Centro de Investigaciones Cardiovasculares, Consejo Nacional de Investigaciones Científicas y Técnicas Facultad de Ciencias Médicas, Universidad Nacional de La Plata La Plata, Argentina
| | | |
Collapse
|
9
|
Wu D, Russano K, Kouz I, Abraham WM. NHE1 inhibition improves tissue perfusion and resuscitation outcome after severe hemorrhage. J Surg Res 2013; 181:e75-81. [DOI: 10.1016/j.jss.2012.07.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 07/05/2012] [Accepted: 07/11/2012] [Indexed: 11/25/2022]
|
10
|
Wu D, Kraut JA, Abraham WM. Sabiporide improves cardiovascular function, decreases the inflammatory response and reduces mortality in acute metabolic acidosis in pigs. PLoS One 2013; 8:e53932. [PMID: 23326542 PMCID: PMC3542271 DOI: 10.1371/journal.pone.0053932] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 12/07/2012] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Acute metabolic acidosis impairs cardiovascular function and increases the mortality of critically ill patients. However, the precise mechanism(s) underlying these effects remain unclear. We hypothesized that targeting pH-regulatory protein, Na(+)/H(+) exchanger (NHE1) could be a novel approach for the treatment of acute metabolic acidosis. The aim of the present study was to examine the impact of a novel NHE1 inhibitor, sabiporide, on cardiovascular function, blood oxygen transportation, and inflammatory response in an experimental model of metabolic acidosis produced by hemorrhage-induced hypovolemia followed by an infusion of lactic acid. METHODS AND RESULTS Anesthetized pigs were subjected to hypovolemia for 30 minutes. The animals then received a bolus infusion of sabiporide (3 mg/kg) or vehicle, followed by an infusion of lactic acid for 2 hours. The animals were continuously monitored for additional 3 hours. Hypovolemia followed by a lactic acid infusion resulted in a severe metabolic acidosis with blood pH falling to 6.8. In association with production of the acidemia, there was an excessive increase in pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR). Treatment with sabiporide significantly attenuated the increase in PAP by 38% and PVR by 67%, as well as significantly improved cardiac output by 51%. Sabiporide treatment also improved mixed venous blood oxygen saturation (55% in sabiporide group vs. 28% in control group), and improved systemic blood oxygen delivery by 36%. In addition, sabiporide treatment reduced plasma levels of TNF-α (by 33%), IL-6 (by 63%), troponin-I (by 54%), ALT (by 34%), AST (by 35%), and urea (by 40%). CONCLUSION These findings support the possible beneficial effects of sabiporide in the treatment of acute metabolic acidosis and could have implications for the treatment of metabolic acidosis in man.
Collapse
Affiliation(s)
- Dongmei Wu
- Department of Research, Division of Neonatology, Mount Sinai Medical Center, Miami Beach, Florida, United States of America.
| | | | | |
Collapse
|
11
|
Liu YH, Lu M, Hu LF, Wong PTH, Webb GD, Bian JS. Hydrogen sulfide in the mammalian cardiovascular system. Antioxid Redox Signal 2012; 17:141-85. [PMID: 22304473 DOI: 10.1089/ars.2011.4005] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
For more than a century, hydrogen sulfide (H(2)S) has been regarded as a toxic gas. This review surveys the growing recognition of the role of H(2)S as an endogenous signaling molecule in mammals, with emphasis on its physiological and pathological pathways in the cardiovascular system. In biological fluids, H(2)S gas is a weak acid that exists as about 15% H(2)S, 85% HS(-), and a trace of S(2-). Here, we use "H(2)S" to refer to this mixture. H(2)S has been found to influence heart contractile functions and may serve as a cardioprotectant for treating ischemic heart diseases and heart failure. Alterations of the endogenous H(2)S level have been found in animal models with various pathological conditions such as myocardial ischemia, spontaneous hypertension, and hypoxic pulmonary hypertension. In the vascular system, H(2)S exerts biphasic regulation of a vascular tone with varying effects based on its concentration and in the presence of nitric oxide. Over the past decade, several H(2)S-releasing compounds (NaHS, Na(2)S, GYY4137, etc.) have been utilized to test the effect of exogenous H(2)S under different physiological and pathological situations in vivo and in vitro. H(2)S has been found to promote angiogenesis and to protect against atherosclerosis and hypertension, while excess H(2)S may promote inflammation in septic or hemorrhagic shock. H(2)S-releasing compounds and inhibitors of H(2)S synthesis hold promise in alleviating specific disease conditions. This comprehensive review covers in detail the effects of H(2)S on the cardiovascular system, especially in disease situations, and also the various underlying mechanisms.
