Protection against ischemia-reperfusion induced oxidative stress by vitamin E treatment

α-Tocopherol preserves cardiac function by reducing oxidative stress and inflammation in ischemia/reperfusion injury

OBJECTIVE

Myocardial infarction (MI) is a leading cause of mortality and morbidity worldwide and new treatment strategies are highly sought-after. Paradoxically, reperfusion of the ischemic myocardium, as achieved with early percutaneous intervention, results in substantial damage to the heart (ischemia/reperfusion injury) caused by cell death due to aggravated inflammatory and oxidative stress responses. Chronic therapy with vitamin E is not effective in reducing the cardiovascular event rate, presumably through failing to reduce atherosclerotic plaque instability. Notably, acute treatment with vitamin E in patients suffering a MI has not been systematically investigated.

METHODS AND RESULTS

We applied alpha-tocopherol (α-TOH), the strongest anti-oxidant form of vitamin E, in murine cardiac ischemia/reperfusion injury induced by ligation of the left anterior descending coronary artery for 60 min. α-TOH significantly reduced infarct size, restored cardiac function as measured by ejection fraction, fractional shortening, cardiac output, and stroke volume, and prevented pathological changes as assessed by state-of-the-art strain and strain-rate analysis. Cardioprotective mechanisms identified, include a decreased infiltration of neutrophils into cardiac tissue and a systemic anti-inflammatory shift from Ly6Chigh to Ly6Clow monocytes. Furthermore, we found a reduction in myeloperoxidase expression and activity, as well as a decrease in reactive oxygen species and the lipid peroxidation markers phosphatidylcholine (PC) (16:0)-9-hydroxyoctadecadienoic acid (HODE) and PC(16:0)-13-HODE) within the infarcted tissue.

CONCLUSION

Overall, α-TOH inhibits ischemia/reperfusion injury-induced oxidative and inflammatory responses, and ultimately preserves cardiac function. Therefore, our study provides a strong incentive to test vitamin E as an acute therapy in patients suffering a MI.

The ameliorating effects of vitamin E on hepatic antioxidant system and xenobiotic-metabolizing enzymes in fenvalerate-exposed iodine-deficient rats

This study investigated the effects of vitamin E (VE) on hepatic antioxidant system and drug-metabolizing enzymes in fenvalerate (FEN)-exposed iodine-deficient (ID) Wistar rats. ID was produced by perchlorate containing drinking water. VE was introduced by a loading dose of 100 mg/kg/d, i.g. for the first three days in the last week of feeding period; then with a single maintenance dose of 40 mg/kg on the 4th day. During last week, FEN groups (F) received 100 mg/kg/d, i.p. FEN. VE alone did not significantly affect thyroid hormones and antioxidant parameters; however, significantly increased total cytochrome P450 (38%) and cytochrome b5 levels (36%). In all ID groups, plasma thyroid-stimulating hormone (TSH) levels increased markedly, but remained at control level in vitamin E plus FEN receiving iodine-deficient group (IDVF) group. Glutathione peroxidase activity showed marked increases in F (19%) and FEN-exposed iodine-deficient group (IDF, 48%) groups. FEN treatment significantly increased total cytochrome P450 (28%) and thiobarbituric acid reactive substance levels (36%), as well as 7-ethoxyresorufin O-deethylase (120%), 7-penthoxyresorufin O-deethylase (139%) and glutathione S-transferase (15%) activities and decreased total glutathione concentrations (28%) versus control. Overall results suggest that vitamin E has ameliorating effects on the measured parameters in ID and/or FEN exposure.

Neutron Scattering at the Intersection of Heart Health Science and Biophysics

There is an urgent quest for improved heart health. Here, we review how neutron radiation can provide insight into the molecular basis of heart health. Lower cholesterol, a daily intake of aspirin and supplemental vitamin E are argued to all improve heart health. However, the mechanisms behind these common regimens, and others, are not entirely understood. It is not clear why a daily intake of aspirin can help some people with heart disease, and the benefits of vitamin E in the treatment of reperfusion injury have been heavily debated. The molecular impact of cholesterol in the body is still a hot topic. Neutron scattering experiments present a unique opportunity for biophysicists attempting to address these problems. We review some recently published studies that are advancing our understanding of how cholesterol, vitamin E and aspirin work at the molecular level, by studying the impact of these molecules on the cell membrane. These insights engage the broader health science community with new ways of thinking about these molecules.

