Donna M. Van Winkle

Soluble epoxide hydrolase inhibition and gene deletion are protective against myocardial ischemia-reperfusion injury in vivo

Soluble epoxide hydrolase (sEH) metabolizes epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acids. EETs are formed from arachidonic acid during myocardial ischemia and play a protective role against ischemic cell death. Deletion of sEH has been shown to be protective against myocardial ischemia in the isolated heart preparation. We tested the hypothesis that sEH inactivation by targeted gene deletion or pharmacological inhibition reduces infarct size (I) after regional myocardial ischemia-reperfusion injury in vivo. Male C57BL\6J wild-type or sEH knockout mice were subjected to 40 min of left coronary artery (LCA) occlusion and 2 h of reperfusion. Wild-type mice were injected intraperitoneally with 12-(3-adamantan-1-yl-ureido)-dodecanoic acid butyl ester (AUDA-BE), a sEH inhibitor, 30 min before LCA occlusion or during ischemia 10 min before reperfusion. 14,15-EET, the main substrate for sEH, was administered intravenously 15 min before LCA occlusion or during ischemia 5 min before reperfusion. The EET antagonist 14,15-epoxyeicosa-5(Z)-enoic acid (EEZE) was given intravenously 15 min before reperfusion. Area at risk (AAR) and I were assessed using fluorescent microspheres and triphenyltetrazolium chloride, and I was expressed as I/AAR. I was significantly reduced in animals treated with AUDA-BE or 14,15-EET, independent of the time of administration. The cardioprotective effect of AUDA-BE was abolished by the EET antagonist 14,15-EEZE. Immunohistochemistry revealed abundant sEH protein expression in left ventricular tissue. Strategies to increase 14,15-EET, including sEH inactivation, may represent a novel therapeutic approach for cardioprotection against myocardial ischemia-reperfusion injury.

Met5-enkephalin protects isolated adult rabbit cardiomyocytes via δ-opioid receptors

In rats and rabbits, endogenous opioid peptides participate in ischemic preconditioning. However, it is not known which endogenous opioid(s) can trigger cardioprotection. We examined preconditioning-induced and opioid-induced limitation of cell death in isolated, calcium-tolerant, adult rabbit cardiomyocytes. Cells were subjected to simulated ischemia by pelleting and normothermic hypoxic incubation. Preconditioning was elicited with 15 min of simulated ischemia followed by 15 min of resuspension and reoxygenation. All cells underwent 180 min of simulated ischemia. Cell death was assessed by trypan blue permeability. Morphine protected cells, as did preconditioning; naloxone blocked the preconditioning-induced protection. Exogenous Met5-enkephalin (ME) induced protection, but exogenous β-endorphin did not. ME-induced protection was blocked by the δ-selective antagonist naltrindole. Additionally, two other proenkephalin products, Leu5-enkephalin and Met5-enkephalin-Arg-Phe, provided protection equipotent to ME. These data suggest that one or more proenkephalin products interact with δ-opioid receptors to endogenously trigger opioid-mediated protection.

Fluorescent vs. radioactive microsphere measurement of regional myocardial blood flow

OBJECTIVES This study compared simultaneous regional myocardial blood flow (RMBF) measurements using fluorescent microspheres (FM) and radiolabeled microspheres (RM). The utility of an internal standard during processing was also examined. METHODS Paired FM and RM were injected into the left atrium of 9 anaesthetised rabbits. RMBF was altered by use of either regional ischaemia or (-)-N6-(2-phenylisopropyl)-adenosine. Radioactivity of blood reference and tissue samples was quantitated using standard methods. Samples were then digested with potassium hydroxide and microspheres recovered by vacuum filtration, with an additional label of FM as the internal standard. FM labels were extracted using Carbitol acetate and quantitated using fluorescence spectroscopy. Agreement between the fluorescent and radioactive methods was assessed using both orthogonal regression and difference-against-mean analyses. RESULTS Using recovery-uncorrected data, the slope of the orthogonal regression of RM and FM-determined RMBF was not statistically different from 1, but the intercept was statistically different from 0 [-0.03(0.01), P = 0.005] and the mean RMBF by each method differed from one another [1.24(0.08) vs. 1.17(0.08) ml.min-1.g-1, P = 0.0002]. The mean +/- 2 s.d. of the differences of RMBF (RM minus FM) was +0.07 +/- 0.30 ml.min-1.g-1. Although recovery of FM from tissue averaged 97.6(1.2)%, use of the internal standard to correct for losses substantially improved the agreement between RM and FM-determined RMBF: the orthogonal regression slope was not statistically different from 1, the intercept was not statistically different from 0, and the means of the flows were not different. The mean +/- 2 s.d. of the differences of RMBF was -0.01 +/- 0.22 ml.min-1.g-1. The internal standard also improved RMBF estimates from samples with simulated large spillage during processing. CONCLUSION Fluorescent microspheres are an equivalent alternative to radiolabeled microspheres for the estimation of RMBF. Although the overall recovery of microspheres using this technique was high, use of an internal standard is recommended for correction of random losses.

