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Previous studies have shown that ischemia-reperfusion (I/R) injury is associated with cardiac dysfunction and depression in sarcolemmal Na+-K+-ATPase activity. This study was undertaken to evaluate the role of proteases in these alterations by subjecting rat hearts to different times of global ischemia, and reperfusion after 45 min of ischemia. Decreases in Na+-K+-ATPase activity at 60 min of global ischemia were associated with augmented activities of both calpain and MMPs and depressed protein content of β1- and β2-subunits, without changes in α1- and α2-subunits of the enzyme. However, reperfusion of ischemic heart produced depression in Na+-K+-ATPase activity, no change in the augmented calpain activity, but decreases in augmented MMP-2 activity and Na+-K+-ATPase content. MDL28170, a calpain inhibitor, was more effective in attenuating I/R-induced alterations than doxycycline, an MMP inhibitor. Incubation of control SL preparation with calpain, unlike MMP-2, depressed Na+-K+-ATPase activity and decreased α1, α2 and β2 without changes in β1. These results support the view that activation of calpain is involved in depressing Na+-K+-ATPase activity and degradation of its subunits in hearts subjected to I/R injury.

La información respecto a la respuesta del corazón aislado de ratas hipertensas espontáneas (SHR) a la isquemia-reperfusión y a los mecanismos de protección descriptos para ratas normotensas [pre y postacondicionamiento isquémicos (PI y PCI, respectivamente) y farmacológicos], es escasa. Por lo tanto, la participación de la vía PI3K/Akt/GSK-3β y del poro de permeabilidad transitoria de la mitocondria (PPTM) en los mecanismos responsables de la muerte ó la sobrevida de los cardiomiocitos de SHR, no están debidamente aclarados. El objetivo general de este trabajo de tesis fue estudiar en corazones de SHR aislados y perfundidos con la técnica de Langendorff los efectos de la isquemia global (IG, 45 min)-reperfusión (R, 60 min), del PI y PCI y del tratamiento con ClLi e IMI (inhibidores de GSK-3β) sobre el tamaño del infarto, el daño oxidativo, la sensibilidad del PPTM al Ca2+, la liberación de citocromo c al citosol y la ultraestructura mitocondrial. El protocolo de IG-R produjo un tamaño del infarto de aproximadamente 50% del área de riesgo y daño oxidativo, evidenciado por un aumento de la peroxidación lipídica (TBARS), una disminución marcada del contenido de GSH y un aumento de la actividad de SODT y SODMn. El contenido de P-GSK-3β y P-Akt y la sensibilidad del PPTM al Ca2+ disminuyeron, mientras que la expresión de citocromo c en el citosol aumentó. La microscopia electrónica reveló que la mayor parte de las mitocondrias estaban dañadas, con edema y destrucción de sus crestas. Las intervenciones PI y PCI y el tratamiento con los inhibidores de GSK-3β protegieron a los corazones de SHR de los daños antes mencionados. Por lo tanto, en los corazones intervenidos y tratados se observó una disminución del tamaño del infarto y del daño oxidativo evidenciado por la disminución de la peroxidación lipídica (TBARS), preservación parcial del contenido de GSH y disminución de la actividad de SODT y SODMn. La expresión de P-GSK3β y de P-Akt y de la sensibilidad del PPTM al Ca2+ aumentó mientras que el contenido de citocromo c en el citosol disminuyó. Por microscopia electrónica fue posible encontrar en estos grupos la presencia de algunas mitocondrias con ultraestructura conservada. Los efectos beneficiosos del PI y PCI fueron anulados cuando la vía de señalización de PI3K/Akt fue inhibida con wortmanina. Las variables mencionadas retornaron a los valores observados en los corazones isquémicos no tratados. De las relaciones examinadas surge que: a- el tamaño del infarto es mayor cuando la peroxidación lipídica aumenta y el contenido de GSH disminuye. En estas condiciones la sensibilidad del PPTM al Ca2+ es menor. La situación opuesta se da en presencia de intervenciones cardiorpotectoras. Por lo tanto, en ellas el tamaño del infarto es menor cuando la peroxidación lipídica disminuye y el contenido de GSH aumenta. En estas condiciones la sensibilidad del PPTM al Ca2+ tiende a recuperarse. En base a los datos obtenidos se concluye que las alteraciones de la formación y/ó apertura del PPTM, participan y determinan la muerte ó la sobrevida celular en el corazón hipertrófico de SHR sometido a isquemia-reperfusión. Así, la disminución del tamaño del infarto obtenida con las intervenciones y/ó tratamientos utilizados fue el resultado de la disminución del daño oxidativo íntimamente asociada a la recuperación parcial de la integridad mitocondrial -menor apertura del PPTM- vía P-Akt/P-GSK-3β. Otro hallazgo interesante fue que la protección por el tratamiento con ClLi (fármaco ampliamente utilizado en psiquiatría) fue similar a la obtenida con las intervenciones de acondicionamiento isquémico (PI y PCI). Por lo tanto, esta droga podría ser una posible herramienta terapéutica para atenuar la injuria por isquemia y reperfusión. / Information regarding to the response to ischemia-reperfusion in isolated hearts from spontaneously hypertensive rats (SHR) as well as the effect of the protective mechanisms described in normotensive rats (ischemic and pharmacological pre and postconditioning, IP and IPC), is scarce. Therefore, the participation of PI3K/Akt/GSK-3β pathway and the mitochondrial permeability transition pore (mPTP) in the mechanisms responsible for cardiomyocyte death or survival are not properly clarified. The objective of this investigation was to study in isolated hearts from SHR the effects of global ischemia (GI, 45 min) and reperfusion (R, 60 min), and the actions of IP, IPC, treatments with LiCl and IMI (GSK-3β inhibitors) on infarct size, oxidative damage, mPTP Ca2+ sensitivity, cytochrome c release to the cytosol and mitochondrial ultrastructure. The protocol of GI-R produced an infarct size of approximately 50%, increased oxidative damage as evidenced by an increase of lipid peroxidation (TBARS), a decrease of GSH content and an increase of Total SOD and MnSOD activity. The content of P-GSK-3β and P-Akt and the mPTP Ca2+ sensitivity decreased while the expression of cytochrome c in the cytosol increased. Electron microscopy showed that most of the mitochondria were damaged, presenting edema and destruction of the cristae. IP, IPC and pharmacologic treatments with both GSK-3β inhibitors protected the hearts against reperfusion injury. Therefore, in the hearts treated we observed a smaller infarct size and reduced oxidative damage (decreased lipid peroxidation (TBARS), partial preservation of GSH and decreased Total SOD and MnSOD activity) compared to non-treated ischemic hearts. The P-GSK-3β and P-Akt expression and mPTP Ca2+ sensitivity increased while the cytosolic cytochrome c content decreased. By electron microscopy it was possible to find some mitochondria with normal ultrastructure. The beneficial effects of IP and IPC were canceled when the PI3K/Akt was inhibited with wortmannin. All the parameters examined returned to the values observed in non-treated ischemic hearts. Analyzing the relationships: Infarct size vs. TBARS and GSH, and mPTP Ca2+ sensitivity vs. Infarct size and TBARS, it arises that: the Infarct size increased when lipid peroxidation increased and GSH content decreased. Under these conditions the mPTP Ca2+ sensitivity decreased. The opposite situation occurs in the presence of the cardioprotective interventions. Therefore, the infarct size decreased when lipid peroxidation decreased and GSH content increased. Under these conditions the mPTP Ca2+ sensitivity tended to recover. Based on the data obtained, we suggest that the alterations of formation and/or opening of the mPTP participate and determine cell death or survival in the hypertrophic heart of SHR subjected to ischemia-reperfusion. Thus, the reduction in infarct size obtained with the ischemic interventions and /or treatments derived from the decreased oxidative damage intimately linked to a partial recovery of mitochondrial integrity- less mPTP opening- via P-Akt/P-GSK-3β. Another interesting finding was that the protection by the treatment with LiCl (drug widely used in psychiatry) was similar to that obtained with ischemic interventions (IP and IPC). Therefore, this drug emerges as a potential therapeutic tool in reducing the post-ischemic changes.

