The mechanisms responsible for the enhanced inflammatory response in type 2 diabetes (T2DM) and its contribution to the severe ischemia/reperfusion (I/R) injury observed in the T2DM heart are unclear. I/R is associated with an acute inflammatory response recognized by reactive oxidant production, complement activation, and leukocyte-endothelial cell adhesion, among others. Complement activation plays an important role in the inflammatory response and is involved in the manifestation of I/R injury in the non-diabetic heart, and is a potent chemoattractant for circulating neutrophils (PMNs). The purpose of this dissertation research was to test the hypothesis that the complement system, predominantly the lectin pathway, is a significant contributor to the excessive response of the Zucker Diabetic Fatty (ZDF), a rat model of T2DM, to myocardial I/R injury. Following 30min of coronary artery occlusion and 120min of reperfusion we measured C3 deposition, PMN accumulation, PMN CD11b expression, and ICAM-1 expression. We found significantly more C3 deposition, PMN accumulation, ICAM-1 and PMN CD11b expression in diabetic samples compared to non-diabetic samples. To elucidate a role for complement system activation, we treated animals with FUT-175, a broad complement inhibitor. In vivo, FUT-175 treatment significantly decreased complement deposition (66%), PMN accumulation (59%), and infarct size (55%) compared to untreated animals in both non-diabetic Sprague-Dawley and diabetic ZDF rats. To specifically examine the role of the lectin pathway, we selectively inhibited rat MBL-A prior to myocardial I/R in ZDF rats. Anti-MBL treatment significantly decreased infarct size, C3 deposition and PMN accumulation in the ZDF post-ischemic left ventricle (LV). Genomic analysis revealed that gene expression of the pro-inflammatory cytokines IL-6 and IL-1α was enhanced in the ZDF heart following reperfusion, and quantitative RT-PCR results confirmed IL-6 upregulation. We found significantly increased complement C5a receptor (CD88) expression on diabetic neutrophils prior to ischemia, suggesting that diabetic PMNs are "primed" to respond to complement activation. Taken together, these results provide evidence that 1) the ZDF rat is a good model for chronic inflammation in the setting of T2DM, 2) lectin pathway activation plays a significant role in the inflammatory response to I/R injury in the ZDF heart, and 3) anti-complement therapy may be particularly cardio-protective in T2DM.

Transplantation is the optimal form of therapy for patients with end-stage liver disease; however, the use of organs with hepatic steatosis is often associated with increased risks for poor function and graft loss. In addition, ischemia reperfusion (IR) injury leads to cellular damage that can culminate in functional impairment and loss of graft. Furthermore, IR injury is aggravated by pre-existing steatosis and may involve additional mechanisms and mediators of cellular damage. Current models to study IR in vitro are not well defined and may overlook periods of injury that are involved in transplantation. In this thesis, I present an in vitro model for IR injury that includes multiple phases of injury and leads to the upregulation of heme oxygenase-1 (HO-1), and possibly enhances the expression of matrix metalloproteinase-9 (MMP-9). As graft HO-1 expression correlates positively with reduced injury, but MMP-9 expression is associated with increased injury, I therefore examined the utility of in vitro gene therapies to affect the expression of these proteins. We conclude that the in vitro model of ischemia and reperfusion is a promising tool to study the cellular response to IR and may provide a platform for the development of future therapies which could have clinical applications.

Liver transplantation is the only life-saving treatment for patients with end-stage liver disease; however, organ availability is insufficient to meet demands. Steatotic livers are extended criteria donor (ECD) organs that could be used for transplantation if not for an increased susceptibility ischemia reperfusion injury (IRI). Heme oxygenase-1 is a gene, that when upregulated has be shown to reduce IRI in animal models of transplantation. Increasing HO-1 activity in steatotic livers by delivery of a functional cell-penetrating HO-1 protein (through the use of cell-penetrating peptides) may provide protection against IRI, making these organs useful for transplantation. The purpose of this thesis was the generation and testing of a cell-penetrating HO-1 protein. HO-1 and EGFP gene sequences were cloned into the pET-28B(+) vector in frame with a CPP or TAT sequence. Resulting plasmids were cloned into E. coli, and protein expression was induced using IPTG. Proteins were purified using Ni-NTA affinity chromatography under denaturing and non-denaturing conditions. Non-denatured proteins were tested for HO-1 activity and the ability of both denatured and non-denatured proteins to transduce cells in vitro was tested by fluorescence microscopy. The cell-penetrating ability of nondenatured proteins was further tested in J774, HepG2 and HUVEC cells using immunofluorescence. Five HO-1 and two EGFP cell-penetrating proteins were generated expressed and purified successfully. Purified non-denatured HO-1 retains its enzymatic activity. Non-denatured CPP-EGFP and CPP-HO1 penetrated cells more effectively than their denatured counterparts. CPP-EGFP and CPP-HO1 proteins are able to penetrate multiple cell types in vitro. Successful generation and testing of a cell-penetrating HO-1 protein, for use in an animal model of steatotic liver transplantation. This protein demonstrates promise for use as a potential therapeutic agent in the field of liver transplantation.