Collapse
Affiliation(s)
- Yi-Hong Liu
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | | | | | | |
Collapse
|
12
|
Villa-Abrille MC, Cingolani E, Cingolani HE, Alvarez BV. Silencing of cardiac mitochondrial NHE1 prevents mitochondrial permeability transition pore opening. Am J Physiol Heart Circ Physiol 2011; 300:H1237-51. [PMID: 21297023 DOI: 10.1152/ajpheart.00840.2010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Inhibition of Na(+)/H(+) exchanger 1 (NHE1) reduces cardiac ischemia-reperfusion (I/R) injury and also cardiac hypertrophy and failure. Although the mechanisms underlying these NHE1-mediated effects suggest delay of mitochondrial permeability transition pore (MPTP) opening, and reduction of mitochondrial-derived superoxide production, the possibility of NHE1 blockade targeting mitochondria has been incompletely explored. A short-hairpin RNA sequence mediating specific knock down of NHE1 expression was incorporated into a lentiviral vector (shRNA-NHE1) and transduced in the rat myocardium. NHE1 expression of mitochondrial lysates revealed that shRNA-NHE1 transductions reduced mitochondrial NHE1 (mNHE1) by ∼60%, supporting the expression of NHE1 in mitochondria membranes. Electron microscopy studies corroborate the presence of NHE1 in heart mitochondria. Immunostaining of rat cardiomyocytes also suggests colocalization of NHE1 with the mitochondrial marker cytochrome c oxidase. To examine the functional role of mNHE1, mitochondrial suspensions were exposed to increasing concentrations of CaCl(2) to induce MPTP opening and consequently mitochondrial swelling. shRNA-NHE1 transduction reduced CaCl(2)-induced mitochondrial swelling by 64 ± 4%. Whereas the NHE1 inhibitor HOE-642 (10 μM) decreased mitochondrial Ca(2+)-induced swelling in rats transduced with nonsilencing RNAi (37 ± 6%), no additional HOE-642 effects were detected in mitochondria from rats transduced with shRNA-NHE1. We have characterized the expression and function of NHE1 in rat heart mitochondria. Because mitochondria from rats injected with shRNA-NHE1 present a high threshold for MPTP formation, the beneficial effects of NHE1 inhibition in I/R resulting from mitochondrial targeting should be considered.
Collapse
Affiliation(s)
- María C Villa-Abrille
- Centro de Investigaciones Cardiovasculares, CONICET Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina
| | | | | | | |
Collapse
|
13
|
Wu D, Qi J, Dai H, Doods H, Abraham WM. Resuscitation with Na+/H+exchanger inhibitor in traumatic haemorrhagic shock: Cardiopulmonary performance, oxygen transport and tissue inflammation. Clin Exp Pharmacol Physiol 2010; 37:337-42. [DOI: 10.1111/j.1440-1681.2009.05296.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
14
|
Low-volume resuscitation from traumatic hemorrhagic shock with Na+/H+ exchanger inhibitor*. Crit Care Med 2009; 37:1994-9. [DOI: 10.1097/ccm.0b013e3181a0052e] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Zakaria ER, Li N, Matheson PJ, Garrison RN. Cellular edema regulates tissue capillary perfusion after hemorrhage resuscitation. Surgery 2007; 142:487-96; discussion 496.e1-2. [PMID: 17950340 PMCID: PMC2131728 DOI: 10.1016/j.surg.2007.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 08/08/2007] [Accepted: 08/10/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hemorrhage-induced activation of endothelial cell Na+/H+ -exchanger results in cellular swelling, which physically impedes capillary filling and compromises gut perfusion. We hypothesized that correction of the vascular volume deficit by conventional resuscitation does not improve capillary filling unless cellular swelling is prevented. Also, we hypothesized that adjunctive direct peritoneal resuscitation (DPR) with topical peritoneal dialysis solution (Delflex; Fresenius USA, Inc., Ogden, Ut) enhances capillary filling and gut perfusion by mechanisms that are independent of the Na+/H+ function. METHODS In vivo intravital videomicroscopy and Doppler velocimeter were used by us to measure microvascular diameter and flow, capillary filling (index of functional capillary density, FCD), and endothelial cell function in the terminal ileum of anesthetized rats. Rats were bled to 50% mean arterial pressure for 60 min and resuscitated with the shed blood plus 2 volumes of saline (conventional resuscitation). Prevention of endothelial cell swelling was achieved with topical amiloride (specific Na+/H+ inhibitor) in the tissue bath before hemorrhage or simultaneously with conventional resuscitation. DPR was simulated by instillation of Delflex in the tissue bath as adjunctive to conventional resuscitation. Sham no hemorrhage group and a simulated DPR group that received topical amiloride treatment served as controls. RESULTS Conventional resuscitation from hemorrhagic shock restored and maintained central hemodynamics but caused progressive and persistent intestinal vasoconstriction and hypoperfusion associated with low FCD and endothelial cell dysfunction. Prevention of endothelial cell swelling when combined with conventional resuscitation, preserved endothelial cell function, and restored local intestinal microvascular variables to near-prehemorrhage levels. Simulated adjunctive DPR produced rapid, sustained, and generalized vasodilation associated with restoration of endothelial cell function, and maximum recruitment of FCD independent of the Na+/H+ -exchanger function. CONCLUSIONS Paradoxical endothelial cell swelling occurs early during hemorrhagic shock because of activation of the Na+/H+ exchanger. This cellular edema, which is not resolved by correction of the vascular volume deficit, explains the persistent postresuscitation endothelial cell dysfunction and gut hypoperfusion. Simulated adjunctive DPR in this study reversed endothelial cell swelling and enhanced gut perfusion by mechanisms that are independent of the Na+/H+ exchanger activity.
