The role of free radical-mediated processes in oxygen-related damage in cultured murine myocardial cells

Cardiovascular surgery in the elderly

The elderly segment of the population is increasing rapidly, and surgeons are more frequently being requested to operate on this group of patients. A number of reports suggest that elderly patients have a significantly higher incidence of operative mortality and 30-day hospital mortality as compared with younger patients. Elderly patients also had a significantly higher increased incidence of complications, such as renal failure, prolonged ventilation, and incidence of strokes and postoperative cardiac arrest. Regarding coronary artery disease, elderly patients are more acutely sick on admission, are more likely to have triple-vessel disease, more likely have comorbid disease, and are usually less likely to receive an internal mammary artery graft. The presence of valvular disorders with concomitant coronary disease (especially mitral ischemic related valve disease) increases operative time, morbidity, and mortality. Efforts must continue to be made to gather data on outcomes of cardiac surgery in the elderly. Consideration must be given to modify the operative approach that minimizes cardiopulmonary bypass time, mitigates the multisystem organ injury associated with cardiopulmonary bypass, and decreases the likelihood of embolization from the ascending aorta. Future efforts must be made to develop measures to decrease the complications rate identified in elderly patients.

Pathophysiology of iron overload

In thalassemia, iron overload is the joint outcome of excessive iron absorption and transfusional siderosis. While iron absorption is limited by a physiologic ceiling of about 3 mg/d, plasma iron turnover in thalassemia may be 10 to 15 times normal, caused by the wasteful, ineffective erythropoiesis of an enormously expanded erythroid marrow. This outpouring of catabolic iron exceeds the iron-binding capacity of transferrin and appears in plasma as non-transferrin-plasma iron (NTPI). The toxicity of NTPI is much higher than of transferrin-iron as judged by its ability to promote hydroxyl radical formation resulting in peroxidative damage to membrane lipids and proteins. In the heart, this results in impaired function of the mitochrondrial respiratory chain and abnormal energy metabolism manifested clinically in fatal hemosiderotic cardiomyopathy. Ascorbate increases the efficacy of iron chelators by expanding the intracellular chelatable iron pool, but, at suboptimal concentrations is a pro-oxidant, enhancing the catalytic effect of iron in free radical formation. NTPI is removed by i.v. DFO in a biphasic manner and reappears rapidly upon cessation of DFO, lending support to the continuous, rather than intermittent, use of chelators. Unlike DFO and other hexadentate chelators, bidentate chelators such as L1 may produce incomplete intermediate iron complexes at suboptimal drug concentrations.

The role of iron and iron chelators in anthracycline cardiotoxicity

The redox cycling of anthracyclines promotes the formation of free radicals which are believed to play a central role in their cardiotoxicity. A number of observations indicate that the mechanism of the antineoplastic effect of anthracyclines is independent of their cardiotoxic effect and that it may be possible to prevent toxicity without interfering with therapeutic effect. Iron plays an important role in anthracycline toxicity by promoting the conversion of superoxide into highly toxic hydroxyl radicals through the Haber-Weiss reaction. Conversely, iron deprivation by its high-affinity binding to iron chelating compounds may inhibit anthracycline toxicity by interfering with free radical formation. ICRF-187, a bispiperazonedione which is hydrolyzed intracellularly into a bidentate chelator resembling EDTA, is able to decrease adriamycin-induced free hydroxyl radical formation and to prevent the development of clinical cardiac toxicity in patients receiving long-term anthracycline therapy. Our studies in rat heart cell cultures have shown that iron overload aggravates anthracycline toxicity and that this interaction can be prevented by prior iron chelating treatment. Since iron overload caused by multiple blood transfusions and bone marrow failure is a common condition in patients requiring anthracycline therapy, these observations may have significant clinical implications to the prevention of anthracycline cardiotoxicity.

Hypothermic fibrillatory arrest for coronary artery bypass grafting

Hypothermic fibrillatory arrest is a technique of myocardial preservation that has a long history of use in cardiac surgery. Numerous studies have documented its efficacy in various subgroups of patients with coronary artery disease. This report reviews the research support of the tenets of the technique and reports the results with its utilization in 2,801 consecutive patients having isolated myocardial revascularization.