Prevalence of catalase (-21 A/T) gene variant in south Indian (Tamil) population

Catalase, an endogenous antioxidant enzyme, is responsible for regulating reactive species levels. Several epidemiologic studies have suggested that single nucleotide polymorphism in catalase gene may be associated with many diseases. The genotype of CAT (-21 A/T) point mutation in promoter region of catalase gene was determined by polymerase chain based restriction fragment length polymorphism analysis in the DNA of 100 healthy volunteers. The frequency of CAT (-21 A/T) gene polymorphism AA, AT, and TT genotypes was found to be 7, 23, and 70 percent, respectively. The mutant “T” allele frequency was found to be 0.82 among the south Indian (Tamil) population. Chi square analysis showed that the study population lies within the Hardy-Weinberg equilibrium. The wild type genotype (AA) was found to be very low (7%) and the mutant genotype (AT/TT) was found to be more prevalent (93%) among the south Indian population. This suggests that the high prevalence of mutant genotype may increase the susceptibility to oxidative stress associated diseases.

Effect of T3 treatment on the response to ischemia–reperfusion of heart preparations from sedentary and trained rats

We investigated whether swim training modifies the effect of T(3) treatment on rat heart response to ischemia-reperfusion. Homogenates of Langendorff preparations perfused for 25 min after 20-min ischemia were used for biochemical determinations and isolation of mitochondrial fractions. Oxidative damage and antioxidant levels of homogenates, O(2) consumption and H(2)O(2) release rates, oxidative damage, and susceptibility to Ca(2+)-induced swelling of mitochondria were determined. During reperfusion, hyperthyroid hearts displayed significant tachycardia and low inotropic recovery. This pattern was improved by training, which also attenuated tissue oxidative damage and glutathione depletion. Similar training effects were shown in euthyroid preparations. Moreover, training reduced mitochondrial H(2)O(2) production and oxidative damage in hyperthyroid and euthyroid hearts and susceptibility to Ca(2+)-induced swelling only in the hyperthyroid ones. Rates of mitochondrial O(2) consumption were not different in sedentary and trained hyperthyroid rats. However, determination of the oxidative capacity suggested that, in the sedentary rats, O(2) consumption was conditioned by oxidative damage mitochondria have suffered, whereas in trained rats, it was due to changes in mitochondrial characteristics. The above results suggest that moderate training is able to reduce hyperthyroid heart susceptibility to oxidative damage and dysfunction modifying mitochondrial population.

Histopathological observations on protective effects of vitamin E on endosulfan induced cardiotoxicity in rats

The protective effects of vitamin E was investigated on the cardiotoxicity induced by endosulfan administration. Male rats in different groups were given endosulfan (2 mg per kg body weight per day in corn oil through gavage), vitamin E (200 mg per kg body weight twice a week in corn oil through gavage) and endosulfan and vitamin E at the same dose and route, to the control group corn oil is given at the dose rate of 2 mL per rat per day through gavage, for a period of28 days. The animals were sacrificed and heart tissues were collected and subjected to histopathology. The result indicated, sever congestion, haemorrhages with interstitial oedema. In some places there was diapedesis of leukocytes. Myocardium showed different degrees of degeneration, some of the myofibrils were found to be granular with pyknotic nuclei. Thickening of wall of arteries were seen. In the Vitamin E and endosulfan treated group the above mentioned lesions were significantly decreased in their severity. This study brought to light the protective effects of vitamin E on the toxic pathological lesions caused by endosulfan administration.

