Nassirah Khandoudi

Inhibition of the cardiac electrogenic sodium bicarbonate cotransporter reduces ischemic injury

OBJECTIVE Although it is believed that sodium-driven acid-base transport plays a central role in the development of the reperfusion injury that follows cardiac ischemia, research to date has demonstrated only a role for Na(+)/H(+) exchange (NHE). However, Na(+)-driven HCO(-)(3) transport, which is quantitatively as important as NHE in cardiac cells, has not been examined. METHODS AND RESULTS Here the results show that a neutralizing antibody raised against the human heart electrogenic Na(+)/HCO(3)(-) cotransporter (hhNBC) blocked the recovery of pH after acidic pulse both in HEK-293 cells expressing hhNBC and in rat cardiac myocytes demonstrating the presence of an electrogenic NBC in rat cardiac myocytes similar to hhNBC. Administration of anti-NBC antibody to ischemic-reperfused rat hearts markedly protects systolic and diastolic functions of the heart during reperfusion. Furthermore, using a quantitative real-time RT-PCR (TaqMan) and Western blot analysis we demonstrated that in human cardiomyopathic hearts, mRNA and protein levels of hhNBC increase, whereas mRNA levels of the electroneutral Na(+)/HCO(3)(-) cotransporter (NBCn1) remain unchanged. CONCLUSION Our data provide evidence that inhibition of hhNBC, whose role in cardiac pathologies could be amplified by overexpression, represents a novel therapeutic approach for ischemic heart disease.

Mechanisms of Intracellular pH Regulation During Postischemic Reperfusion of Diabetic Rat Hearts

A marked decrease in the activity of the amiloride-sensitive Na+/H+ exchanger has been demonstrated in hearts from streptozotocin (STZ)-induced diabetic rats. The aim of this study was to investigate the contribution of other specific sarcolemmal transport mechanisms to intracellular pH (pHi) recovery upon reperfusion in STZ-induced diabetic rat hearts and their relation to recovery of ventricular function. Isovolumic rat hearts were submitted to a zero-flow ischemie period of 28 min at 37°C and then reperfused for 28 min. The time course of pHi decline during ischemia and of recovery on reperfusion was followed by means of 31P-labeled NMR. The perfusion buffers used were either HEPES or CO2/HCO3−. An HCO3−-dependent (amiloride-insensitive) mechanism contributed to pHi recovery after ischemia in the diabetic rat hearts. Even when the Na+/H+ exchanger was blocked by amiloride in nominally HCO3−-free solution, a rapid rise in pHi occurred during the first 3 min of reperfusion. The early rise in pHi was reduced by external lactate and inhibited by α-cyano-4-hydroxycinnamate. This suggested that a coupled H+-lactate efflux may be a major mechanism for acid extrusion in the initial stage of reperfusion. The observation of a higher functional recovery on reperfusion in diabetic hearts is in accordance with previous studies using HCO3− buffer. However, this study shows that a good recovery of function occurred even more rapidly in diabetic hearts receiving HEPES-buffered solution than in those receiving HCO3−-buffered solution. This suggests that the HCO3−-dependent mechanism of regulation may be depressed in diabetic rat hearts.

Protective effect of the sodium/hydrogen exchange inhibitors during global low-flow ischemia

We investigated the potential role of the Na+/H+ exchanger (NHE) during global low-flow ischemia. Isolated working rat hearts were subjected to a low-flow ischemic period of 30 or 60 min at 37 degrees C and then reperfused for 30 min. Under those conditions, the effects of two NHE inhibitors 3-methylsulphonyl-4-piperidinobenzoyl guanidine methanesulphonate (HOE-694, 1 microM) and 5-(N-ethyl-N-isopropyl) amiloride (EIPA, 1 microM), were compared. When added to the perfusion fluid 15 min before induction of ischemia, EIPA partially preserved aortic output (AO) during either a 30- or 60-min low-flow period. A lesser effect, which was not statistically significant, was observed with HOE-694. Therefore, after 30-min ischemia, AO was 18.7 +/- 2.7, 31.4 +/- 3.3% (p < 0.05 vs. control group) and 25.8 +/- 3.2% of the preischemic value in control and EIPA- and HOE-694-treated groups, respectively. Similarly, after 60-min low-flow ischemia, AO was 15.7 +/- 1.8, 32.7 +/- 4.2% (p < 0.05 vs. control group) and 23.3 +/- 5.6% in control and EIPA- and HOE-694-treated groups, respectively. When EIPA and HOE-694 were added to the perfusion solution during the 60-min ischemic period, i.e., at 15 min of low-flow ischemia, AO was maintained at 38.9 +/- 4.9 and 30.2 +/- 2.4% (vs. 15.7 +/- 1.8% in the controls) in HOE-694- and EIPA-treated groups, respectively. EIPA but not HOE-694 also significantly (p < 0.05) improved the AO recovery during reperfusion. When administered later during ischemia, EIPA but not HOE-694 caused some recovery of AO during the remainder of the ischemic period but did not aid recovery during reperfusion. Our data suggest that although inhibition of NHE may be of some benefit during low-flow ischemia, additional effects may be necessary to provide a more efficient cardioprotection. An additional action, e.g., inhibition of the Na+/HCO3- cotransporter, could explain the superior effect of EIPA with respect to HOE-694.

