Hydrogen sulfide (H2S) reduces ischemia reperfusion (IR) injury by stimulating adenosine triphosphate (ATP) sensitive potassium channels (KATP) [1-5]. Demonstrating H2S stimulation is unique to KATP, as other inwardly rectifying potassium (Kir) channels demonstrate inhibition or are unaffected [6]. We recently showed that H2S inhibits Kir2 and Kir3 by decreasing channel sensitivity to phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2 or PIP2) [6]. Here, we test the hypothesis that H2S regulation of Kir6.2, a pore-forming subunit of the KATP channel, is also dependent on PIP2. Using whole-cell patch-clamp we show that H2S increases the activity of Kir6.2 channels expressed in HEK-293 cells. To study the mechanism, we modulated PIP2 levels by expressing a light- activated phosphatase, or by including high levels of a water-soluble PIP2 analog in the patch pipette. The results suggest that H2S augmentation of Kir6.2 channel activity is increased when PIP2 levels are elevated.

Includes bibliographical references (leaves 292-352) Determines the role of matrix metalloproteinases, MMP-2 and MMP-9 in reperfusion injury following skeletal muscle ischaemia; and, whether inhibition of MMPs by doxycycline protects against tissue damage.

Ischaemic heart disease is a major contributor to premature death and heart failure in the Westernised world. Ischaemic injury within the heart may be beneficially modulated by the nucleoside adenosine. Derived from catabolism of ATP, adenosine was initially known as a potent bradycardic and hypotensive agent. However, more recently the protective function of adenosine has been investigated. The protective effects of adenosine are mediated via activation of adenosine receptors: A1, A2A, A2B, and A3 receptors. Activation of these potentially protective (or retaliatory) adenosine receptors hinges upon accumulation of adenosine during ischaemia-reperfusion. This Thesis examines the role and mechanisms of adenosine mediated cardioprotection in young and aged hearts, exploring endogenous and exogenous adenosine receptor activation, genetic manipulation of A1 receptors and adenosine deaminase and pharmacological manipulation of adenosine metabolism. The effects of age on ischaemic responses and adenosine handling and protection are also assessed. The core approach to assess each of the above issues involved the Langendorff isolated mouse heart preparation. Experiments within Chapter 3 focuses on the contractile effects of adenosine receptors in normoxic hearts. This study indicates A2A receptors have no direct effect on contractility, while adenosine exerts positive inotropy independently of coronary flow and perfusion pressure (i.e. Independent of the Gregg phenomenon). In addition, investigations in genetically modified hearts hint at positive inotropy in response to A1 receptors. Since the latter is only evidenced in modified lines, it is possible A1-mediated inotropy may be abnormal or supraphysiological. In Chapter 4 the impact of genetic 'deletion' of A1ARs and/or adenosine deaminase (ADA) on intrinsic tolerance to ischaemia were studied. Data demonstrate that genetic deletion of A1 receptors significantly limits the ability of the mouse myocardium to withstand injury during ischaemic insult. Thus, providing strong support for a role of A1ARs in determining intrinsic tolerance to ischaemia-reperfusion. ADA KO mice confirm protection afforded by endogenous adenosine and the notion of adenosine metabolism modification as a protective strategy. Interestingly, effects of A1AR KO differ from A1AR overexpression or A1AR agonism in that the latter decrease contractile diastolic dysfunction while A1AR KO selectively increase systolic dysfunction and increase oncosis without altering diastolic injury. This challenges current dogma regarding the action of A1 adenosine receptors on ischaemic injury. In Chapter 5 the effects of adenosine metabolism inhibition (via adenosine deaminase (ADA) and adenosine kinase (AK) inhibitors) were studied. Inhibition of adenosine deaminase with the drug EHNA, and adenosine phosphorylation with iodotubercidin significantly protected mouse hearts from ischaemia-reperfusion, reducing contractile dysfunction and cardiac enzyme efflux. However, inhibitors failed to improve the outcome of the aged myocardium. 8-SPT and 5-HD reduced the protective effects of EHNA and iodotubercidin demonstrating thus; cardioprotection via ADA and AK appears to rely on adenosine receptor activation and involves a mitoK ATP dependent mechanism. Since aging is of considerable importance with regard to outcomes of ischaemic heart disease, experiments in Chapter 6 focused on effects of aging (and gender) on cardiovascular function and injury during ischaemia-reperfusion. In assessing post ischaemic outcomes in hearts from young adult (2-4 months), mature adult (8 months), middle aged (12 months), aged (18 months) and senescent (24-28 months) C57/BL/6J mice, data reveal a substantial age-related decline in ischaemic tolerance (which appears selective for myocardial vs. vascular injury). The decline in ischaemic tolerance is expressed primarily within the initial 12 months in both males and females with relatively little further decline with continued aging. There is evidence of a modest improvement in tolerance in senescence vs. aged hearts possibly reflecting selection of a protected phenotype in senescent populations. In addition, mature and middle-aged female hearts showed improved tolerance to ischaemia-reperfusion compared to males, supporting a role for hormonal changes. Effects of aging and purine metabolism were studied in Chapter 7. Data suggest impaired tolerance to ischaemia-reperfusion in older hearts may stem in part from shifts in myocardial purine catabolism. Data reveal reduced accumulation of salvageable and cardioprotective adenosine and enhanced accumulation of poorly salvaged (and potentially injurious) hypoxanthine and xanthine. These changes may potentially predispose the aged myocardium to ischaemic injury and radical generation via the xanthine oxidase reaction. The final data Chapter of this Thesis describes preliminary data regarding aging, signalling and adenosine mediated protection. It was found that protein kinase C (PKC) and A1 receptors mediate protection in young hearts and also that A1 receptors appear to mediate protection via a PKC LindependentLi signalling cascade. In addition, experiments in aged hearts (attempting to elucidate mechanisms behind impaired adenosinergic protection with age) suggest a PKC-independent A1-mediated protection path may be preserved with aging, since A1 receptors continue to offer some protection while PKC activation does not. It is possible the failure of exogenous adenosine to offer protection in aged hearts may result from a lesion at or downstream of PKC.