Beneficial effects of low doses of ethanol on reoxygenation injury following anoxia in rat hearts

We investigated the effect of ethanol on adverse effects of anoxia and reoxygenation in isolated rat hearts. Perfusion of the anoxic Krebs-Henseleit medium for 40 min followed by 30 min of perfusion with aerobic medium produced considerable myocardial cell injury. Incorporation of ethanol (21.7 mM), in both anoxic and aerobic perfusion media resulted in a significant reduction of cell injury and inhibition of creatine phosphokinase release. The contraction bands were reduced to 0.24 as compared to 1.14 per field in the non-treated hearts. The tissue Ca++ was decreased to 8.72 mumol/gm/dry dry wt as compared to 20.17 mumol/gm/dry wt), as compared to the nontreated anoxic tissue (4.41 mumol/gm/dry wt). However, the inclusion of only ethanol in the anoxic medium did not decrease the damage, suggesting that maximal injury occurred during reoxygenation. Ethanol appears to inhibit myofibril contractures and preserve the structural integrity of plasma membrane during anoxia and reoxygenation. This study suggests a beneficial effect of ethanol in low doses on the post anoxic reperfusion injury in the myocardium.

Biological models for studying iron chelating drugs

Experimental models for studying the biological effects of iron chelators range from in vitro cell cultures to in vivo models in a variety of animals. Apart from screening for chelating efficacy, such models have been useful in providing information on the pharmacology of desferrioxamine and a number of other, orally effective iron chelators; in the identification of the biological source of iron mobilized by such chelators; in defining optimal methods of drug delivery; in providing evidence for the ability of iron chelators to prevent or reverse iron toxicity; and in exploring the potential usefulness of iron chelating therapy in conditions unrelated to iron overload, where iron may fulfil a central role in the pathogenesis of disease. Although cell cultures are inexpensive and permit the rapid screening of large numbers of new chelating compounds, they may overlook alternative sources of chelatable iron, pro-drugs, and orally effective compounds. In vivo models provide information on drug toxicity, allow comparison of oral versus parenteral efficacy, routes of excretion of chelated iron, monitoring of selective interaction with various iron pools, and promotion of the excretion of various trace metals. Although iron metabolism in large animals such as dogs and monkeys closely resembles that of humans, small animals such as mice and rats are usually preferred because of their low cost and ease of handling. Thorough knowledge of the pharmacology of iron chelators is a prerequisite for their successful therapeutic application. Interaction with a rapidly exchanging, intracellular, low molecular weight chelatable iron pool requires a steady supply of a drug capable of penetrating the relevant effector cells. The high effectiveness of continuous desferrioxamine infusion illustrates this point and underlines the need for developing new orally effective iron chelators which, by virtue of their slower absorption, would be more suitable for providing a continuous supply of circulating drug.

Effect of hyperosmotic mannitol on magnetic resonance relaxation parameters in reperfused canine myocardial infarction

To determine how administration of a hyperosmotic agent alters regional nuclear magnetic resonance (NMR) relaxation parameters and imaging characteristics in ischemic-reperfused myocardium, 7 dogs were infused with mannitol for 15 minutes before and after the release of a 3 hour left anterior descending coronary artery (LAD) occlusion. Nine control animals received normal saline during the 3 hour occlusion and 1 hour reperfusion periods. Normal posterior left ventricular (LV) wall and the ischemic anterior LV wall (risk area) myocardium was sampled for calculation of segmental microsphere myocardial blood flow, % tissue water content, NMR relaxation times (T1, T2) and myocyte ultrastructure using electron microscopy. Mean infarct T1 values were 14% greater than normal segments in saline-treated controls, but only 5% greater after mannitol. The difference in tissue water content between infarcted and normal segments was 4% in saline-treated (83 vs. 79%) compared to 2% in mannitol-treated dogs (79 vs. 77%). T1, T2 and % water content of control infarct segments were greater than treated infarcts (p less than 0.01). T1 and T2 rose as occlusion flow fell below 0.5 ml/min/g in control hearts but did not rise until flows were reduced to 0.1 ml/min/g in mannitol-treated hearts. Areas of increased signal in T1 and T2 NMR images correlated well with histochemical infarct volume (r = 0.98, SEE = 1.1 cc) in mannitol-treated dogs, but infarct borders were qualitatively less well-defined than in controls. We concluded that mannitol (1) diminishes tissue edema and reduces NMR relaxation parameters (T1, T2) in infarcted myocardium; and (2) attenuates the rise in T1 and T2 and ultrastructural myocyte injury in ischemic-reperfused myocardium.