Ischemic preconditioning limits infarct size following regional ischemia–reperfusion in in situ mouse hearts

OBJECTIVE Ischemic preconditioning has been demonstrated in a wide variety of animals, from dogs to rats. Experimentally-induced murine myocardial ischemia-reperfusion has been described, but ischemic preconditioning has not been reported in mouse hearts. To test the hypothesis that mouse hearts exhibit preconditioning-induced protection, experiments were conducted in anesthetized open chest mice subjected to regional myocardial ischemia-reperfusion. METHODS Following barbiturate anesthesia the FVB and C57BL/6J mice underwent a tracheostomy and were mechanically ventilated. The heart was exposed via a left thoracotomy performed with the aid of a dissecting microscope. A 7-0 silk suture on a curved taper needle was passed under the proximal left anterior descending coronary artery to form a snare. Mice were then randomly assigned to receive either no preconditioning or preconditioning. All mice were subjected to 60 min regional myocardial ischemia followed by 2.5 h of reperfusion. Ischemic preconditioning (IP) was induced with two (FVB mice) or three (C57BL/6J mice) cycles of 5 min coronary occlusion and 5 min reperfusion. Control animals did not receive preconditioning ischemia. Area-at-risk was assessed with fluorescent particles. Infarct size was assessed with triphenyl tetrazolium chloride, and is expressed below as a percentage of the area-at-risk. RESULTS In FVB mice preconditioning reduced infarct size 49%, from 36.7 +/- 4.5% to 18.9 +/- 2.8% (P < 0.05). In C57BL/6J mice preconditioning reduced infarct size by 66%, from 56.4 +/- 8.3% to 18.9 +/- 4.2% (P < 0.05). CONCLUSION From these data we conclude that the infarct limiting effect of ischemic preconditioning is demonstrable in murine hearts.

Inhibition of soluble epoxide hydrolase preserves cardiomyocytes: role of STAT3 signaling

Soluble epoxide hydrolase (sEH) metabolizes epoxyeicosatrienoic acids (EETs), primarily 14,15-EET. EETs are derived from arachidonic acid via P-450 epoxygenases and are cardioprotective. We tested the hypothesis that sEH deficiency and pharmacological inhibition elicit tolerance to ischemia via EET-mediated STAT3 signaling in vitro and in vivo. In addition, the relevance of single nucleotide polymorphisms (SNPs) of EPHX2 (the gene encoding sEH) on tolerance to oxygen and glucose deprivation and reoxygenation and glucose repletion (OGD/RGR) was assessed in male C57BL\6J (WT) or sEH knockout (sEHKO) cardiomyocytes by using transactivator of transcription (TAT)-mediated transduction with sEH mutant proteins. Cell death and hydrolase activity was lower in Arg287Gln EPHX2 mutants vs. nontransduced controls. Excess 14,15-EET and SEH inhibition did not improve cell survival in Arg287Gln mutants. In WT cells, the putative EET receptor antagonist, 14,15-EEZE, abolished the effect of 14,15-EET and sEH inhibition. Cotreatment with 14,15-EET and SEH inhibition did not provide increased protection. In vitro, STAT3 inhibition blocked 14,15-EET cytoprotection, but not the effect of SEH inhibition. However, STAT3 small interfering RNA (siRNA) abolished cytoprotection by 14,15-EET and sEH inhibition, but cells pretreated with JAK2 siRNA remained protected. In vivo, STAT3 inhibition abolished 14,15-EET-mediated infarct size reduction. In summary, the Arg287Gln mutation is associated with improved tolerance against ischemia in vitro, and inhibition of sEH preserves cardiomyocyte viability following OGD/RGR via an EET-dependent mechanism. In vivo and in vitro, 14,15-EET-mediated protection is mediated in part by STAT3.