Collapse
Affiliation(s)
- El Rasheid Zakaria
- Department of Physiology and Biophysics, University of Louisville, Louisville, KY 40292, USA.
| | | | | | | |
Collapse
|
16
|
Park JW, Roh HY, Jung IS, Yun YP, Yi KY, Yoo SE, Kwon SH, Chung HJ, Shin HS. Effects of [5-(2-methoxy-5-fluorophenyl)furan-2-ylcarbonyl]guanidine (KR-32560), a novel sodium/hydrogen exchanger-1 inhibitor, on myocardial infarct size and ventricular arrhythmias in a rat model of ischemia/reperfusion heart injury. J Pharmacol Sci 2005; 98:439-49. [PMID: 16082174 DOI: 10.1254/jphs.fp0050078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The cardioprotective effects of the novel sodium/hydrogen exchanger-1 (NHE-1) inhibitor KR-32560 {[5-(2-methoxy-5-fluorophenyl)furan-2-ylcarbonyl]guanidine} were studied in an anesthetized rat model of 30-min ischemia / 2.5-h reperfusion heart injury. KR-32560 (0.01 - 1 microM) dose-dependently inhibited NHE-1-mediated rabbit platelet swelling induced by intracellular acidification. KR-32560 at 0.1 and 1.0 mg/kg (i.v. bolus, given 10 min before ischemia) reduced infarct size from 65.9% (control) to 49.7% and 32.7%, respectively, while reducing the extension of myocardial injury (mm(3)/g of left heart weight) from 405.1 (control) to 302.9 and 185.4, respectively (all P<0.05 vs control). KR-32560 dose-dependently reduced the total number of ventricular premature beats (VPBs) during ischemia from 510.2 (control) to 353.8 and 134.2 beats (all P<0.05, n = 6), while reducing ventricular tachycardia (VT) incidence from 49.3 (control) to 26.8 and 4.3 and VT duration from 249.2 s (control) to 150.5 and 26.7 s (all P<0.05, n = 6). KR-32560 dose-dependently reduced ventricular fibrillation (VF) incidence from 19.0 (control) to 9.2 and 1.2 and VF duration from 88.0 s to 34.5 and 2.8 s (all P<0.05, n = 6). KR-32560 also exerted similar effects on reperfusion arrhythmias, except for VPBs. These results indicate that KR-32560 may exert significant cardioprotective effects in ischemia/reperfusion heart injury.
Collapse
Affiliation(s)
- Jung-Woo Park
- Department of Applied Biochemistry, Division of Life Science, College of Biomedical and Health Science, Konkuk University, Chungju 380-701, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Roh HY, Jung IS, Park JW, Yun YP, Yi KY, Yoo SE, Kwon SH, Chung HJ, Shin HS. Cardioprotective effects of [5-(2-methyl-5-fluorophenyl)furan-2-ylcarbonyl]guanidine (KR-32568) in an anesthetized rat model of ischemia and reperfusion heart injury. Pharmacology 2005; 75:37-44. [PMID: 15942274 DOI: 10.1159/000086192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Accepted: 04/11/2005] [Indexed: 11/19/2022]
Abstract
The effects of a novel sodium/hydrogen exchanger-1 (NHE-1) inhibitor, KR-32568, were studied in an anesthetized rat model of 30 min ischemia/2.5 h reperfusion heart injury. KR-32568 dose-dependently inhibited NHE-1-mediated rabbit platelet swelling induced by intracellular acidification. In our anesthetized rat model, KR-32568 reduced infarct size from 67 (control) to 43 and 24% at 0.1 and 1.0 mg/kg (i.v. bolus, given 10 min before ischemia), respectively. KR-32568 at the same doses also significantly reduced the total number of ventricular premature beats during ischemia/reperfusion from 530 (control) to 266 and 115 beats, ventricular tachycardia (VT) incidence from 51 (control) to 21 and 8, VT duration from 238 s (control) to 63 and 33 s, ventricular fibrillation (VF) incidence from 17 (control) to 8 and 0, and VF duration from 85 s to 18 and 1 s. These results indicate that KR-32568 may exert potent cardioprotective effects in rats via inhibition of sodium/hydrogen exchanger-1.
Collapse
Affiliation(s)
- Hui-Yul Roh
- Department of Applied Biochemistry, Division of Life Science, College of Biomedical and Health Science, Konkuk University, Chungju, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Sikes PJ, Zhao P, Maass DL, White J, Horton JW. Sodium/hydrogen exchange activity in sepsis and in sepsis complicated by previous injury: 31P and 23Na NMR study*. Crit Care Med 2005; 33:605-15. [PMID: 15753754 DOI: 10.1097/01.ccm.0000155910.89252.fe] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sepsis or septic shock occurs frequently in sick and injured patients and is associated with a significant mortality. Myocardial contractile dysfunction has been proposed to be a major determinant of sepsis-related mortality. This study was directed to examine the role of Na/H exchange activity in myocardial defects after sepsis or after sepsis complicated by a previous burn injury. DESIGN Laboratory study. SETTING University research laboratory. SUBJECTS Sprague-Dawley rats (300-350 g, males). INTERVENTIONS Cardiac function, cellular Na and Ca, myocardial pH, and high-energy phosphates were examined in perfused hearts harvested after sepsis alone (intratracheal Streptococcus pneumoniae, 0.4 mL of 1 x 10 CFU/mL), after sepsis complicated by previous burn injury (40% total body surface area), and after amiloride (a selective inhibitor of Na/H exchange) treatment of either sepsis alone or sepsis plus burn. MEASUREMENTS AND RESULTS The ratio of Na signal from the intracellular compartment (Nai) compared with an external standard (monitored by Na-NMR spectroscopy, TmDOTP shift reagent) increased by 70% in sepsis alone and by 41% in sepsis complicated by previous burn injury compared with shams. Cardiac adenosine triphosphate and intracellular pH (P nuclear magnetic resonance spectroscopy) were unchanged by sepsis or sepsis plus burn. Left ventricular pressure and maximal change in pressure over time were reduced after sepsis or after sepsis plus burn injury. Amiloride treatment in either sepsis or sepsis complicated by a previous burn injury prevented myocardial Na and Ca accumulation, attenuated sepsis-related lactic acidosis, and improved left ventricular function. CONCLUSION Our results suggest that sepsis-related cardiac dysfunction is mediated, in part, by Na/H exchange activity, and inhibition of Na/H exchange activity improves cardiac function after sepsis alone or sepsis complicated by a previous injury.
