M L Hill

Effect of reperfusion late in the phase of reversible ischemic injury. Changes in cell volume, electrolytes, metabolites, and ultrastructure.

The acute effects of reperfusion on myocardium reversibly damaged by 15 minutes of severe ischemia in vivo, were studied. Changes in the adenine nudeotide pool, cell volume regulation, myocardial calcium, and ultrastructure were studied at the end of 15 minutes of ischemia and after 0.5, 3.0, and 20 minutes of reflow. Before reperfusion, adenosine triphosphate and the adenylate pool decreased by 63% and 44% of control, respectively, and the adenylate charge was reduced to 0.65. After 3 minutes of reperfusion, the adenylate charge was restored to control by the rephosphorylation of adenosine mono- and diphosphate, but adenosine triphosphate was still reduced by 45%. Mild tissue edema was detected after 0.5 minute of reflow and persisted throughout 20 minutes of reperfusion. The increased tissue water was accompanied by a slight increase in sodium and a marked increase in tissue potassium. Although massive calcium accumulation develops when irreversibly injured tissue is reperfused, no calcium overload was detected during early reperfusion of reversibly injured myocytes. Reperfusion for 3 minutes exaggerated the mitochondrial swelling induced by 15 minutes of ischemia but after 20 minutes of reperfusion, myocardial ultrastructure was essentially normal except for rare swollen, or disrupted, mitochondria. Thus, the cellular abnormalities associated with brief periods of ischemia persist for variable periods of time after reperfusion of reversibly injured myocytes. First: although adenine nudeotide repletion occurs very slowly, the adenylate charge was restored after 3 minutes, indicating rapid resumption of mitochondrial adenosine triphosphate production. Second: caldum overload was not detected, but myocardial edema and increased potassium persisted throughout the 20 minutes of reperfusion. Third: the ultrastructural consequences of ischemia were nearly reversed after 20 minutes of reperfusion.

Prolonged Depletion of ATP and of the Adenine Nucleotide Pool due to Delayed Resynthesis of Adenine Nucleotides following Reversible Myocardial Ischemic Injury in Dogs

Abstract After 15 min of severe ischemia induced by circumflex artery occlusion in open-chest dogs, 65% of the ATP and 50% of the total adenine nucleotide (ΣAd) pool is lost from the subendocardial myocardium [ 12 ]. Nevertheless, this injury is reversible if the affected tissue is reperfused with coronary arterial blood. In the present experiment, we assessed the effects of various periods of arterial reflow following 15 min of ischemic injury, on resynthesis of ATP and ΣAd. The circumflex artery was occluded for 15 min and reperfused for 20 or 60 min, or 24 or 96 h. Ten seconds prior to excision of the heart, the circumflex artery was reoccluded and the fluorescent dye thioflavine S was injected intravenously in order to identify the ischemic or the reperfused tissue which had been ischemic. The mean ATP after 15 min of ischemia was reduced 62% from 5.42 ± 0.33 to 2.08 ± 0.21 μmol/g; and the total nucleotide content was reduced by 50%. ATP content recovered slightly during the first 20 min of reperfusion but remained markedly depressed for at least 24 h because of the initial depletion of adenine nucleotides and because minimal salvage or de novo synthesis occurred in the injured muscle during this time period. By 4 days, ATP and total adenine nucleotides were still slightly depressed but had recovered to 88% and 91% of control. Electrolyte changes and an increased inulin diffusible space, which are characteristic of irreversibly injured myocardium reperfused for 20 or 60 min, were not observed. Also tissue necrosis was absent in the hearts reperfused for 24 or 96 h. These observations indicate that the marked depression of ATP and adenine nucleotides and the slow recovery of these metabolites occurred in myocardium which nevertheless was reversibly injured in terms of cellular viability.

Total ischemia in dog hearts, in vitro. 1. Comparison of high energy phosphate production, utilization, and depletion, and of adenine nucleotide catabolism in total ischemia in vitro vs. severe ischemia in vivo.

This study was done to compare rates of high energy phosphate (HEP) utilization and depletion, as well as the production and distribution of catabolic products of adenine nucleo tides in dog heart during total ischemia in vitro and severe ischemia in vivo. Both HEP production from anaerobic glycolysis and HEP utilization occurred much more quickly during the first 15 mmtuet of severe ischemia in vivo than in total ischemia in vitro. HEP utilization exceeded production in both types of ischemia and tissue HEP decreased progressively. Much of the creatine phosphate (CP) was lost within the first 1–3 minutes; adenosine triphosphate (ATP) depletion occurred more slowly than CP and more slowly in vitro than in vivo. ATP was reduced from control contents of 5–6 μmol/g to 1.0 μmol/g by 75 minutes of total ischemia in vitro, but reached a similar level within only 30 minutes of severe ischemia in vivo. HEP utilization and production during ischemia were estimated from the rate of accumulation of myocardial lactate and essentially ceased when the ATP reached 0.4 μmol/g wet weight. At this time, more than 80% of the HEP that had been utilized in ischemia in vivo or in total ischemia in vitro had been derived from anaerobic glycolysis. ATP depletion was paralleled by dephosphorylation of adenine nucleottdeg. The lost nucleotides were recovered stoichiometrically as adenosine, inosine, hypoxantbine, and xanthine in both models of ischemia, a finding which demonstrates that the low collateral flow of severe ischemia allows little washout of nucleosides, bases, or lactate to the systemic circulation. These results Indicate that total ischemia in vitro can be used as a model of severe ischemia in vivo in that the pathways of energy production and depletion and of adenine nucleotide degradation generally are similar.