Effects of adenosine receptor agonists on guinea-pig isolated working hearts and the role of endothelium and NO

The hypothesis that the coronary vasodilator effects of adenosine receptor agonists are independent of the vascular endothelium or mediators derived therefrom was examined in guinea‐pig isolated working hearts. Adenosine receptor agonists, 5′‐(N‐ethylcarboxamido)‐adenosine (NECA; two‐fold selective for A2 over A1 receptors), 2‐[p‐(2‐carboxyethyl)phenylethylamino]‐5′‐N‐ethylcarboxamidoadenosine (CGS21680; A2A selective), N6‐cyclopentyl‐adenosine (CPA; A1 selective) and N6‐(3‐iodobenzyl)adenosine‐5′‐N‐methyluronamide (IB‐MECA; A3 selective), were infused (3 times 10−7 M) after endothelium removal by passing oxygen through the coronary circulation. In spontaneously beating hearts, CGS21680 and NECA increased, while CPA decreased, coronary flow. NECA and CPA reduced heart rate, left ventricular pressure and aortic output. The nitric oxide synthase (NOS) inhibitor, NG‐nitro‐L‐arginine (L‐NOARG; 3 times 10−5 M) abolished the vasodilatation by NECA but not CGS21680, indicating that nitric oxide (NO) of a non‐endothelial source mediated the NECA response. Coronary vasodilatation by CGS21680 was inhibited by the A2A receptor antagonist, 4‐(2‐[7‐amino‐2‐(2‐furyl)[1,2,4]triazolo [2,3‐a][1,3,5]triazin‐5‐ylamino]ethyl)phenol (ZM241385). Indometacin (10−6 M) attenuated the coronary vasodilatation to CGS21680, suggesting a partial role for cyclooxygenase products. IBMECA had no effect, indicating no A3 receptor involvement. In paced working hearts, the responses were similar except CPA had no effect on coronary flow or aortic output and CGS21680 increased left ventricular pressure and the maximum rate of ventricular pressure rise. This study has demonstrated functionally effective removal of the endothelium by a novel method of passing oxygen through the coronary vasculature. A coronary vasodilator action of adenosine receptor agonists mediated via A2A receptors is endothelium‐and NO‐independent, but partially involves cyclooxygenase products.

Impaired endothelium-dependent relaxation by adrenomedullin in monocrotaline-treated rat arteries.

The effects of adrenomedullin were evaluated in isolated vascular rings from rats treated with monocrotaline (60 mg/kg, s.c.) causing pulmonary hypertension and right ventricular hypertrophy within 3 to 4 weeks. Sham animals (NaCl-treated rats) were used for comparison. The relaxing effects of adrenomedullin (10(-8) M) and acetylcholine (10(-6) M) were determined in thoracic aorta and pulmonary artery rings precontracted with phenylephrine (10(-7) M). In sham animals, adrenomedullin caused significant vasorelaxation of aorta and pulmonary artery although of different amplitude (24 +/- 3% and 40 +/- 2%, respectively). A greater relaxation was observed in response to acetylcholine. Monocrotaline-treated rats exhibited a reduction in adrenomedullin relaxation in pulmonary artery (54 and 68% loss of effect, at 3 and 4 weeks, respectively, P < 0.01 vs. sham) and comparable reductions in acetylcholine responses. The decrease in adrenomedullin relaxing effect was less pronounced in aorta than in pulmonary artery, suggesting a distinct tissue sensitivity to monocrotaline. In contrast, the relaxing effect of acetylcholine on aorta was decreased at 4 weeks (36% reduction, P < 0.01 vs. sham). In this model, the adrenomedullin-induced relaxation of the pulmonary artery was impaired due to a severe endothelial dysfunction which may contribute partly to the evolving pathophysiological process.