Herzl Schwalb

An improved method for endothelial cell seeding on polytetrafluoroethylene small caliber vascular grafts

The creation of nonthrombogenic synthetic surfaces is a major challenge in biomedical research. The feature that clearly distinguishes natural blood vessels from their artificial counterparts is the presence of endothelial cell lining that besides being nonthrombogenic is capable of repair and renewal. This study describes a method of coating vascular grafts with a uniform, naturally produced subendothelial extracellular matrix before implantation. This substrate provides a most suitable bilayer for endothelial cell adhesion, growth, and differentiation, as compared with grafts coated with fibronectin or basement membrane extracts. It contains both adhesive glycoproteins (fibronectin, laminin, collagen) and proteoglycans (heparan sulfate) as well as endothelial cell growth factors (basic fibroblast growth factor) that support adhesion and normal growth of suboptimal concentrations of endothelial cells. We suggest that the presence in extracellular matrix of both adhesive macromolecules and potent endothelial cell-growth promoting factors will make the extracellular matrix a promising substrate for vascular grafts.

Protection of myocardium by cyclosporin A and insulin: In vitro simulated ischemia study in human myocardium

BACKGROUND The efficacy of myocardial protection by cyclosporin A (CSA) and insulin was tested in human right atrial myocardial slices subjected to simulated ischemia and reoxygenation. METHODS Slices of right atrial trabeculae were obtained from patients undergoing elective cardiac surgery. Trabeculae were incubated with oxygenated glucose containing phosphate buffered saline (O(2), G-PBS). After 30 minutes of stabilization the sections were exposed to 90 minutes of simulated ischemia (N(2), PBS without glucose) followed by 90 minutes reoxygenation (O(2), G-PBS). Cyclosporin A (0.2 micromol/L) or insulin (5 mU/mL) was added during the stabilization period prior the ischemia. Cell viability was measured by using 3-[4.5 dimethylthiazol 2-yl]-2,5-diphenyltetrazolium bromide (MTT), which is cleaved by active mitochondrial dehydrogenases of living cells. RESULTS The viability of untreated slices (control) was 30.45% +/- 2.5% versus 52.65% +/- 4.4% in the CSA treated slices, p less than 0.001. The extent of protection by CSA was affected by oral antiglycemic drugs (glibenclamide). The effect obtained by CSA was inhibited by 5-hydroxydecanoate (5HD), a specific blocker of mitochondrial K(ATP) channels. Protection of the myocardial slices with insulin appears to be superior and not affected by the medication before surgery. This protection was maximal when insulin was present during both preischemic equilibration and reoxygenation periods (68.9% +/- 9.3% viability with insulin versus 33.2% +/- 6.9% in the control, p < 0.001). CONCLUSIONS Protection of right atrial trabeculae slices with insulin is superior to that obtained with CSA and is independent of preoperative medication.

Interaction between allopurinol and copper: possible role in myocardial protection.

Allopurinol, a potent inhibitor of xanthine oxidase, is known to effectively protect the heart against damage in patients undergoing cardiac bypass surgery. There is still an ambiguity concerning the presence of xanthine oxidase in the human heart. Thus, the mechanism underlying the protective effect of allopurinol is unclear. Transition metal ions, such as iron and copper, can participate in single-electron reactions and mediate the formation of oxygen-derived free radicals. In this study the interaction between allopurinol and Cu(II) was investigated. Spectrophotometric investigation shows that allopurinol (0-0.8 mM) form a 1:1 complex with Cu(II) ions (0-0.8 mM) with a specific absorbance peak at 364 nm. Also, the rate constant (k) for the copper-catalyzed aerobic oxidation of ascorbate was markedly decreased in the presence of allopurinol (from 0.068 min-1 to 0.014 min-1). Allopurinol substantially reduced the copper-mediated and ascorbate-driven DNA breakage. Spectrophotometric measurements did not indicate a specific interaction between iron ions and allopurinol. It is suggested that the beneficial effects of allopurinol during reperfusion of the heart could stem from its chelation of copper, yielding a complex with low redox activity.

Effect of nitric oxide and nitroxide SOD-mimic on the recovery of isolated rat heart following ischemia and reperfusion.

Nitric oxide synthesized from L-arginine in cells has important salutary physiological roles, but can also exert deleterious effects. Nitric oxide (NO) can ameliorate post-ischemic reperfusion myocardial injury, yet formation from NO and O(2)z*(-) of peroxynitrite and its downstream toxic products, such as *OH, *NO(2) and CO(3)*(-), can ultimately exacerbate reperfusion damage. Nitroxide stable radicals, such as 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (TPL), unlike SOD, readily penetrate cells and catalytically remove intracellular O(2)*(-). Hence, nitroxides by virtue of catalytic removal of O(2)*(-) would be expected to diminish the adverse effect of NO and lower post-ischemic reperfusion cardiac damage. We show that post-ischemic recovery of hemodynamic functions of isolated perfused rat hearts treated with L-arginine or TPL alone did not differ from that of the control hearts. However, the recovery of hearts treated with the combined regimen of L-arginine and TPL was significantly improved, e.g. the Work Index=(left ventricular developed pressure x heart rate) recovered to 92+/-1.6% (L-arginine and TPL) vs. 59.4+/-5.4% (Control), 60+/-2.9% (L-arginine) and 53.3+/-4.3% (TPL) of the pre-ischemic value; mean+/-SEM, N=10, P<0.001. The enhanced recovery of hemodynamic function of hearts treated with L-arginine and TPL was accompanied by an increased recovery of oxygen consumption during the reperfusion. The combined regimen of L-arginine and TPL reduces the negative effects of NO by either inhibiting the production of ONOO(-) or through reaction with CO(3)z.rad;(-) and *NO(2) radicals formed during the decomposition of peroxynitrite in the presence of bicarbonate, thus promoting cardioprotection following post-ischemic reperfusion.