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

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

Lipid peroxidation in hepatocyte cell cultures: modulation by free radical scavengers and iron

Rat hepatocytes were isolated and then maintained in serum-free cell culture medium for 24 h. The amount of malondialdehyde (MDA) accumulated in the medium was assayed and used as a measure of lipid peroxidation. The activity of lactate dehydrogenase (LDH) and urea were measured in the medium and used as indicators of hepatocellular viability and function. The effects of iron; desferrioxamine mesylate (Desferal), an iron chelator; and mannitol, a hydroxyl free radical scavenger were investigated. The addition of iron, Fe2 resulted in a three-fold increase in the levels of MDA. Desferal inhibited the production of MDA and blocked the effect of Fe2+. Neither iron nor Desferal had any effect on LDH or urea levels. Mannitol had no effect on MDA or urea production, but caused a 4 to 8-fold increase in the LDH levels in the medium. The results show that iron is involved in the mechanism of lipid peroxidation in hepatocyte cultures but suggest that as a pathologic event lipid peroxidation is not expressed in terms of viability during the first 24 h of hepatocyte culture.

Leukocytes, oxygen radicals, and myocardial injury due to ischemia and reperfusion

Ischemic myocardium generates stimuli for neutrophil chemotaxis before the final extent of irreversible ischemic injury is attained. Reperfusion accelerates the infiltration of ischemic myocardium by neutrophils. Oxygen radicals released by the activated neutrophils may exacerbate the tissue damage caused by ischemia. Neutrophil depletion by antiserum was shown to limit infarct size in dogs undergoing coronary occlusion for 90 minutes followed by reperfusion for 6 or 72 hours, but not in dogs undergoing occlusion for 4 hours. Prostacyclin, which inhibits the generation of superoxide anions by neutrophils, also limited canine myocardial injury despite no effect on collateral blood flow. Iloprost, an analogue of prostacyclin that inhibits neutrophils also reduced infarct size, while SC39902, an analogue that does not inhibit neutrophils, did not alter infarct size. The results suggest that oxygen radicals released by activated neutrophils play a role in the pathophysiology of myocardial injury due to ischemia followed by reperfusion.

Iron-chelating therapy

Because of the catalytic action of iron in one-electron redox reactions, it has a key role in the formation of harmful oxygen derivatives and production of peroxidative damage to vital cellular structures. The clinical manifestations of iron overload may be prevented and even reversed by the effective administration of the iron-chelating drug deferoxamine (DF). Recent experimental evidence suggests that DF may also be useful in modifying disease conditions unrelated to iron overload by preventing the formation of free radicals, the powerful final effectors of tissue damage resulting from the respiratory burst of granulocytes and macrophages participating in the inflammatory response. Although much experimental work is still needed, this novel approach in iron-chelating therapy may have far-reaching implications in the management of autoimmune disease, adult respiratory distress syndrome, and organ transplantation. The poor intestinal absorption of DF, its almost prohibitive price, and short duration of action underline the need for new, orally effective iron chelators. A number of very promising orally effective drugs have been identified in recent years, such as the polyanionic amines, aryl hydrazones, and hydroxypyridones. Further development for clinical use of this new generation of iron-chelating drugs is a major challenge for future research.

Moderating effect of low doses of ethanol on reoxygenation injury in the anoxic myocardium

We have investigated the action of ethanol on the reoxygenation injury in isolated rat hearts. Perfusion of the anoxic Krebs-Henseleit medium for 40 minutes followed by 30 minutes of perfusion with aerobic medium produced considerable myocardial cell injury. Incorporation of ethanol (21.7 mMol), in both anoxic and aerobic perfusion media resulted in a marked reduction of cell injury and inhibition of creatine kinase. Contraction band necrosis was reduced to 0.25 as compared to 1.14 per field in the nontreated hearts. The tissue Ca++ was decreased to 8.2 as compared to 12.12 mumol/g/dry weight in the non-treated hearts and tissue ATP was increased by 50% in the treated tissue (9.33 mumol/g/dry wt) as compared to the non-treated anoxic tissue (5.5 mumol). Thus, ethanol appears to lessen myofibrilar contraction bands and preserve plasma membrane integrity during anoxia and reoxygenation. This suggests a scavenging role of free radicals which include hydroxy radicals or closely related species, in the pathogenesis of anoxic cell injury and beneficial effect of ethanol in low doses on the post anoxic reoxygenation injury.