Includes bibliographical references (leaves 292-352) / xvi, 352 leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Determines the role of matrix metalloproteinases, MMP-2 and MMP-9 in reperfusion injury following skeletal muscle ischaemia; and, whether inhibition of MMPs by doxycycline protects against tissue damage. / Thesis (M.D.)--University of Adelaide, Dept. of Surgery, 2002

Diverses études épidémiologiques ont mis en évidence une relation étroite entre pollution urbaine au monoxyde de carbone (CO) et mortalité cardiovasculaire. Récemment il a été mis en évidence, chez le rat, qu'une exposition prolongée à ce polluant urbain avait pour conséquence le développement d'un phénotype cellulaire pathologique, pouvant influencer la vulnérabilité du coeur à un stress aigu. L'objectif de nos travaux était donc i) d'évaluer l'impact de la pollution au CO, sur la sensibilité du myocarde de rats au syndrome d'ischémie-reperfusion (IR) ; et ii) d'évaluer les effets potentiellement cardioprotecteurs d'un exercice pratiqué régulièrement à intensité modérée, sur le remodelage phénotypique cellulaire myocardique. Pour cela, 187 rats Wistar ont été séparés en 3 groupes : des rats contrôles, des rats exposés pendant 4 semaines au CO (30-100 ppm), et des rats entraînés en endurance avant d'être exposés au CO. La sensibilité à l'IR était évaluée par ischémie régionale réalisée sur modèle de coeur isolé perfusé de Langendorff. La fonction et les mouvements calciques de cardiomyocytes isolés était évalués en condition basale et consécutivement à un protocole d'anoxie-réoxygénation. Les résultats de ce travail confirment l'apparition d'un phénotype pathologique chez les rats exposés de façon prolongée au CO. Ce phénotype pathologique caractérisé dans notre travail par une altération de l'homéostasie calcique et du statut redox cellulaire ainsi qu'une expression tissulaire de iNOS apparait comme à l'origine de la plus grande vulnérabilité du coeur à un stress d'IR. Un autre résultat majeur de ce travail est qu'une stratégie de cardioprotection par un exercice d'intensité modérée pratiqué de manière régulière, permet de prévenir le remodelage pathologique cardiomyocytaire et ainsi l'augmentation de la sensibilité du myocarde à l'IR