Proposed mechanisms for red palm oil induced cardioprotection in a model of hyperlipidaemia in the rat

High-cholesterol diets alter myocardial and vascular NO-cGMP signaling and have been implicated in ischaemic/reperfusion injury. We investigated the effects of dietary red palm oil (RPO) containing fatty acids, carotonoids, tocopherols and tocotrienols on myocardial ischaemic tolerance and NO-cGMP pathway function in the rat. Wistar rats were fed a standard rat chow+/-RPO, or a standard rat chow+cholesterol+/-RPO diet. Myocardial mechanical function and NO-cGMP signaling pathway intermediates were determined before, during and after 25 min ischaemia. RPO-supplementation improved aortic output recovery and increased myocardial ischaemic cGMP concentrations. Simulated ischaemia (hypoxia) increased cardiomyocyte nitric oxide levels in the two RPO supplemented groups, but not in control non-supplemented groups. RPO supplementation also increased hypoxic nitric oxide levels in the control diet fed, but not the cholesterol fed rats. These data suggest that dietary RPO may improve myocardial ischaemic tolerance by increasing bioavailability of NO and improving NO-cGMP signaling in the heart.

Alpha-tocopherol supplementation favorable effects on blood pressure, blood viscosity and cardiac remodeling of spontaneously hypertensive rats

Spontaneously hypertensive rats (SHR) were separated into two groups (n = 6 per group) and, since 5 months old, received alpha-tocopherol (alpha-tocopherol acetate120 IU) or vehicle by daily gavage for 2 weeks. Blood viscosity, blood pressure (BP) and myocardial remodeling were analyzed. The SHRs treated with alpha-tocopherol showed a significant reduction of BP and a major reduction of blood viscosity in comparison with the control SHRs. The cardiac hypertrophy indices showed some differences when the two SHR groups were compared, the LV mass index was not different between the groups; however, the cardiomyocyte size was more than 20% smaller in SHRs treated with alpha-tocopherol than in control SHRs (P < .05). The intramyocardial vessels distribution was more than 45% greater in alpha-tocopherol-treated SHRs than in control rats, significantly improving the vessels-to-myocytes ratio in treated SHRs than in control SHRs (P < .05). In conclusion, present findings strongly suggest a beneficial effect of alpha-tocopherol supplementation to genetically hypertensive rats. This was observed by a reduction of both blood viscosity and BP, and a consequent cardiomyocyte hypertrophy in treated SHRs; an improvement of vessels-to-myocytes ratio in these rats was also observed.

Intensive swimming exercise-induced oxidative stress and reproductive dysfunction in male wistar rats: protective role of alpha-tocopherol succinate

In the present study, 30 male rats (age 3 mos, Wt 128.6 +/- 3.7 g) were randomly divided into Control group (CG), Experimental group (EG), and Supplemented group (SG), 10 per group. An exercise protocol (3 hrs swimming per day, 5 days a week for 4 weeks) was followed in EG and SG, with no exercise in CG. In SG, alpha-tocopherol succinate was injected sub-cutaneously at a dose of 50 mg x kg(- 1) per body weight per day. After 4 weeks of exercise, significant diminutions (p < 0.05) were noted in somatic indices of testes and accessory sex organs; seminiferous tubuler diameter (STD); testicular (delta (5), 3 beta-hydroxysteroid dehydrogenase delta(5), 3 beta-HSD), 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) activities; plasma levels of testosterone (T), luteinizing hormone (LH); preleptotine spermatocytes (pLSc), mid-pachytene spermatocytes (mPSc), and Stage 7 spermatids (7 Sd); testicular alpha-tocopherol and glutathione (GSH) content; superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione-s-transferase (GST) activities in EG when compared to CG. Moreover, a significant elevation (p < 0.05) in malondialdehyde (MDA) was found in testes of EG compared to CG. No significant alteration was noted in body weight among the groups. Co-administration of alpha-tocopherol succinate restored the above parameters. Intensive swimming exercise-induced oxidative stress causes dysfunction in the male reproductive system, which can be protected by alpha-tocopherol succinate.