Effects of oxygen radicals on substrate oxidation by cardiac myocytes

Freshly isolated adult rat heart cells were used to study the effects of oxygen-free radicals on the myocardial oxidation of different substrates. The calcium-tolerant quiescent cells were incubated with xanthine plus xanthine oxidase as the source of free radicals. The oxidation of exogenous glucose, lactate and octanoate was severely inhibited (approx. 70%) by products of xanthine oxidase activity. Superoxide dismutase plus catalase effectively prevented the inhibition of oxidation. Cellular high energy phosphate levels were decreased in the presence of the oxygen free radical generating system although cell viability determined by Trypan blue exclusion and light microscopic assessment of normal morphology was not affected. These data suggest that oxygen free radicals decrease myocardial substrate oxidation which may contribute to the functional and ultrastructural changes in the myocardium under conditions such as reoxygenation after hypoxia and reperfusion after ischemia.

Brain lactate during partial global ischemia and reperfusion: effect of pretreatment with dichloroacetate in a rat model

Elevated cerebral lactate levels following cerebral ischemia have been associated with brain cell damage and death. We previously found that pre- or postischemia treatment with dichloroacetate (DCA), presumably by its activation of brain pyruvate dehydrogenase, effectively lowers cerebral lactate levels in rats subjected to 30 minutes of partial global ischemia (PGI) followed by 30 minutes of recirculation. The goal of the present study was to determine the effects of preischemia DCA treatment on cortical lactate levels during the ischemia period or during early recirculation. Rats (four in each group) received preischemia treatment with DCA and were then subjected to 0, 10, or 30 minutes of PGI or 30 minutes of PGI followed by 15 minutes of recirculation. Cortical lactate levels in pretreated animals were not significantly different from lactate levels of untreated rats at any time during PGI, but were significantly lower than levels in untreated rats at 15 minutes of recirculation (P less than .05, ANOVA). These results suggest that preischemia treatment with DCA does not limit the accumulation of cortical lactate during PGI but may promote its clearance during recirculation following PGI. If reperfusion events influence the degree of brain cell injury, DCA may enhance cell recovery by lower cortical lactate levels in the reperfusion period.

Event-free survival following nonemergency myocardial revascularization during hypothermic fibrillatory arrest

To better assess the late results of hypothermic fibrillatory arrest during myocardial revascularization, 1,000 consecutive patients having nonemergency coronary artery grafting during hypothermic fibrillatory arrest from August, 1979, through November, 1984, were studied to determine event-free survival. Hospital mortality was 0.4% and the rate of perioperative myocardial infarction, 1.8%. At follow-up (mean, 30.5 months), 11 patients had sustained an interval nonfatal myocardial infarction, 3 had had percutaneous angioplasty, and 2 had undergone reoperative revascularization. Actuarial survival at five years was 91.6 +/- 2.0%. Actuarial event-free rates at five years were 97.7 +/- 0.8% for myocardial infarction, 99.4 +/- 0.4% for percutaneous transluminal coronary angioplasty, 99.5 +/- 0.4% for reoperative revascularization, and 88.6 +/- 2.2% for all combined morbidity and mortality. Among the 122 patients meeting randomizable admission criteria of the Coronary Artery Surgery Study, there were no operative deaths and no perioperative infarctions, and the actuarial survival was 97.5% at five years. Hypothermic fibrillatory arrest is effective for myocardial preservation during coronary revascularization and when combined with complete revascularization, yields excellent event-free survival.

S-thiolation of cytoplasmic cardiac creatine kinase in heart cells treated with diamide

Two methods for quantitation of protein S-thiolation, by isoelectric focusing or by enzyme activity, were used for studying S-thiolation of cytoplasmic cardiac creatine kinase. With these methods, creatine kinase was identified as a major S-thiolated protein in both bovine and rat heart. In rat heart cell cultures, creatine kinase became 10% S-thiolated during a 10 min incubation with 0.2 mM diamide. This enzyme became S-thiolated more slowly than other heart cell proteins and it also dethiolated more slowly. Two sequential additions of diamide at a 25 min interval caused twice as much S-thiolation after the second addition as compared to the first. This increased sensitivity to the second diamide treatment may have resulted from glutathione loss during the first addition which produced a higher GSSG-to-GSH ratio after the second treatment. The GSSG-to-GSH ratio was highest prior to the maximum S-thiolation of creatine kinase, but, in general, the time course of glutathione was similar to the S-thiolation of creatine kinase. This study demonstrates that cytoplasmic creatine kinase is S-thiolated and, therefore, inhibited during a diamide-induced oxidative stress in heart cells. Implications for regulation of cardiac metabolism during oxidative stress are discussed.