Collapse
Affiliation(s)
- Patricia J Sikes
- UT Southwestern Medical Center Department of Surgery, Dallas, Texas, USA
| | | | | | | | | |
Collapse
|
19
|
Kristo G, Yoshimura Y, Ferraris SP, Jahania SA, Mentzer RM, Lasley RD. The preischemic combination of the sodium–hydrogen exchanger inhibitor cariporide and the adenosine agonist AMP579 acts additively to reduce porcine myocardial infarct size. J Am Coll Surg 2004; 199:586-94. [PMID: 15454144 DOI: 10.1016/j.jamcollsurg.2004.05.274] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2003] [Revised: 05/05/2004] [Accepted: 05/11/2004] [Indexed: 11/13/2022]
Abstract
BACKGROUND We tested whether the combination of two known cardioprotective agents, the type-1 sodium-hydrogen exchanger inhibitor cariporide plus the adenosine A(1)/A(2a) receptor agonist AMP579 ([1S-[1a,2b,3b, 4a(S*)]]-4-[7-[[2-(3-chloro-2-thienyl)-1-methylpropyl]amino]-[(3)H]-imidazo[4,5-b]pyridyl-3-yl]cyclopentane carboxamide), acted additively to reduce myocardial infarct size. STUDY DESIGN Pigs underwent 1 hour of coronary artery occlusion and 3 hours reperfusion. Vehicle-treated controls were compared with animals treated before ischemia with low-dose and high-dose cariporide and AMP579, and low-dose cariporide plus AMP579. The effects of both agents, alone and in combination, were also tested in isolated porcine polymorphonuclear neutrophils (PMNs). The PMN respiratory burst was induced with phorbol 12-myristate 13-acetate and quantified by the increase in 2',7'-dichlorofluorescein fluorescence, measured by flow cytometry. RESULTS Infarct size in the control pigs was 65 +/- 1% of the area at risk. Cariporide dose-dependently reduced infarct size to 39 +/- 2% and 24 +/- 3% in the low- and high-dose groups, respectively. Infarct size was 54 +/- 3% in the low-dose AMP579 group and 47 +/- 3% with high dose. The combination of low doses of cariporide and AMP579 reduced infarction to 25 +/- 6% of the area at risk. In the PMN studies, cariporide and AMP579 alone had no effect on 2',7'-dichlorofluorescein fluorescence, but the combination of the two agents reduced the PMN 2',7'-dichlorofluorescein increase to 79 +/- 5% of the vehicle control response. CONCLUSIONS The preischemic combination of low doses of cariporide and AMP579 decreased myocardial infarct size more than either agent used alone in low concentration, indicating an additive effect of the two agents. Given the effects that cariporide plus AMP579 combination exerted on PMN activity, it appears that this combination has the potential to reduce PMN-mediated effects during myocardial reperfusion.
Collapse
Affiliation(s)
- Gentian Kristo
- Department of Surgery, University of Kentucky, College of Medicine, Lexington, KY 40536-0084, USA
| | | | | | | | | | | |
Collapse
|
20
|
Wernly JA. Ischemia, reperfusion, and the role of surgery in the treatment of cardiogenic shock secondary to acute myocardial infarction: an interpretative review. J Surg Res 2004; 117:6-21. [PMID: 15013709 DOI: 10.1016/j.jss.2003.12.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Indexed: 10/26/2022]
Abstract
Cardiogenic shock (CS) is the leading cause of death for patients hospitalized with acute myocardial infarction (AMI). Despite contemporary management of AMI, the incidence of shock due to left ventricular failure has not declined and its mortality continues to be in excess of 50%. Furthermore, the role and indications of the different means of acute revascularization remain unclear. Recent observational and randomized studies have shown improved survival in patients acutely revascularized by either percutaneous interventions or conventional surgery, particularly in patients younger than 75 years of age. Current guidelines recommend surgical revascularization in selected patients with multiple vessel disease who develop shock due to progressive ischemia of the remote myocardium up to 18 h from the onset of shock. However, patients with single-vessel disease who develop shock as a consequence of the initial infarction can only be helped if revascularization is achieved during the first 4 to 6 h after the occlusion of the infarct related artery, preferable by percutaneous techniques. Not all ischemic myocytes become irreversibly injured at the same time. Due to variability in the distribution of collateral flow, there is great variability in the severity of ischemia. Myocytes can exhibit different metabolic responses including hibernation, ischemic preconditioning, stunning, reperfusion injury, and necrosis. Precise knowledge of these biochemical and metabolic changes that take place in the myocardium after arterial occlusion and following reperfusion is paramount to the understanding of the indications for acute revascularization, the implementation of the different management strategies to enhance myocardial preservation and recovery, and the role of circulatory support in these exceedingly sick patients.