Oxidative stress and heart disease: cardiac dysfunction, nutrition, and gene therapy

Oxidative stress is defined as the imbalance between the generation of reactive oxygen species and antioxidant defense mechanisms. The cardiovascular system is a major target for reactive oxygen species. Cardiomyocytes and the vasculature of the heart can be severely damaged as a result of oxidative stress. In this paper, we discuss recent findings with respect to the role of oxidative stress in heart disease. The efficacies of treatments with vitamins and wine-derived compounds, as well as innovative gene therapeutic experiments that may potentially alleviate oxidative stress-induced disease, are also discussed.

Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) activation suppresses ischemic induction of Egr-1 and its inflammatory gene targets

The peroxisome proliferator-activated receptor (PPAR) is a nuclear receptor whose activation regulates metabolism and inflammation. Recent data indicate that the zinc finger transcription factor early growth response gene-1 (Egr-1) acts as a master switch for the inflammatory response in ischemic vessels. Experiments tested the hypothesis that activation of endogenous PPAR-gamma inhibits induction of Egr-1. Egr-1 is rapidly induced in murine lungs after ischemia-reperfusion, as well as in alveolar mononuclear phagocytes deprived of oxygen as an ischemic model. In vitro, the natural PPAR-gamma ligand (15-deoxy-Delta12,14-prostaglandin J2) and a PPAR-gamma activator (troglitazone), but not a PPAR-alpha activator (bezafibrate), strikingly diminished Egr-1 mRNA and protein expression and nuclear DNA binding activity corresponding to Egr-1. In vivo, treatment with troglitazone before ischemia prevented induction of Egr-1 and its target genes such as interleukin-1beta, monocyte chemotactic protein-1, and macrophage inflammatory protein-2. As a consequence of PPAR-gamma activation, pulmonary leukostasis was decreased and oxygenation and overall survival were improved. Activation of PPAR-gamma suppresses activation of Egr-1 and its inflammatory gene targets and provides potent protection against ischemic pulmonary injury. These data reveal a new mechanism whereby PPAR-gamma activation may decrease tissue inflammation in response to an ischemic insult.

Effect of antioxidant therapy with dl-alpha-tocopherol on cardiovascular structure in experimental renal failure

BACKGROUND

Chronic renal failure is characterized by remodeling of the structure of the heart and the vasculature, for example, left ventricular hypertrophy, myocardial fibrosis, capillary/myocyte mismatch, as well as thickening of intramyocardial arteries and of peripheral arteries and veins. Furthermore, uremia is a state of increased oxygen stress. It was the purpose of this study to examine whether these findings are interrelated.

METHODS

To investigate whether antioxidative therapy with dl-alpha-tocopherol (Toco; vitamin E) interferes with the development of abnormal cardiovascular structure in experimental renal failure, 28 male Sprague-Dawley rats were subjected to partial renal ablation (subtotal nephrectomy, SNX) or to sham operation (sham). SNX were either left untreated or received the antioxidant Toco (2 x 1500 IE/kg BW/week in the pellets). Blood pressure was measured using tail plethysmography. The experiment was terminated after 12 weeks. Heart and left ventricular weight were determined and the following parameters were measured using morphometry and stereology: volume densities of cardiomyocytes, capillaries and non-vascular interstitium; length density and total length of cardiac capillaries, wall thickness of intramyocardial arterioles and of the aorta.

RESULTS

Systolic blood pressure and body weight were comparable in all groups. Treatment with Toco led to significantly increased plasma concentrations of Toco. Left ventricular weight and wall thickness of intramyocardial arteries were significantly higher in both SNX groups compared to sham controls. Volume density of the cardiac interstitial tissue was significantly higher in untreated SNX than in Toco treated SNX and sham control rats. Length density of capillaries was significantly lower in untreated SNX than in control rats; however, the values were significantly higher, and even higher than in sham controls, when SNX were treated with Toco.

CONCLUSIONS

Treatment with the antioxidant dl-alpha-tocopherol prevented cardiomyocyte/capillary mismatch, and to some extent also myocardial fibrosis in rats with renal failure. The results point to a role of oxidative stress in the genesis of myocardial interstitial fibrosis and capillary deficit of the heart.