Oxygen radicals alter the cell membrane potential in a renal cell line (LLC-PK1) with differentiated characteristics of proximal tubular cells

We employed a carbocyanine dye (1,1',3,3,3',3'-hexamethylindocarbocyanine iodide) to measure the plasma membrane potential of LLC-PK1 renal epithelial cells exposed to either xanthine oxidase-generated oxygen radicals or to hydrogen peroxide. Measurements were performed using a fluorescent-activated cell sorter to record fluorescence on a cell by cell basis. Initial exposure of cells to low concentrations of either H2O2 or xanthine oxidase resulted in a transient increase in membrane potential relative to control cells (P less than 0.001), followed by an exponential decline in potential (P less than 0.001). The addition of extracellular catalase diminished the H2O2-related decline in potential, consistent with a role for hydrogen peroxide in producing this effect. Pretreatment of cells with inhibitors of intracellular catalase and superoxide dismutase prior to exposure to xanthine oxidase caused an even larger decline in potential (P less than 0.001). Cells could be partially protected from the radical-mediated loss of potential by incubating them in a hypertonic (400 mosmolal) environment during radical exposure. Similarly, the loss of membrane potential was increased after incubation of cells in a hypotonic (200 mosmolal) environment during radical exposure. These observations are consistent with a reduction in membrane potential effected by exposure to oxygen radicals (including superoxide anion and hydrogen peroxide). This reduction may be prevented, in part, by radical scavenging enzymes and by reducing the degree of cellular swelling in response to oxygen radical exposure.

Myocardial protection by antioxidant during permanent and temporary coronary occlusion in dogs

In an ischaemic heart model the lipid peroxidation, scavenger state and ultrastructure were studied, to determine the action of a new antioxidant of dihydroquinoline type (MTDQ-DA). In dog experiments, the left descending coronary artery (LAD) was ligated permanently (30 minutes, 1, 2 or 3 hours) or temporarily (30 minutes, 1 or 2 hours of ischaemia followed by 1 hour of recirculation). The experimental protocol involved two groups: control animals without antioxidant treatment and animals treated with antioxidant infusion during the ischaemic and reperfusion period. In both groups, the thiobarbituric acid reactive product, the malondialdehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD) were measured, to illustrate the injured or scavenged state of the membrane system. In nontreated animals the permanent and temporary LAD increased the MDA content, decreased GSH concentration (mainly during reperfusion) and reduced SOD activity. Treatment with MTDQ-DA diminishes the characteristic biochemical changes. According to ultrastructural investigations, irreversible alterations (Ca deposits in the mitochondria, disruption of intramitochondrial membranes, hypercontraction bands) occurred only in the control group. Anti-oxidant therapy is able to reduce the myocardial damages both quantitatively and qualitatively.

Serum-mediated enhancement of ANF accumulation in the culture medium of cardiac atriocytes

Cultured cardiac myocytes provide a useful system for investigating ANF biosynthesis and regulation. It has previously been demonstrated that the predominant form of ANF stored in and released from this myocyte model is the 17 kD prohormone, proANF. We report here that as quantitated both by radioimmunoassay and by SDS-PAGE of intrinsically labelled ANF released from these cardiocytes, the addition of serum promotes a 5-6 fold increase in ANF accumulation in the medium of these cells as compared to ANF accumulation in the presence of a defined chemical medium alone. The stimulating effect of serum is immediate and persists in a linear manner for at least 120 minutes. This effect of serum can be reproduced by the addition of albumin or other proteins to the medium but not by alterations in osmolality. Whether this phenomenon represents enhanced release of proANF or is secondary to inhibition of proANF degradation has yet to be determined.