Collapse
Affiliation(s)
- Jorge A Wernly
- The University of New Mexico, Health Sciences Center, Thoracic and Cardiovascular Surgery, Division of Cardiothoracic Surgery, MSC 10-5610, 1 University of New Mexico, Albuquerque, New Mexico 87131, USA.
| |
Collapse
|
21
|
Huang J, Ito Y, Morikawa M, Uchida H, Kobune M, Sasaki K, Abe T, Hamada H. Bcl-xL gene transfer protects the heart against ischemia/reperfusion injury. Biochem Biophys Res Commun 2003; 311:64-70. [PMID: 14575695 DOI: 10.1016/j.bbrc.2003.09.160] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ischemia and reperfusion (I/R) injury causes the progression of cardiac dysfunction. The prevention of cardiomyocyte-loss due to I/R injury is important for the treatment of heart failure. Therefore, we employed antiapoptotic Bcl-xL protein to prevent I/R injury in the heart and evaluated the cardioprotective effect of Bcl-xL transduction by adenoviral vector (Adv) after I/R injury. Adv with Bcl-xL gene was injected in the rat heart 4 days prior to I/R. The prevention of cardiac performance-loss and the reduction of cardiac apoptosis, after 30min ischemia and 30min reperfusion of global I/R, were demonstrated in the heart with adenoviral Bcl-xL transduction. Also, significant reductions of the infarct size and serum creatine kinase levels were observed in the heart transduced with Bcl-xL gene compared with control after 30min ischemia and 24h reperfusion of the left anterior coronary artery. Thus, Bcl-xL may serve as a potential therapeutic tool for cardioprotection.
Collapse
Affiliation(s)
- Jianhua Huang
- Department of Molecular Medicine, Sapporo Medical University, Sapporo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Cosar EO, O'Connor CJ. Hibernation, Stunning, and Preconditioning: Historical Perspective, Current Concepts, Clinical Applications, and Future Implications. Semin Cardiothorac Vasc Anesth 2003. [DOI: 10.1177/108925320300700202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite considerable advances, coronary artery disease is the leading cause of morbidity and mortality in the Western world. The development of effective therapeutic strategies for protecting the myocardium from ischemia would have major impact on patients with coronary artery disease. It is now accepted that patients with coronary artery disease can experience prolonged regional ischemic dysfunction that does not necessarily arise from irreversible tissue damage, and to some extent, can be reversed by restoration of blood flow. The initial stages of dysfunction are probably caused by chronic stunning that can be reversed after revascularization, resulting in rapid and complete functional recovery. On the other hand, the more advanced stages of dysfunction likely correspond to chronic hibernation. After revascularization, functional recovery will probably be quite delayed and mostly incomplete. Over the past decade, the possibility that an innate mechanism of myocardial protection might be inducible in the human heart has generated considerable excitement. In the last two decades, there was phenomenal growth in the understanding of the mechanism known as ischemic preconditioning that is responsible for the innate myocardial protection. Continued research and progress in this area may soon lead to the availability of preconditioning-mimetic treatments. The current concepts, mechanisms, and potential clinical applications of myocardial hibernation, stunning, and ischemic preconditioning are reviewed.
Collapse
Affiliation(s)
| | - Christopher J. O'Connor
- Department of Anesthesiology, Rush Medical College, Rush-Presbyterian-St. Lukes Medical Center, Chicago, Illinois
| |
Collapse
|
23
|
Hosomi N, Takahashi T, Kohno M. Effect of angiotensin II on cerebral edema following cerebral ischemia and reperfusion. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0531-5131(03)00022-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
24
|
Mentzer RM, Lasley RD, Jessel A, Karmazyn M. Intracellular sodium hydrogen exchange inhibition and clinical myocardial protection. Ann Thorac Surg 2003; 75:S700-8. [PMID: 12607715 DOI: 10.1016/s0003-4975(02)04700-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although the mechanisms underlying ischemia/reperfusion injury remain elusive, evidence supports the etiologic role of intracellular calcium overload and oxidative stress induced by reactive oxygen species. Activation of the sodium hydrogen exchanger (NHE) is associated with intracellular calcium accumulation. Inhibition of the NHE-1 isoform may attenuate the consequences of this injury. Although there is strong preclinical and early clinical evidence that NHE inhibitors may be cardioprotective, definitive proof of this concept in humans awaits the results of ongoing clinical trials.
Collapse
Affiliation(s)
- Robert M Mentzer
- Department of Surgery, University of Kentucky, Lexington, Kentucky 40536, USA.
| | | | | | | |
Collapse
|
25
|
Bolli R. The role of sodium-hydrogen ion exchange in patients undergoing coronary artery bypass grafting. J Card Surg 2003; 18 Suppl 1:21-6. [PMID: 12691376 DOI: 10.1046/j.1540-8191.18.s1.4.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Sodium-hydrogen ion exchange (NHE) is one of the principal mechanisms of restoring intracellular pH following ischemia and reperfusion. However, up-regulation of the NHE process results in a compensatory increase in the activity of the sodium-calcium exchanger. Intracellular hypercalcemia, resulting from the exchange of sodium for calcium, precipitates myocardial stunning and cell death. It has been postulated that NHE inhibition can protect the ischemic/reperfused myocardium, and preclinical studies have uniformly supported this concept. The Guard During Ischemia Against Necrosis (GUARDIAN) trial suggested benefits of NHE inhibition in subjects undergoing coronary artery bypass grafting (CABG). The sodium-hydrogen eXchange inhibition to Prevent coronary Events in acute cardiac conDITIONs (EXPEDITION) trial will further explore the use of cariporide in a randomized, controlled trial of CABG subjects at risk of myocardial necrosis.