Volume regulation and plasma membrane injury in aerobic, anaerobic, and ischemic myocardium in vitro. Effects of osmotic cell swelling on plasma membrane integrity.

The relationship between cell swelling and plasma membrane disruption has been evaluated in thin myocardial slices incubated in oxygenated or anoxic Krebs-Ringer phosphate media. Electron microscopy and measurements of inulin-diffusible space were used to monitor plasma membrane integrity. Inulin is excluded from the intracellular space of intact cells; therefore, an increase in tissue inulin content is an excellent marker of loss of plasma membrane integrity. Cell volume was increased during exposure of aerobic slices to hypotonic media, but the inulin-diffusible space was not increased and electron micrographs showed no detectable plasma membrane alterations. Likewise, during prolonged anoxic isotonic incubation, no evidence of plasma membrane damage was observed. Incubation in anoxic hypotonic media for 60 minutes resulted in a larger increase in cell volume than under aerobic conditions, but plasma membrane integrity was maintained. Extended anoxic hypotonic incubation (300 minutes) produced no further change in tissue water, but the inulin-diffusible space was increased and electron micrographs revealed breaks in the plasma membranes primarily in association with large subsarcolemmal blebs. Likewise, myocardial slices incubated in isotonic anoxic media for 240 minutes and hypotonic anoxic media for 60 minutes had an increased inulin-diffusible space and the ultrastructural appearance was similar. This ultrastructural appearance is indistinguishable from that observed in myocytes lethally injured by ischemia. Measurements of tissue osmolarity during total ischemia showed that osmotically induced cell swelling could occur in ischemic myocardium prior to the onset of plasma membrane disruption. Our results indicate that cell swelling per se is incapable of rupturing plasma membranes; however, after prolonged periods of energy deficiency, the plasma membrane or its cytoskeletal scaffold become injured, which allows the membrane to rupture if the cell is swollen, as might occur during ischemia or reperfusion.

Cytoskeletal damage during myocardial ischemia: changes in vinculin immunofluorescence staining during total in vitro ischemia in canine heart.

The role of cytoskeletal damage in the disruption of the plasma membrane observed during myocardial ischemia has been studied using antibodies to vinculin to identify changes in the distribution of this membrane associated cytoskeletal protein. Vinculin is a component of the cytoskeletal attachment complex between the plasma membrane and the Z-line of the underlying myofibrils. The effects of varying periods of total ischemia on the localization of vinculin were assessed by immunofluorescence and evidence of membrane disruption was evaluated by electron microscopy. Thin tissue slices prepared from the ischemic tissue were incubated in oxygenated Krebs-Ringer phosphate buffer at 37 degrees C to assess inulin permeability, ultrastructure, and any changes in the distribution of vinculin associated with incubation. The previously reported costameric pattern of vinculin staining was observed in longitudinal sections of control myocardium, myocardium subjected to 60 minutes of total ischemia, and myocardium subjected to 60 minutes of ischemia followed by 60 minutes of incubation in oxygenated media. Electron microscopy and inulin permeability measurements confirmed that plasma membrane integrity was preserved under these conditions. However, when the duration of total ischemia was extended to 120 minutes or longer, there was a progressive loss of vinculin staining along the lateral margin of myocytes. This change correlates with the appearance of subsarcolemmal blebs and breaks in the plasma membranes observed by electron microscopy and confirmed by the increase in inulin permeability observed in tissue slices.(ABSTRACT TRUNCATED AT 250 WORDS)

Total ischemia in dog hearts, in vitro 2. High energy phosphate depletion and associated defects in energy metabolism, cell volume regulation, and sarcolemmal integrity.