The purpose of this study was to determine if del Nido cardioplegia provides superior protection for aged and young adult hearts. We used our isolated working heart model of cardioplegic arrest and reperfusion to compare functional recovery in both senescent and young adult rat hearts, with delivery of del Nido or our standard cardioplegia. In the aged hearts, use of del Nido cardioplegia prevented spontaneous contractions during arrest, reduced troponin release, and provided superior functional recovery during working heart. In contrast, in the young adult hearts, although stroke work was higher in the del Nido group, there were no significant differences in spontaneous activity, troponin release, and cardiac output between del Nido and standard cardioplegia, suggesting that del Nido cardioplegia did not provide superior functional recovery in the young adult heart. Del Nido cardioplegia has the potential to provide superior myocardial protection for elderly patients undergoing cardiac surgery.

CapZ is an actin capping protein that locates at cardiac Z-discs and anchors sarcomeric actin [1]. Transgenic (TG) mice overexpressing CapZ in cardiac myocytes develop a lethal cardiac hypertrophy [2], while a large reduction in CapZ protein causes severe myofibrillar disarray and death [2]. However, a TG model that contains a modest reduction in cardiac CapZ protein levels is viable and is associated with decreased PKC-dependent regulation of myofilament function [3]. Given the well known role of PKC in myocardial pathogenesis, the general aim of this thesis was to investigate how the modest reduction in CapZ protein affects cardiac function in models of cardiac stress. I found that PKC-translocation to cardiac myofilaments during cold cardioplegic arrest impairs myofilament activation, and that decreased cardiac CapZ protein disrupts this pathway and provides cardioprotective benefit. Using an in vivo model of ischemia-reperfusion (IR), I made the novel discovery that myofilament-associated PKC is altered during prolonged global ischemia, and found that a CapZ deficiency affects the translocation of PKC to myofilaments in a time-dependent manner. Furthermore, I found that TG mice deficient in CapZ demonstrate significant reductions in IR injury, while providing enhanced cardioprotection following ischemic preconditioning. The cardioprotected phenotype of CapZ-deficient TG mice is associated with altered translocation of several PKC-isoforms to cardiac myofilaments. Finally, having uncovered new information about the activation of protein phosphatase type 2A (PP2A) in IR, I investigated the role of CapZ in PP2A-dependent myofilament regulation. I found that reductions in CapZ may affect cardiac contractility by interrupting the association of PP2A with myofilaments. Together these findings expand the role of CapZ as a regulator of intracellular signaling molecules and demonstrate the novel ability of reduced CapZ to protect the heart against significant pathological threats. / Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario (HSFO), Heart and Stroke Foundation of Canada (HSFC), The Premier's Research Excellence Award (PREA), Ontario Graduate Scholarship Program (OGS).