In vitro antioxidant properties of pentoxifylline, piracetam, and vinpocetine

Oxygen-free radicals play an important role in several physiologic and pathophysiologic processes. In pathologic circumstances, they can modify and damage biologic systems. Because oxygen-free radicals are involved in a wide range of diseases (cerebrovascular, cardiovascular, etc.), scavenging these radicals should be considered as an important therapeutic approach. In our in vitro study, we investigated the antioxidant capacity of three drugs: pentoxiphylline (Sigma Aldrich, St. Louis, MO, USA) piracetam (Sigma Aldrich), and vinpocetine (Richter Gedeon RT, Budapest, Hungary). Phenazine methosulphate was applied to generate free radicals, increasing red blood cell rigidity. Filtration technique and potassium leaking were used to detect the cellular damage and the scavenging effect of the examined drugs. According to our results, at human therapeutic serum concentration, only vinpocetine (Richter Gedeon RT) had significant (p < 0.01) scavenging activity with a protective effect that increased further at higher concentrations. Pentoxiphylline (Sigma Aldrich) and piracetam (Sigma Aldrich) did not have significant antioxidant capacity at therapeutic concentrations, but increasing their concentrations (pentoxiphylline at 100-times, and piracetam at 10-times higher concentrations) led to a significant (p < 0.01) scavenger effect. Our findings suggest that this pronounced antioxidant effect of vinpocetine and even the milder scavenging capacity of pentoxiphylline and piracetam may be of value in the treatment of patients with cerebrovascular disorders, but merits further investigations.

Evaluation of oxidative stress in patients with cancer

The oxidative stress is considered to be involved in the pathophysiology of cancers. In the current study we explored the oxidative stress in patients with different cancers and corresponding benign diseases by evaluation of the level of lipid peroxidation products (MDA level) in the plasma and the activity of erythrocyte antioxidant defense enzymes superoxide dismutase (SOD) and catalase (CAT). Significantly higher plasma levels of lipid peroxidation products were detected in patients with early and advanced cancers in comparison to the healthy volunteers (mean 3.1 micromol/l and 2.3 micromol/l, p = 0.0003 and p = 0.029, respectively, t-test). In addition, 10-20 days after radical operations of cancer patients with normal postoperative recovery period, the plasma levels of MDA decreased and reached values close to the controls (mean 2.0 micromol/l). SOD in erythrocytes of patients with benign diseases and malignant solid tumors before and after surgery did not differ from that of the controls. In contrast, CAT activity of patients with early cancers was found to be significant higher than that of the controls (mean 22157.2 U/gHb vs. 12832.0 U/gHb, p = 0.032, t-test). A decrease of CAT activity was observed after surgery (mean 15225.0 U/gHb). In conclusion, our results suggest the presence of an increased oxidative stress accompanied by a lack of changes of erythrocyte SOD activity and an adaptive increase of CAT activity.

Neuroprotective effects of MK 801 and hypothermia used alone and in combination in hypoxic-ischemic brain injury in neonatal rats

Although accumulating evidence suggests that increased extracellular glutamate concentrations may play an important role in hypoxic-ischemic brain injury, dopamine and other catecholamines also seem to be involved. The N-methyl-D-aspartate receptor antagonist MK 801 and moderate hypothermia (32-34 degrees C) are each known to be neuroprotective, but their combined effect on the release and metabolism of neurotransmitters is unknown. Seven-day-old pups (n: 150) underwent right common carotid artery ligation to induce hemispheric ischemia, and were later subjected to 120 minutes of hypoxia with 8% O2 and 92% N2O. Half the rats (Group I, n: 74) were subjected to normothermic conditions throughout the hypoxic period. Moderate hypothermia (30-32 degrees C) was induced in the other pups (Group II, n: 76) immediately after artery occlusion, and was maintained throughout the hypoxic period. Prior to inducing hypoxia, half of the rats in each group (Groups IA and IIA) received vehicle solution (0.9% NaCI) and the other rats (Groups IB and IIB) received MK 801 (0.5 mg/kg) subcutaneously at 45 and 120 minutes after occlusion. Intracerebral temperature was recorded every 15 minutes after occlusion. Infarct area (n: 40) was calculated after staining with 2% 2,3,5 triphenyltetrazolium chloride. Neuronal damage (n: 42) was assessed by quantifying CA1-CA3 neuronal loss at five hippocampal levels. The amount of damage to the monoamine system of the corpus striatum was determined based on the dopamine and 3,4 dihydroxyphenylacetic acid levels in the corpus striatum in both hemispheres (n: 46), as measured by high-pressure liquid chromatography and compared with normal control pups' values (n: 10). The normothermia/saline-treated pups had significantly larger infarct areas than the MK 801 only, hypothermia only, or MK 801/hypothermia combination groups. Neuropathological examination and striatal tissue monoamine data also confirmed marked neuronal damage in this group. Although MK 801 treatment alone resulted in significantly smaller infarct area and less tissue damage than was observed in the normothermia/saline-treated group, the moderate hypothermia and the MK 801/hypothermia combination treatment groups both exhibited better neuronal protection, especially in the corpus striatum. The rats that received combined treatment also had a significantly lower mortality rate.