This study was done to assess the capacity of tissue, injured by varying periods of total ischemia, to perform integrated cellular functions. The principal aim was to learn the nature of the associations between the decreasing ATP of the ischemic tissue and the appearance of defective high energy phosphate regeneration, cell volume and ion regulation, and membrane permeability. Total ischemia in vitro was produced by incubating papillary muscles from dog hearts at 37°C. Slices were cut from control tissue and from injured tissue after 60–150 minutes of total ischemia. We incubated these slices in oxygenated phosphate Krebs-Ringer phosphate buffer containing MC-inulin in order to assess their capacity to resynthesize ATP and CP. to maintain ion gradients and water content, and to retain membrane impermeability to inulin and creatine. The results demonstrate that there was a close association between ATP depletion and the failure of the damaged tissue to regenerate high energy phosphates, and to preserve cell volume and ionic regulation. As long as the ATP of the tissue was not depleted below 6 μmol/g dry weight prior to incubation, no cellular abnormalities were detected by subsequent aerobic incubation of slices of the injured tissue. However, lower ATP levels were associated with depressed high energy phosphate resynthesis and failure of cell volume regulation. These defects preceded the development of overt membrane damage, which occurred only after the tissue ATP content decreased to less than 2.0 μmol/g. When overt membrane damage was present, it was associated with marked Impairment of other integrated cellular functions. Although the pathogenesis of the membrane damage in ischemia is unknown, its presence is an objective sign of lethal injury in this system.

Effect of hypothermia on changes in high-energy phosphate production and utilization in total ischemia

Abstract The effect of temperature on the rate of production, utilization and destruction of high-energy phosphate in total ischemia was investigated in the dog heart. These studies were performed utilizing a new model of ischemic injury which was designed to test the effect of interventions on the metabolism and structure of ischemic myocardium. In this model, the normal heart was isolated from the circulation in vivo and was arrested immediately with hyperkalemic, oxygenated, autogenous arterial blood prior to the induction of total ischemia. Left ventricular pressure changes in the isolated heart were used to time the onset of ATP depletion to the levels associated with the development of contracture-rigor. Decrements in temperature progressively slowed both ATP production from anaerobic glycolysis and ATP utilization and delayed but did not prevent ATP depletion and the onset of contracture-rigor. Reserve supplies of high-energy phosphates were utilized and much of the adenine nucleotide pool was destroyed at all temperatures studied. Anaerobic glycolysis provided more than 80% of the high-energy phosphates utilized by the ischemic cell at all temperatures but always ceased when ATP levels decreased to 1–2% of control. The results demonstrate that the protective effect of hypothermia in total ischemia is due to a proportional slowing in rates of energy production and utilization. Consequently, hypothermia only delays the depletion of the high-energy phosphate reserves of the myocyte and the destruction of the adenine nucleotide pool.

T-lymphocyte proliferation: tyrosine kinases in interleukin 2 signal transduction

Interleukin 2 (IL-2)-induced tyrosine phosphorylation appears to play a major role in IL-2-induced cellular proliferation. Several intracellular substrates including the beta chain of the IL-2 receptor complex (IL-2R beta), raf, MAP2 kinase, the regulatory 83 kDa subunit of phosphatidylinositol-3 kinase and S6 kinases are substrates for the IL-2 receptor activated kinase(s). However, none of the identified members of the IL-2 receptor complex exhibits intrinsic tyrosine kinase activity. Therefore, the IL-2R complex must activate intracellular tyrosine kinases. We have demonstrated that specific tyrosine and serine/threonine kinases are coprecipitated with IL-2 receptor constructs that mediate IL-2-induced cell proliferation but not with those that do not. The IL-2-activated tyrosine kinase appears to be associated with a serine and proline rich intracellular domain which is highly conserved between IL-2R beta and the erythropoietin receptor. Although the responsible kinase has not been identified, lck, fyn, fgr, ltk, hck and lyn can be ruled out as obligatory mediators. Using methods to clone tyrosine kinases from T cells, we have identified potential candidate kinases, including several which had not been known to be expressed by T lymphocytes as well as several unique kinases which had not been previously identified in any cell type.

Prolonged Depletion of ATP Because of Delayed Repletion of the Adenine Nucleotide Pool following Reversible Myocardial Ischemic Injury in Dogs

Sixty-five percent of the ATP and 50% of the total adenine nucleotide (sigma Ad) pool is lost from the subendocardial myocardium after 15 min of severe ischemia induced by circumflex artery occlusion in open-chest dogs (12). In the present experiment, we assessed the effects of various periods of arterial reflow following 15 min of ischemic injury on resynthesis of ATP and sigma Ad. The circumflex artery was occluded for 15 min and reperfused for 20 or 60 min or 24 or 96 hr. The mean ATP after 15 min of ischemia was reduced 62% from 5.42 +/- 0.33 to 2.08 +/- 0.21 mumol/g; and the total nucleotide content was reduced by 50%. ATP content recovered slightly during the first 20 min of reperfusion but remained markedly depressed for at least 24 hr because of the initial depletion of adenine nucleotides and because minimal salvage of de novo repletion occurred in the injured muscle during this time period. By 4 days, ATP and total adenine nucleotides were still slightly depressed but had recovered to 88% and 91% of control. Electrolyte changes and an increased inulin-diffusible space, which are characteristic of irreversibly injured myocardium, reperfused for 20 or 60 min, were not observed. Also, tissue necrosis was absent in the hearts reperfused for 24 or 96 hr. These observations indicate that the marked depression of ATP and adenine nucleotides and the slow recovery of these metabolites occurred in myocardium that nevertheless was reversibly injured in terms of cellular viability.