Reduction of ischemic, pharmacological and remote preconditioning effects by an antioxidant N-acetyl cysteine pretreatment in isolated rat heart

Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Punjab, India.
Yakugaku zasshi journal of the Pharmaceutical Society of Japan (Impact Factor: 0.31). 04/2008; 128(3):469-77. DOI: 10.1248/yakushi.128.469
Source: PubMed

ABSTRACT The present study was designed to investigate the possible role of free radicals in cardioprotective effects of ischemic, pharmacological and remote preconditioning. Isolated rat heart was perfused on Langendorff apparatus with Kreb's Henseleit solution and subjected to 30 min global ischemia followed by 120 min reperfusion. To assess myocardial injury, coronary effluent was analyzed for lactate dehydrogenase and creatine kinase activity. Myocardial infarct size was estimated using triphenyl tetrazolium chloride staining. Ischemic preconditioning, pharmacological preconditioning (angiotensin II; H2O2), remote aortic preconditioning markedly attenuated I/R induced increase in lactate dehydrogenase and creatine kinase release and myocardial infarct size. Administration of N-Acetyl Cysteine (NAC), in vitro, during ischemic and pharmacological, and in vivo during remote preconditioning attenuated the cardioprotective effects of preconditioning. On the basis of these results, it may be concluded that sub threshold generation of Reactive Oxygen Species (ROS) may activate redox signaling which may be responsible for preconditioning induced cardioprotection.

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    ABSTRACT: Ischemic preconditioning is an intrinsic process in which preconditioning ischemia (ischemia of shorter duration) protects the organs against the subsequent index ischemia (sustained ischemia). Remote ischemic preconditioning (RIPC) is an innovative treatment approach in which interspersed cycles of preconditioning ischemia followed by reperfusion to a remote organ (other than target organ) protect the target organ against index ischemia and reperfusion-induced injury. RIPC of various organs to provide multi-organ salvage became a successful approach in numerous species of animals. Consequently, the concept of RIPC evolved in clinical setups, and provided beneficial effects in alleviating ischemia-reperfusion-induced injury in various remote organs, including myocardium. Clinically, RIPC stimulus is generally delivered by inflating the blood pressure cuff tied on the upper arm 20mm greater than the systolic blood pressure, rendering the forearm ischemic for 5min, followed 5min reperfusion by deflating the cuff. This cycle is repeated for 3-4 consecutive periods to precondition the tissue and improve the survival. The institution of RIPC is beneficial in mitigating myocardial injury in patients undergoing various surgical interventions including coronary artery bypass graft surgery, abdominal aortic aneurysm repair, percutaneous coronary intervention, heart valve surgery, drug-eluting stent implantation, kidney transplantation, elective decompression surgery. The involvement of hypoxia inducible factor-1α (HIF-1α), ATP-sensitive potassium channels, signal transducer and activator of transcription (STAT), matrix metalloproteinases, O-linked β-N-acetylglucosamine (O-GlcNAc) levels, autonomous nervous system in mediating RIPC-induced cardioprotective effects has been explored clinically. However, comprehensive studies are required to elucidate the other possible mechanisms responsible for producing multi-organ protection during RIPC.
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