Schisandrin B modulates the ischemia-reperfusion induced changes in non-enzymatic antioxidant levels in isolated-perfused rat hearts

Isolated Langendorff-perfused rat hearts were subjected to a fixed period of ischemia followed by increasing periods of reperfusion for investigating the changes in the extent of ischemia-reperfusion (IR) injury and tissue levels of non-enzymatic antioxidants. Effects of schisandrin B (Sch B) and (+/-) alpha-lipoic acid (LA) pretreatment were also examined. A 40-min of ischemia (40-I) followed by 20- or 40-min of reperfusion (20-R or 40-R) caused sustainable tissue damage in isolated hearts, as indicated by the increased extent of lactate dehydrogenase (LDH) leakage and impaired contractile force. The myocardial IR injury was associated with a marked decrease in tissue ascorbic acid (V(C)) level. However, myocardial reduced glutathione (GSH) and alpha-tocopherol (V(E)) levels remained relatively unchanged except under a more severe IR condition (40-I, 40-R). Pretreating rats with Sch B or LA at a daily dose of 1.2 mmol/kg for 3 days protected against IR injury in isolated hearts to varying degrees. While only Sch B pretreatment could improve the recovery of contractile force, LA pretreatment produced a better inhibitory effect on LDH leakage. The protection against IR injury was associated with significant increases in myocardial V(E) and V(C) levels in both Sch B and LA pretreated hearts. The ensemble of results suggests that the cardioprotection afforded by Sch B or LA pretreatment may at least in part be attributed to the modulation on the interplay among non-enzymatic antioxidants under oxidative stress induced by IR.

Effects of ischemia on the metabolism of cardiac enkephalins

The effect of ischemia on cardiac Leucine enkephalin (Leu-enk) content, degradation and coronary release was studied in the isolated perfused hearts of male Sprague Dawley rats. Hearts were electrically stimulated at 180 beats/min. Cardiac Leu-enk concentrations were increased when hearts were perfused (635 +/- 41 vs 301 +/- 60 fmol/g in control non-perfused hearts,) or during ischemia-reperfusion (520 +/- 78 vs 277 +/- 42 fmol/g in heart submitted to ischemia alone). The quantity of leucine-enkephalin released by the heart during perfusion was four times higher than the initial content measured in the heart tissue. The rate of this release was the same throughout the experiment (25.9 +/- 2.9 fmol/min/g during perfusion vs. 19.2 +/- 1.6 during ischemia-reperfusion). These findings suggested that cardiac enkephalin metabolism is regulated by cardiac events. In fact, enzymes involved in enkephalin degradation were decreased during perfusion (39%) and increased during ischemia (50%). The decrease in the enzyme activity during coronary perfusion depended on a reduced activity in the membrane fraction only while membrane and soluble fractions were interested in the increased enzyme activity after ischemia. Ischemia-reperfusion induced a larger release of Leu-enk than perfusion without ischemia. In view of the protective actions of enkephalin peptides against oxidative stress, we can infer from our results an implication of Leu-enk in ischemia-reperfusion and thus eventually in preconditioning phenomenon.