Ischemia, resuscitation, and reperfusion: mechanisms of tissue injury and prospects for protection

Since its introduction in 1960, CPR has evolved into a complex program involving not only the medical community but also the lay public. Currently, program activities include instruction of the lay public in basic life support techniques, development and deployment of emergency medical systems, recommendations for drug protocols for advanced cardiac life support and, most recently, introduction of new methods for tissue protection following resuscitation. After 25 years of experience, we are beginning to understand the pathophysiology of tissue ischemia during cardiac arrest and the interventions required to improve chances of survival and quality of life of the cardiac arrest victim. Recent data in the literature suggest that modification of certain interventions in the resuscitation program may be needed. The poor neurologic outcomes with prolonged standard CPR show that it is not protective after 4 to 6 minutes of cardiac arrest. Modifications to this technique, including SVC-CPR or IAC-CPR, have not been shown to increase resuscitability or hospital discharge rates. Human studies of open-chest cardiac massage are needed to evaluate this option. Defibrillation is the definitive treatment for ventricular fibrillation. Greater emphasis should be placed on the earliest possible delivery of this treatment modality. Computerized defibrillators may provide greater and earlier access to defibrillation in the homes of patients at high risk of ventricular fibrillation. They may also be applicable by untrained public service personnel (police and firemen), individuals in geographically inaccessible areas (aircraft), or emergency medical technicians in rural areas where skill retention is a significant problem. Calcium has no proved benefit in cardiac resuscitation. There is biochemical evidence that it may be harmful in brain resuscitation. Its use in resuscitation should be discontinued. The dose of epinephrine currently advocated in the ACLS protocols may be inadequate to increase aortic diastolic pressure and coronary and cerebral perfusion pressures and thus aid resuscitation. Animal studies indicate that substantial increases in the current dosage are needed to achieve these effects. Human studies are needed to verify these results. A role for calcium antagonists in the treatment of postarrest encephalopathy has been demonstrated in animals and is currently undergoing clinical trials. Iron-dependent lipid peroxidative cell membrane injury may be important in the pathogenesis of postarrest encephalopathy. Animal studies suggest that the iron chelator deferoxamine may have a significant therapeutic role in the treatment of postarrest encephalopathy.

A comparison of protein S-thiolation (protein mixed-disulfide formation) in heart cells treated with t-butyl hydroperoxide or diamide

Beating neonatal heart cell cultures were treated with diamide or t-butyl hydroperoxide, and changes in glutathione oxidation, cell beating, and protein S-thiolation (protein mixed-disulfide formation) were examined. Both compounds caused extensive oxidation of glutathione. Cells treated with diamide stopped beating within 2 min, and beating returned to normal after 30-45 min. Cells stopped beating 25 min after the addition of t-butyl hydroperoxide, and beating did not resume. t-Butyl hydroperoxide caused S-thiolation of a variety of proteins, but only one protein, of molecular mass 23 kDa, was extensively modified. Diamide caused extensive modification of proteins with molecular masses of 97, 42 and 23 kDa as well as three proteins of about 35 kDa. Though the GSSG content of cell cultures returned to normal by 15 min after diamide treatment. S-thiolation of several proteins persisted. These studies show that S-thiolation of proteins is an important metabolic response in cells exposed to an oxidative challenge by t-butyl hydroperoxide or diamide, and that the specificity of the response depends on the agent used.

Biosynthesis and secretion of proatrial natriuretic factor by cultured rat cardiocytes

Rat atrial natriuretic factor (ANF) is translated as a 152-amino acid precursor preproANF. PreproANF is converted to the 126-amino acid proANF, the storage form of ANF in the atria. ANF isolated from the blood is approximately 25 amino acids long. It is demonstrated here that rat cardiocytes in culture store and secrete proANF. Incubation of proANF with serum produced a smaller ANF peptide. PreproANF seems to be processed to proANF in the atria, and proANF appears to be released into the blood, where it is converted by a protease to a smaller peptide.

The importance of free radicals and catalytic metal ions in human diseases

The study of free radical reactions is not an isolated and esoteric branch of science. A knowledge of free radical chemistry and biochemistry is relevant to an understanding of all diseases and the mode of action of all toxins, if only because diseased or damaged tissues undergo radical reactions more readily than do normal tissues. However it does not follow that because radical reactions can be demonstrated, they are important in any particular instance. We hope that the careful techniques needed to assess the biological role of free radicals will become more widely used.