Remifentanil limits infarct size but attenuates preconditioning-induced infarct limitation

ObjectivesWe investigated the influence of the narcotic anesthetic remifentanil on irreversible myocardial ischemic injury. MethodsNew Zealand White rabbits were anesthetized with propofol (0.7–1.8 mg·kg−1·min−1) and then subjected to 30 min regional myocardial ischemia and 3 h reperfusion (CON). Some animals also underwent ischemic preconditioning, elicited by either one (IP1) or two (IP2) cycles of 5 min ischemia and 5 min reperfusion, and/or remifentanil, administered either as a transient infusion mimicking the preconditioning protocol (RP2, 10 μg·kg−1·min−1) or as a continuous infusion (R, 3–10 μg·kg−1·min−1). Rabbits were randomly assigned to experimental groups. Infarct size was assessed with tetrazolium. Results are reported as mean±SD. ResultsNon-preconditioned infarct size was ∼50% of the area-at-risk (49.6±20.1% CON). Both one and two cycles of ischemic preconditioning markedly reduced infarct size (49.6±20.1% CON versus 18.6±8.6% IP and versus 7.5±7.6% IP2; both p<0.001). Preconditioning with remifentanil modestly reduced infarct size (49.6±20.1% CON versus 29.3±8.5% RP2; p<0.01). However, sustained administration of remifentanil did not provide protection (49.6±20.1% CON versus 43.9±16.2% R), and it attenuated the protection offered by preconditioning (49.6±20.1% CON versus 35.6±20.7% R+IP1, p=NS; and versus 14.5±14.5% R+IP2; p<0.05). ConclusionTransient pre-ischemic administration of remifentanil modestly reduces infarct size in propofol-anesthetized rabbits, but continuous administration of remifentanil increases the threshold for ischemic preconditioning-induced infarct limitation.

Dichloroacetate reduces plasma lactate levels but does not reduce infarct size in rabbit myocardium.

Dichloroacetate (DCA), an activator of pyruvate dehydrogenase (PDHC), enhances postischemic mechanical recovery of isolated hearts. It is not known whether this is secondary to reduced infarction or preservation of contractile function in viable cardiomyocytes. This study investigated the effect of DCA on myocardial infarct size. Anesthetized open chest rabbits underwent regional coronary occlusion and reperfusion. DCA (300 mg/kg plus 150 mg/kg 1 h later) was administered intravenously either before occlusion (DCA-O; n = 8) or at reperfusion (DCA-R; n = 7). Control rabbits (n = 8) received saline vehicle. Myocardial PDHC activity was measured after administration of 300 mg/kg i.v. DCA in 10 separate rabbits. DCA reduced plasma lactate levels and increased PDHC activity by 76%, from 2.79 +/- .30 mumol/min.g-1 to 4.92 +/- .44 mumol/min.g-1 (p < .005). However, infarct size in DCA-treated animals was not significantly different from Control (60 +/- 5% DCA-O, 57 +/- 6% DCA-R, 58 +/- 7% Control). We conclude that stimulation of pyruvate dehydrogenase does not limit infarct size.