Collapse
Affiliation(s)
- Roberto Bolli
- Division of Cardiology, University of Louisville, Louisville, Kentucky 40292, USA.
| |
Collapse
|
26
|
Inhibition of the Sarcolemmal Sodium-Hydrogen Exchanger: A Potential Treatment for Resuscitation from Cardiac Arrest. Intensive Care Med 2003. [DOI: 10.1007/978-1-4757-5548-0_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
27
|
Castellá M, Buckberg GD, Tan Z, Ignarro LJ. Myocyte and endothelial effects of preconditioning the jeopardized heart by inhibiting Na/H exchange. J Thorac Cardiovasc Surg 2002; 124:1113-21. [PMID: 12447176 DOI: 10.1067/mtc.2002.125485] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The preconditioning effects of the adjunctive, cardiac-specific sodium-hydrogen ion exchange inhibitor cariporide (cariporide mesilate, HOE 642) were studied in hearts subjected to 30 minutes of normothermic ischemia and reperfusion to assess myocardial and endothelial changes. METHODS Sixteen Yorkshire-Duroc pigs (27-34 kg) receiving cardiopulmonary bypass underwent either cardiopulmonary bypass alone (control, n = 4) or 30 minutes of normothermic ischemia, followed by 30 minutes of blood reperfusion (n = 12). Six hearts were treated with 5 mg/kg cariporide administered intravenously 15 minutes before ischemia. RESULTS Cardiopulmonary bypass alone caused no changes. Conversely, 30 minutes of global normothermic ischemia caused 33% mortality and, in survivors, depression of left ventricular function to 22% +/- 6% of baseline preload recruitable stroke work and increased creatine kinase MB by 406% (88 +/- 13 U/L), conjugated dienes by 17% (161 +/- 0.2 AU/mL), and myeloperoxidase activity by 297% (0.036 +/- 0.005 U/g). Myocardial edema developed (3.5% water gain). Coronary sinus endothelin 1 increased by 111% (2.05 +/- 0.38 pg/mL), and nitric oxide production decreased by 10%. These adverse effects were limited by pretreatment with cariporide, which allowed complete survival and restored preload recruitable stroke work to 78% +/- 11%. Measurements of creatine kinase MB, conjugated dienes, myeloperoxidase, water, and endothelin 1 returned to baseline values, and nitric oxide production was accentuated 3-fold. CONCLUSIONS These observations show that adjunctive pretreatment with cariporide delays myocardial and endothelial injury during ischemia and reperfusion, limits oxygen-derived radical injury, restores function, reduces edema, and preserves endothelin and nitric oxide balance at normal values. The myeloperoxidase changes show that less white blood cell adherence supports reduced reperfusion endothelial damage.
Collapse
Affiliation(s)
- Manuel Castellá
- Department of Surgery, Division of Cardiothoracic Surgery, and the Department of Physiology, University of California, Los Angeles, School of Medicine, Los Angeles, CA 90095-1701, USA
| | | | | | | |
Collapse
|
28
|
Verma S, Fedak PWM, Weisel RD, Butany J, Rao V, Maitland A, Li RK, Dhillon B, Yau TM. Fundamentals of reperfusion injury for the clinical cardiologist. Circulation 2002; 105:2332-6. [PMID: 12021216 DOI: 10.1161/01.cir.0000016602.96363.36] [Citation(s) in RCA: 293] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Subodh Verma
- Division of Cardiac Surgery, University of Toronto, Toronto, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Gazmuri RJ, Ayoub IM, Kolarova JD, Karmazyn M. Myocardial protection during ventricular fibrillation by inhibition of the sodium-hydrogen exchanger isoform-1. Crit Care Med 2002; 30:S166-71. [PMID: 11940795 DOI: 10.1097/00003246-200204001-00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Activation of the sarcolemmal sodium-hydrogen exchanger isoform-1 (NHE-1) in response to the intense intracellular acidosis that develops during ischemia has been identified as an important mechanism of myocardial cell injury. NHE-1 inhibition in the quiescent (nonfibrillating) heart ameliorates functional manifestation of ischemia and reperfusion injury. We investigated in isolated heart and intact rat models of ventricular fibrillation whether NHE-1 inhibition, by using the selective inhibitor cariporide, could ameliorate myocardial abnormalities that develop during ventricular fibrillation and limit resuscitability and survival. In the isolated rat heart, cariporide significantly reduced the magnitude of ischemic contracture during ventricular fibrillation and the accompanying increases in coronary vascular resistance. Hearts that had received cariporide during ventricular fibrillation had no diastolic dysfunction after resuscitation and recovered their systolic function earlier. In intact rats, cariporide given immediately before starting chest compression allowed generation of a coronary perfusion pressure and end-tidal Pco2 comparable with control rats but with significantly less depth of compression. Cariporide had an unprecedented effect in this rat model, prompting spontaneous defibrillation after approximately 8 mins of chest compression. After resuscitation, rats treated with cariporide had significantly less ventricular ectopic activity, better hemodynamic function, and higher survival rates (22 of 24 [94%] vs. 15 of 24 [63%] in control rats, p <.05). We conclude that NHE-1 inhibition may represent a novel and highly effective form of treatment for resuscitation from ventricular fibrillation.