Nicorandil decreases postischemic actin oxidation.

This study examined the hypothesis that preconditioning can decrease postischemic oxidative protein damage. Isolated rat hearts were subjected to 25 min of normothermic global ischemia followed by 45 min of reperfusion. These were compared with hearts pretreated with 20 microM nicorandil or preconditioned with two cycles of ischemia. Changes in the high energy phosphates, ATP and phosphocreatine, were followed using (31)P-NMR spectroscopy. Protein carbonyls were assessed using an immunoblot technique. Postischemic hemodynamic function and high energy phosphates recovered to significantly (p <.05) higher levels in nicorandil-treated and ischemic preconditioned hearts as compared to controls. Postischemic protein carbonyl formation was highest in control reperfused hearts but reduced to intermediate between control and preischemic hearts by ischemic preconditioning and virtually prevented by nicorandil pretreatment, with a prominent band at 43 kDa significantly affected (p <.05). Based on immunoshift and immunoprecipitation studies, this band was identified as a mixture of actin isoforms. These studies support the conclusion that nicorandil diminishes protein oxidative damage in general, and specifically actin oxidation, which in the presence of improved supply of high energy phosphates, leads to enhanced postischemic contractile function.

Myocardial Mitochondrial Injury Induced by Pulmonary Exposure to Particulate Matter in Rats

Exposure to air pollution has been associated with acute myocardial ischemia, impaired myocardrial function, and ST-segment depression. Particulate matter (PM)–associated metals, especially vanadium and nickel, have been implicated in observed cardiovascular impairments. We aimed to assess the effect of single intratracheal pulmonary exposure to vanadium-rich respirable oil combustion PM (HP-10) on the intrinsic myocardial ischemic tolerance and mitochondrial integrity in rats. The authors subjected isolated heart tissue slices derived from saline or PM-exposed rats to low glucose low oxygen induced ischemia followed by oxygenated condition with glucose supplementation. Mitochondrial structural integrity was determined by TEM (transmission electron microscopy) and functionality by the 3-(4, 5 dimethylthiazol-2yl)-2, 5 diphenyltetrazolium bromide (MTT) assay. Rats exposed to PM exhibited no apparent inhibition of mitochondrial dehydrogenase activity in oxygenated conditions at 24 or 48 hr post–PM exposure. However, in conditions of simulated ischemia/reoxygenation, these heart slices showed a delayed but consistent and significant decrease in dehydrogenase activity compared to controls at 48 hr after exposure to PM. Electron microscopy revealed significant myocardial mitochondrial injury upon exposure to PM characterized by mitochondrial swelling and fusion. The authors conclude that exposure to soluble vanadium-rich PM induces mitochondrial functional impairment and structural abnormality, which compromises mitochondrial respiration and results in decreased tolerance to ischemia/reoxygenation in rats.

Interactions of cardiac glycosides with cardiac cells. III. Alterations in the sensitivity of (Na+ + K+)-ATPase to inhibition by ouabain in rat hearts

The causes of the resistance of adult rats to cardiac glycosides were examined using two approaches: (a) alterations in the binding parameters of ouabain to post-natal heart cells during their maturation in culture, a process which could be indicative of aging; and (b) changes in the I50 values of cardiac (Na+ + K+)-ATPase and K+-phosphatase activities by ouabain during the process of enzymes purification, from post-natal to adult rats, which could be indicative of structural changes. The amounts of the cell-bound ouabain decreased from 120 to 12 fmol/mg protein or from 8 to 2 fmol/μg DNA between the 2nd and the 10th day or between the 2nd and the 8th day of growth, respectively. Furthermore, partially purified preparations of (Na+ + K+)-ATPase from post-natal rat hearts, obtained following treatment with deoxycholate and high concentrations of NaI, were most sensitive to inhibition by ouabain (I50 = (4.6±0.6) · 10−5 M) than similar preparations from adult rats (I50 = (22.4±5.3) · 10−5 M, P<0.005). The I50 values for the detergent-treated enzyme and the salt-treated enzyme in the adult rat or adult cat hearts were: (22.4±5.3)·10−5 M and (4.89±0.83)·10−5 M (P<0.001), respectively, for the rat and (178±52)·10−8 M and (2.0±0.48)·10−8 M (P<0.005), respectively, for the cat. Frozen and thawed homogenates of either species responded neither to the cations nor to inhibition by ouabain. The K+-activated, ouabain-inhibited changes in p-nitrophenylphosphatase sensitivity to inhibition by the cardiac glycoside were minimal during the purification of the enzyme from both the cat or rat hearts, although the purification factors were 6.4 and 9.0, respectively. The decrease in ouabain binding to new-born rat cardiac muscle cells, but not to non-muscle cells, during maturation in culture; the decrease in sensitivity of (Na+ + K+)-ATPase from new-born rats, compared to adult rats, to inhibition by ouabain; and the increase in the sensitivity of the enzyme to inhibition by the drug during the process of the enzymes purification from adult rat or from cat suggested that certain structural alterations could occur in the ouabain receptor during aging in culture or maturation in vivo. These may be reflected by the removal of certain components during the process of the enzymes purification and may provide a partial explanation for the resistance of the rat to ouabain.