Malgré de très nombreuses études expérimentales et cliniques dans le domaine de l'arrêt circulatoire, seulement 2% à 12% des patients quittent l'hôpital avec une bonne récupération neurologique. Il est donc nécessaire de proposer de nouvelles thérapeutiques pour tenter d'augmenter la survie après un arrêt circulatoire. Pour atteindre ce but il semble indispensable d'améliorer la qualité du massage cardiaque durant la réanimation et de protéger le myocarde et le cerveau contre les phénomènes d'ischémie-reperfusion. Dans la première partie de ce travail, nous avons évalués dans une étude pré hospitalière l'utilisation d'un dispositif innovant de massage cardiaque interne par minithoracotomie et montré une amélioration de l'hémodynamique en comparaison avec le massage cardiaque standard. Dans la deuxième partie, nous avons testés les possibles effets protecteurs de l'EPO (érythropoïétine) dans deux types d'arrêt circulatoire. Dans un modèle d'arrêt cardiaque expérimental chez le rat nous avons démontré que lorsque l'EPO était injectée avant l'arrêt cardiaque, la réanimation initiale était améliorée et la survie des animaux augmentée ce qui pouvaient suggérer un effet cardio et/ou neuroprotecteur de l'EPO contre les effets délétères de l'ischémie reperfusion. Dans une étude clinique en chirurgie cardiaque sous circulation extra corporelle, nous n'avons pas pu démontré d'effet bénéfique de l'EPO ni sur l'ischémie myocardique, ni sur l'ischémie cérébrale ni sur les paramètres de l'inflammation. Sur la base de ces deux études, il est donc difficile de conclure sur le potentiel rôle bénéfique de l'EPO dans l'arrêt circulatoire. Néanmoins, sur la seule base des résultats expérimentaux, l'EPO pourrait faire partie de l'arsenal thérapeutique pour mieux protéger le myocarde et le cerveau contre les effets délétères de l'ischémie reperfusion après un arrêt cardiaque.

Ischemia-reperfusion (IR) injury is a severe complication in lung transplantation characterized by inflammation, alveolar damage, and hypoxemia. Alpha 1-antitrypsin (A1AT), a protease inhibitor, is currently used clinically for the treatment of A1AT deficiency emphysema. A1AT has been shown to have the potential to reduce IR injury through its anti-inflammatory and anti-apoptotic effects. We hypothesized that A1AT will ameliorate IR injury through these effects. We tested A1AT in two models of IR: a cell culture model of simulated lung transplantation and a rat in situ pulmonary ligation model. In cell culture, we found that A1AT exerts its protective effects by inhibiting cell death and inflammatory cytokine release in a dose-dependent manner. In the rat pulmonary ischemia-reperfusion model, we found that A1AT improved lung function by inhibiting apoptosis and inflammation. There is potential for future application of A1AT in the treatment of IR injury in lung transplantation.

Ischemia-reperfusion (IR) injury is a severe complication in lung transplantation characterized by inflammation, alveolar damage, and hypoxemia. Alpha 1-antitrypsin (A1AT), a protease inhibitor, is currently used clinically for the treatment of A1AT deficiency emphysema. A1AT has been shown to have the potential to reduce IR injury through its anti-inflammatory and anti-apoptotic effects. We hypothesized that A1AT will ameliorate IR injury through these effects. We tested A1AT in two models of IR: a cell culture model of simulated lung transplantation and a rat in situ pulmonary ligation model. In cell culture, we found that A1AT exerts its protective effects by inhibiting cell death and inflammatory cytokine release in a dose-dependent manner. In the rat pulmonary ischemia-reperfusion model, we found that A1AT improved lung function by inhibiting apoptosis and inflammation. There is potential for future application of A1AT in the treatment of IR injury in lung transplantation.