Ischemic Preconditioning of Myocardium: Effect of Adenosine

Recently, it was suggested that adenosine is involved in the cardioprotection of ischemic preconditioning (PC). If PC is mediated via adenosine, then administration of adenosine antagonists should abolish the cardioprotection, and exogenous administration of adenosine agonists should provide tolerance to ischemia. We tested these hypotheses in anesthetized rabbits (n = 40) which underwent 30 min coronary artery occlusion and 3 h reperfusion. PC was elicited by 5 min coronary artery occlusion and 10 min reperfusion before the 30-min coronary artery occlusion. PD115,199 (3 mg/kg iv), a nonselective adenosine antagonist (henceforth referred to as PD), was given 5 min before the first ischemic episode. R(–) N6-(2-phenylisopropyl)-adenosine (R-PIA, 200μg/kg/min iv) an adenosine A1 agonist, or CGS 21680 (CGS, 16μg/kg/min iv) an adenosine A2 agonist, were administered in place of PC. Infarct size (IS) was measured with tetrazolium and expressed as a percentage of the area-at-risk (mean ± SEM). Blockade of adenosine receptors attenuated the PC-induced infarct reduction (IS 34.5 ± 5.1% control [CON], 5.3 ± 1.8%* PC, 30.5 ± 9.0% PD, and 22.6 ± 5.3% PC + PD; *P < 0.05 vs CON), while administration of R-PIA resulted in a reduction in infarct size (R-PIA 18.7 ± 4.7% vs CON 34.5 ± 5.1%, P < 0.05) that was not different from PC hearts (R-PIA 18.7 ± 4.7% vs PC 5.3 ± 1.8%, P = NS). CGS did not confer any cardioprotection (IS CGS 40.9 ± 14.8% vs CON 34.5 ± 5.1%, P = NS). Since (a) administration of an adenosine antagonist attenuated the infarct-reducing effect of PC, and (b) administration of an A1—but not of an A2—agonist in place of transient ischemia mimicked the infarct-reducing effect of PC, we conclude that the activation of adenosine A1 receptors is involved in ischemic preconditioning.

Estradiol abolishes reduction in cell death by the opioid agonist Met5-enkephalin after oxygen glucose deprivation in isolated cardiomyocytes from both sexes

There is evidence for differences in the response to the treatment of cardiovascular disease in men and women. In addition, there are conflicting results regarding the effectiveness of pharmacologically induced protection or ischemic preconditioning in females. We investigated whether the ability of Met(5)-enkephalin (ME) to reduce cell death after oxygen-glucose deprivation (OGD) is influenced by the presence of 17beta-estradiol (E(2)) in a nitric oxide (NO)- and estrogen receptor-dependent manner. On postnatal day 7 to 8, murine cardiomyocytes from wild-type or inducible NO synthase (iNOS) knockout mice were separated by sex, isolated by collagenase digestion, cultured for 24 h, and subjected to 90 min OGD and 180 min reoxygenation at 37 degrees C (n = 4 to 5 replicates). Cell cultures were incubated in E(2) for 15 min or 24 h before OGD. ME was used to increase cell survival. Cell death was assessed by propidium iodide. More than 300 cells were examined for each treatment. Data are presented as means +/- SE. As a result, in both sexes, ME-induced cell survival was lost in the presence of E(2), and the ability of ME to improve cell survival was restored after treatment with the estrogen receptor antagonist ICI-182780. Furthermore, iNOS was necessary for ME to increase cell survival following OGD in vitro. We conclude that ME-induced reduction in cell death is abolished by E(2) in a sex-independent manner via activation of estrogen receptors, and this interaction is dependent on iNOS.

Inability of Left Ventricular Decompression to Limit Myocardial Infarct Size

Although the restoration of blood flow is the treatment of choice for myocardial ischemia, uncontrolled reperfusion itself may be injurious. We wished to determine whether unloading the beating left ventricle at the onset of reperfusion could limit myocardial infarct size. We studied isolated rabbit hearts, perfused with blood from a support rabbit and electrically paced at 200 beats/min. Rabbits were chosen because of the lack of preformed coronary collateral vessels. Four groups of rabbits were studied; all hearts underwent 60-min coronary artery occlusion and 2 h of reperfusion. The experimental conditions were as follows: In group 1, hearts contracted isovolumetrically on a fluid-filled balloon in the left ventricle during both occlusion and reperfusion. In group 2, the balloon was present only during occlusion, and the heart was vented during reperfusion. Group 3 hearts were vented during both occlusion and developed pressure during reperfusion. Hearts in group 4 were vented during both occlusion and reperfusion. Total coronary flow was measured by timed collection of effluent blood. Infarct size was assessed by the triphenyl tetrazolium method, and expressed as a percent of the area at risk, as determined with fluorescent particles. Perfusion pressure and coronary flow were not different between groups.