Ozone administration reduces reperfusion injury in an isolated rat heart model.

Abstract  Background: Accumulating clinical experience with ozone administration for conditions associated with ischemia has been encouraging. The aim of our study was to determine the effect of ozone on reperfusion injury in an isolated rat heart model. Methods: Isolated rat hearts were perfused with modified Krebs‐Henseleit buffer solution via ascending aorta cannulation. After 15 minutes, perfusion was stopped and global ischemia was maintained for 30 minutes, following which perfusion was restarted, and continued for 40 minutes. Baseline hemodynamic measurements (heart rate, left ventricular developed pressure (LVDP), dP/dt, and coronary flow) were taken prior to ischemia, and every 10 minutes after reperfusion was started. Eleven hearts were treated with ozone during reperfusion and eight hearts served as controls. In the treatment group, after 5 minutes of reperfusion, ozone was administered in distilled water via a side arm for 5 minutes. Results: Preischemic baseline hemodynamic measurements and coronary flow were similar in the two groups. Hearts treated with ozone during reperfusion exhibited better recovery than did controls. Mean (±SE) percent recovery for treatment and control groups, respectively, was: LVDP 69 ± 2% vs 51 ± 6% (p = 0.04); dP/dt 68.9 ± 13.3% vs 53.7 ± 20.4% (p = 0.05); and LVDPxHR 61.4 ± 3.3% vs 44.4 ± 3.5% (p = 0.02). Conclusion: In the isolated rat heart model, treatment with ozone during reperfusion enables better recovery than in controls. Although the mechanism by which ozone exerts its beneficial effect is not identified, it is possibly due to reduction in reperfusion injury.

Interactions of cardiac glycosides with cultured cardiac cells: II. Biochemical and electron microscopic studies on the effects of ouabain on muscle and non-muscle cells

Electron microscopic and biochemical studies revealed a salient difference in the response to toxic doses of ouabain by cultured cardiac muscle and non-muscle cells from neonatal rats. Progressive cellular injury in myocytes incubated with 1 . 10(-4)--1 . 10(-3) M ouabain ultimately leads to swelling and necrosis. The morphological damage in myocytes was accompanied by a drastic decrease in 14CO2 formation from 14C-labeled stearate or acetate but not glucose. Neither morphological nor biochemical impairments were observed in non-muscle cells. The interaction between ouabain and the cultured cells, using therapeutic doses of ouabain (i.e., less than 1 . 10(-7) M), was characterized. Two binding sites were described in both classes of cells, one site is a saturable K+-sensitive site whereas the other is non-saturable and K+-insensitive. The complexes formed between the sarcolemma receptor(s) and ouabain, at low concentrations of the drug (e.g., 7.52 . 10(-9) M), had Kd values of 8.9 . 10(-8) and 2.3 . 10(-8) M for muscle and non-muscle cells, respectively. The formation and dissociation of the complexes were affected by temperature and potassium ions.

Occult Cardiotoxicity—Toxic Effects on Cardiac Ischemic Tolerance

The outcome of cardiac ischemic events depends not only on the extent and duration of the ischemic stimulus but also on the myocardial intrinsic tolerance to ischemic injury. Cardiac ischemic tolerance reflects myocardial functional reserves that are not always used when the tissue is appropriately oxygenated. Ischemic tolerance is modulated by ubiquitous signal transduction pathways, transcription factors and cellular enzymes, converging on the mitochondria as the main end effector. Therefore, drugs and toxins affecting these pathways may impair cardiac ischemic tolerance without affecting myocardial integrity or function in oxygenated conditions. Such effect would not be detected by current toxicological studies but would considerably influence the outcome of ischemic events. The authors refer to such effect as “occult cardiotoxicity.” In this review, the authors summarize current knowledge about main mechanisms that determine cardiac ischemic tolerance, methods to assess it, and the effects of drugs and toxins on it. The authors offer a view that low cardiac ischemic tolerance is a premorbid status and, therefore, that occult cardiotoxicity is a significant potential source of cardiac morbidity. The authors propose that toxicologic assessment of compounds would include the assessment of their effect on cardiac ischemic tolerance.