Collapse
Affiliation(s)
- Raúl J Gazmuri
- Section of Critical Care Medicine, North Chicago VA Medical Center, North Chicago, IL 60064, USA.
| | | | | | | |
Collapse
|
30
|
Abstract
During the past two decades (i.e., since 1980), in excess of 1000 published papers have focused on the phenomenon of the 'stunned myocardium', with many of these studies seeking to identify mechanisms-based treatment strategies to attenuate post-ischemic contractile dysfunction. Early investigations focused largely on abrogating the deleterious effects of oxygen-derived free radicals and unfavorable alterations in calcium homeostasis, both considered to contribute significantly to the pathogenesis of the stunned myocardium. More recently, favorable results have also been obtained using a somewhat different paradigm: that is, attempting to capitalize on endogenous cardioprotective mediators, most notably adenosine, nitric oxide, and the ATP-sensitive potassium channel. Now that potential therapeutic candidates have been identified in the experimental laboratory, the as-yet unmet challenge is to translate this information into the design of effective pharmacologic therapies to treat myocardial stunning in the clinical arena.
Collapse
Affiliation(s)
- K Przyklenk
- Heart Institute/Research, Good Samaritan Hospital, Los Angeles, CA 90017-2395, USA.
| |
Collapse
|
31
|
Gazmuri RJ, Ayoub IM, Hoffner E, Kolarova JD. Successful ventricular defibrillation by the selective sodium-hydrogen exchanger isoform-1 inhibitor cariporide. Circulation 2001; 104:234-9. [PMID: 11447092 DOI: 10.1161/01.cir.104.2.234] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sodium-hydrogen exchanger isoform-1 (NHE-1) activation worsens functional myocardial abnormalities associated with ischemia and reperfusion. We hypothesize that these abnormalities may limit cardiac resuscitation from ventricular fibrillation (VF) and investigated whether NHE-1 inhibition with the benzoylguanidine derivative cariporide could improve resuscitability, postresuscitation myocardial function, and short-term survival in isolated heart and intact rat models of VF. Methods and Results-- In the isolated rat heart, VF was induced for 25 minutes. Perfusion was interrupted for the initial 10 minutes and restarted at 10% of baseline flow for the remaining 15 minutes (simulating chest compression). Cariporide ameliorated ischemic contracture, prevented postresuscitation diastolic dysfunction, and favored earlier return of contractile function. In the intact rat, cariporide, injected into the right atrium before chest compression was started (after 6 minutes of untreated VF), prompted spontaneous defibrillation between minutes 7 and 9 of chest compression in 6 of 8 rats. In contrast, electrical defibrillation was required in each of 8 control rats after completion of a predetermined 16-minute interval of VF. After resuscitation, cariporide-treated rats had less ventricular ectopic activity and normalized their hemodynamic function faster. Electrical defibrillation was then timed in control rats to match the time when spontaneous defibrillation occurred in cariporide-treated rats. With comparable VF duration, postresuscitation hemodynamic dysfunction was ameliorated by cariporide, but only when more severe ischemia was modeled by prolongation of the interval of untreated VF from 6 to 10 minutes. CONCLUSION NHE-1 inhibition may represent a novel and remarkably effective intervention for resuscitation from VF.
Collapse
Affiliation(s)
- R J Gazmuri
- Medical Service, Section of Critical Care Medicine, North Chicago VA Medical Center, Chicago, IL 60064, USA.
| | | | | | | |
Collapse
|
32
|
Karmazyn M. Therapeutic potential of Na-H exchange inhibitors for the treatment of heart failure. Expert Opin Investig Drugs 2001; 10:835-43. [PMID: 11322861 DOI: 10.1517/13543784.10.5.835] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The Na-H exchanger (NHE) represents a family of transporters which regulate intracellular pH by removing protons in exchange for sodium influx in an electroneutral 1:1 stoichiometric relationship. Six isoforms have thus far been identified with the NHE-1 subtype representing the primary isoform in the cardiac cell. It is well-established that NHE-1 contributes to cardiac injury produced by ischaemia and reperfusion and inhibitors of the antiporter exert excellent cardioprotection. More recent evidence suggests that NHE-1 may also be important for cell growth and may contribute to the maladaptive remodelling which contributes to heart failure particularly the early hypertrophic responses. Evidence from in vitro studies suggest that NHE-1 inhibitors attenuate cardiomyocyte hypertrophy in response to various stimuli whereas in vivo studies report substantial attenuation of both hypertrophy and heart failure by these agents, especially after myocardial infarction. Accordingly, NHE-1 inhibitors could emerge as important therapeutic tools for the attenuation and treatment of heart failure.
Collapse
Affiliation(s)
- M Karmazyn
- Department of Pharmacology and Toxicology, University of Western Ontario, Medical Sciences Building, London, Ontario N6A 5C1, Canada.
| |
Collapse
|
33
|
Guzman-Perez A, Wester RT, Allen MC, Brown JA, Buchholz AR, Cook ER, Day WW, Hamanaka ES, Kennedy SP, Knight DR, Kowalczyk PJ, Marala RB, Mularski CJ, Novomisle WA, Ruggeri RB, Tracey WR, Hill RJ. Discovery of zoniporide: a potent and selective sodium-hydrogen exchanger type 1 (NHE-1) inhibitor with high aqueous solubility. Bioorg Med Chem Lett 2001; 11:803-7. [PMID: 11277524 DOI: 10.1016/s0960-894x(01)00059-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Zoniporide (CP-597,396) is a potent and selective inhibitor of NHE-1, which exhibits high aqueous solubility and acceptable pharmacokinetics for intravenous administration. The discovery, synthesis, activities, and rat and dog pharmacokinetics of this compound are presented. The potency and selectivity of zoniporide may be due to the conformation that the molecule adopts due to the presence of a cyclopropyl and a 5-quinolinyl substituent on the central pyrazole ring of the molecule.