Sepsis, a great challenge to the physician, is characterized with massive oxidative stress of tissue, cytokine inflammation and increases in nitric oxide (NO) production. Meanwhile, free radical induced by oxidative stress also injures cell membrane or DNA. The way to terminate free radical chain reaction is to administer antioxidant. The commonly used anesthetic, propofol, was thought to be with antioxidant capacity. In the first part of this thesis, we investigated the different role of oxidative injury and NO via systemic injection of LPS in rats. We demonstrated oxidative injury is associated with both early and late stage whereas NO is engaged primarily in late stage cardiovascular depression. Propofol, a rapid onset and fast recovery anesthetic, is attributed to protect anainst cardiovascular depression via attenuating the late stage NO surge in aorta by inhibition of iNOS upregulation. We also examine the influence of propofol on temporal changes in power density of frequency components of systemic arterial pressure (SAP) variability in rat with sepsis and the role of inducible NO synthase (iNOS). We have the conclusions that iNOS-induced NO might be involved in the manifestation of high-frequency and low-frequency components of the SAP spectrum during endotoxemia when low-dose propofol is used and the effect of NO is blunted when high-dose propofol is administered. Due to further investigation was needed to the cellular protective mechanisms of propofol, we delineate the effect of propofol to free radical related enzymel involved in sepsis via both in vivo and vitro studies with rats subjected to LPS (15 mg/kg) and H9C2, L2, NR8383 (derived from rat cardiac myocyte, lung, macrophage, respectively), respectively. Our results demonstrated that propofol may play the major protective role on iNOS, superoxide dismutase and p47 phox oxidative enzymes on lung epithelial cells. Propofol also provided protective effects on cardiac myocyte and macrophage with suppression of iNOS only although free radical production were all significantly suppressed. Ischemia-reperfusion (IR) injury may also produce a lot of free radical and cytokines to cause tissue damage and is common in clinical. We investigated the effect of propofol on free radical and cytokine production via this different model and compared with another rapid recovery anesthesitc, sevoflurane. Aortic decalmping surgery in porcine and their monocyte, aortic and coronary smooth muscle cells were applied for in vivo and in vitro model, respectively. We also demonstrated that propofol but not sevoflurane suppressed the production of free radical and cytokine in monocyte and smooth muscle cells but not in vivo model. In sepsis and IR model that produced a lot free radical and cytokines, propofol eliminated the free redical and cytokines via suppressed different kinds of oxidative enzymes in different cells of different organs to express its protective role. However, as an anesthetic, propofol must be used carefully to perform its maximal benefit.

According to the theory of Traditional Chinese Medicine, the main etiology of stroke results from blood stasis. Ligustic Rhizoma (LR), a Chinese herb, is considered to stimulate stasis-dispelling. As Tetramethyl Pyrazine (TMP) is a major component of LR, the aim of the present study is to investigate the effects of TMP on cerebral infarct. We establish an animal model of cerebral infarct by occluding the both common carotid arteries and right middle cerebral artery for 90 minutes, then reperfusing for 24 hrs. Effects of TMP on cerebral infarct are evaluated by the ratio of infarction areas and modified neurologica severity scale (mNSS). In addition, we observe the changes of ED1, tumor necrosis factor-£\ (TNF-£\) and interleukin-1£] (IL-1£]) immuno-reacting cells in the infarction region. The founding indicate that pre-treatment with TMP 100 mg/kg, 120 mg/kg and 140 mg/kg, and post-treatment with TMP 100 mg/kg will decrease the ratio of cerebral infarction area and the neurological deficit. Moreover, pre-treatment TMP 100 mg/kg also decreases ED1, TNF-£\ and IL-1£] immuno-reacting cell. In conclusion, TMP can decrease cerebral infarction area and neurological deficit. The effects of TMP, at least in part, are closely related to microglia, TNF-£\ and IL-1£], suggesting that TMP can be used to treat stroke in human.