Background/Objective: Reperfusion injury is a serious consequence of blood flow reestablishment after myocardial infarction (MI) mediated by reactive oxygen species and neutrophilic cellular damage. Following MI, the left ventricle (LV) undergoes remodeling characterized by progressive wall thinning and cavity dilatation. Heme-Oxygenase-1 (HO-1) dependent decrease in oxidative stress may attenuate injury in part by inhibiting transcription factor NFκB-mediated inflammation. Hypothesis: I hypothesized that upregulation of HO-1 by hemin administration confers acute and chronic cardioprotection against I/R injury in rats and attenuates LV remodeling post-MI. I proposed the HO-1-dependent decrease in oxidative stress attenuates post-ischemic myocardial injury in part by inhibiting NFκB-mediated inflammation. Methods: Six week old male Wistar rats were randomly assigned to sham, vehicle, or hemin-treated groups. Vehicle and hemin were administered intraperitoneally once daily for 3 consecutive days prior to left anterior descending (LAD) coronary artery occlusion. Administration resumed 48 hours post-operatively and continued once every 3 days. Infarct size was determined by H&E histological analysis and fibrosis was quantified by Masson’s Trichrome staining. Transthoracic echocardiography was used to assess LV parameters and wall motion. Results: Hemin increased HO-1 expression, decreased infarct size and fibrosis, and attenuated LV remodeling in the short-term (4 days post-infarction). The decrease in infarct size and area of fibrosis in the hemin group was accompanied by a decrease in NFκB activity. No significant difference in infarct size and area of fibrosis between hemin and vehicle-treated groups was observed at 3 months. LV diameter and cardiac function did not differ significantly between the two groups at 3 months despite an attenuation of anterior wall thinning in the hemin group. Conclusion: HO-1 upregulation by hemin administration conferred acute cardioprotection and attenuated LV remodeling, possibly by inhibiting NFκB-mediated inflammation. However, chronic treatment with hemin did not prevent long-term post-infarction LV remodeling. It is possible that cardioprotection afforded by HO-1 upregulation is strong enough to curtail inflammation post-reperfusion and prevent LV remodeling acutely, but is not robust enough to protect the myocardium to the same degree in the long-term. Future research should focus on optimal HO-1 upregulation to attenuate long-term LV remodeling due to reperfusion injury. / Thesis (Master, Physiology) -- Queen's University, 2007-09-25 19:01:33.87

No description available.

Cardiovascular disease is one of the main causes of mortality and one of the significant burdens to society. Major cardiovascular diseases such as acute myocardial infarction (heart attack), heart failure and cardiac arrhythmia often result in the development of ischemia/reperfusion (I/R) injury. Untreated I/R injury is known to cause cardiac contractile dysfunction. It is established that matrix metalloproteinase-2 (MMP-2) is activated and degrades contractile proteins during I/R, and many other factors including metabolic enzymes, kinases and structural proteins are affected by I/R. However, the molecular mechanisms responsible for these changes are unclear. Since MMP-2 is known to its broad spectrum of action, I hypothesize that, in addition to contractile proteins, proteins related to regulation of energy metabolism are MMP-2 targets during I/R, and protein kinase such as myosin light chain kinase (MLCK) is also involved in this process. The use of proteomics in studying heart injury triggered by I/R will reveal new potential targets for pharmacological protection of heart from I/R induced contractile dysfunction. In addition, selective inhibition of MMP-2 using MMP-2 siRNA protects the heart from I/R injury. In this study, we investigated the protein modulation during I/R using proteomic approach. In order to study the effect of protein kinases (MLCK) and MMP-2, their selective inhibitors were used to inhibit those factors and evaluate the changes in energy metabolic proteins during I/R. Proteomic analysis revealed that six proteins are involved in energy metabolism: ATP synthase β subunit, cytochrome b-c1 complex subunit 1, 24-kDa mitochondrial NADH dehydrogenase, NADH dehydrogenase [ubiquinone] iron-sulfur protein 8, cytochrome c oxidase subunit, and succinyl-CoA ligase subunit, resulting in decreased levels in I/R hearts. The data suggests that energy metabolic proteins, especially the metabolic enzymes involved in the electron transport chain in the mitochondria may contribute to I/R injury. In addition, our data provides evidence that the right and left ventricles of the heart respond differently to I/R injury, in terms of the regulation of contractile proteins and energy metabolic enzymes. Studies using MLCK inhibitor, ML-7, and MMP-2 inhibitor, MMP-2 siRNA to investigate the effect of myosin light chain kinase (MLCK) and MMP-2 in energy metabolic proteins have shown that succinyl-CoA ligase and ATP synthase are affected by MLCK and MMP-2 respectively. These results demonstrate that the effect of inhibition of the MLCK and MMP-2 involves optimization of energy metabolism in I/R injury, likely resulting in increased energy production. Hence, the observed proteins increase in cardiac recovery after I/R. Also, inhibition of MLCK and MMP-2 by ML-7 and MMP-2 respectively shows cardio protective effect during I/R. In summary, this study provides a novel pathogenesis in the development of I/R-induced cardiac contractile dysfunction. Moreover, we suggest a new therapeutic approach whereby using MMP-2 siRNA can be a promising gene therapy in the development of new preventive or treatment strategies against I/R injury.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 4 uppsatser.

Thesis (M. Phil.)--University of Hong Kong, 2008. / Also available in print.