Collapse
Affiliation(s)
- A Guzman-Perez
- Pfizer Global Research and Development, Pfizer Inc., Groton CT 06340, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Portman MA, Panos AL, Xiao Y, Anderson DL, Ning X. HOE-642 (cariporide) alters pH(i) and diastolic function after ischemia during reperfusion in pig hearts in situ. Am J Physiol Heart Circ Physiol 2001; 280:H830-4. [PMID: 11158983 DOI: 10.1152/ajpheart.2001.280.2.h830] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The specific Na(+)/H(+) exchange inhibitor HOE-642 prevents ischemic and reperfusion injury in the myocardium. Although this inhibitor alters H(+) ion flux during reperfusion in vitro, this action has not been confirmed during complex conditions in situ. Myocardial intracellular pH (pH(i)) and high-energy phosphates were monitored using (31)P magnetic resonance spectroscopy in open-chest pigs supported by cardiopulmonary bypass during 10 min of ischemia and reperfusion. Intravenous HOE-642 (2 mg/kg; n = 8) administered before ischemia prevented the increases in diastolic stiffness noted in control pigs (n = 8), although it did not alter the postischemic peak-elastance or pressure-rate product measured using a distensible balloon within the left ventricle. HOE-642 induced no change in pH(i) during ischemia but caused significant delays in intracellular realkalinization during reperfusion. HOE-642 did not alter phosphocreatine depletion and repletion but did improve ATP preservation. Na(+)/H(+) exchange inhibition through HOE-642 delays intracellular alkalinization in the myocardium in situ during reperfusion in association with improved diastolic function and high-energy phosphate preservation.
Collapse
Affiliation(s)
- M A Portman
- Division of Cardiology, Department of Pediatrics, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Washington 98105, USA.
| | | | | | | | | |
Collapse
|
35
|
Goel DP, Vecchini A, Panagia V, Pierce GN. Altered cardiac Na(+)/H(+) exchange in phospholipase D-treated sarcolemmal vesicles. Am J Physiol Heart Circ Physiol 2000; 279:H1179-84. [PMID: 10993782 DOI: 10.1152/ajpheart.2000.279.3.h1179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac sarcolemmal Na(+)/H(+) exchange is critical for the regulation of intracellular pH, and its activity contributes to ischemia-reperfusion injury. It has been suggested that the membrane phospholipid environment does not modulate Na(+)/H(+) exchange. The present study was carried out to determine the effects on Na(+)/H(+) exchange of modifying the endogenous membrane phospholipids through the addition of exogenous phospholipase D. Incubation of 0.825 U of phospholipase D with 1 mg of porcine cardiac sarcolemmal vesicles hydrolyzed 34 +/- 2% of the sarcolemmal phosphatidylcholine and increased phosphatidic acid 10.2 +/- 0.5-fold. Treatment of vesicles with phospholipase D resulted in a 46 +/- 2% inhibition of Na(+)/H(+) exchange. Na(+)/H(+) exchange was measured as a function of reaction time, extravesicular pH, and extravesicular Na(+). All of these parameters of Na(+)/H(+) exchange were inhibited following phospholipase D treatment compared with untreated controls. Passive efflux of Na(+) was unaffected. Treatment of sarcolemmal vesicles with phospholipase C had no effect on Na(+)/H(+) exchange. We conclude that phospholipase D-induced changes in the cardiac sarcolemmal membrane phospholipid environment alter Na(+)/H(+) exchange.
Collapse
Affiliation(s)
- D P Goel
- Division of Stroke and Vascular Disease, St. Boniface General Hospital Research Centre, Winnipeg, Manitoba, Canada R2H 2A6
| | | | | | | |
Collapse
|
36
|
Theroux P, Chaitman BR, Erhardt L, Jessel A, Meinertz T, Nickel WU, Schroeder JS, Tognoni G, White H, Willerson JT. Design of a trial evaluating myocardial cell protection with cariporide, an inhibitor of the transmembrane sodium-hydrogen exchanger: the Guard During Ischemia Against Necrosis (GUARDIAN) trial. CURRENT CONTROLLED TRIALS IN CARDIOVASCULAR MEDICINE 2000; 1:59-67. [PMID: 11714411 PMCID: PMC56207 DOI: 10.1186/cvm-1-1-059] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2000] [Accepted: 07/19/2000] [Indexed: 11/10/2022]
Abstract
Inhibition of the sodium-hydrogen exchanger (NHE) is a powerful experimental tool to inhibit sodium and calcium accumulation within the ischemic myocyte and halt progression of cell ischemia to cell necrosis. This paper describes the protocol and rationale of a first large-scale clinical trial designed to evaluate the safety and efficacy of cariporide, a novel specific and potent inhibitor of the exchanger.
Collapse
Affiliation(s)
- Pierre Theroux
- University of Montreal and Montreal Heart Institute, Montreal, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|