Previous studies have shown that ischemia-reperfusion (I/R) injury is associated with cardiac dysfunction and depression in sarcolemmal Na+-K+-ATPase activity. This study was undertaken to evaluate the role of proteases in these alterations by subjecting rat hearts to different times of global ischemia, and reperfusion after 45 min of ischemia. Decreases in Na+-K+-ATPase activity at 60 min of global ischemia were associated with augmented activities of both calpain and MMPs and depressed protein content of β1- and β2-subunits, without changes in α1- and α2-subunits of the enzyme. However, reperfusion of ischemic heart produced depression in Na+-K+-ATPase activity, no change in the augmented calpain activity, but decreases in augmented MMP-2 activity and Na+-K+-ATPase content. MDL28170, a calpain inhibitor, was more effective in attenuating I/R-induced alterations than doxycycline, an MMP inhibitor. Incubation of control SL preparation with calpain, unlike MMP-2, depressed Na+-K+-ATPase activity and decreased α1, α2 and β2 without changes in β1. These results support the view that activation of calpain is involved in depressing Na+-K+-ATPase activity and degradation of its subunits in hearts subjected to I/R injury.

Thesis (MScMed)--University of Stellenbosch, 2006. / Bibliography. Also available via the Internet.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 4 uppsatser.

There is a large body of clinical and experimental evidence linking heart disease with impairment of myocardial energetics, particularly the creatine kinase (CK) system. The goal of the experiments described in this thesis was to develop and study models of increased CK phosphotransfer, by overexpressing the CK isoenzymes and/or augmenting intracellular creatine stores. Pilot experiments were performed in cultured cells, which were used to (a) study the effects of CK overexpression in vitro, and (b) validate constructs prior to generation of transgenic mice. Expression was verified at the protein level for all constructs in HL-1 and HEK293 cells, and enzymatic activity was confirmed. Mitochondrial CK (CKmt) was expressed in the mitochondria, as expected, and CKmt overexpression was associated with a significant reduction in cell death in a model of ischemia/reperfusion injury (68.1 ± 7.1% of control, p≤0.05). Transgenic mice overexpressing CKmt in the heart were generated by a targeted approach, using PhiC31 integration at the ROSA26 locus. Transgene expression was confirmed in vitro in embryonic stem cells, and in vivo at the mRNA and protein levels. There was only a modest increase in CKmt activity; therefore, homozygous transgenic mice were generated to increase expression levels, and had 27% higher CKmt activity than wild-types (p≤0.01). Mitochondrial localization of CKmt was confirmed by electron microscopy. Citrate synthase activity, a marker of mitochondrial volume, was ~10% lower in transgenic mice (p≤0.05). Baseline phenotyping studies found that CKmt-overexpressing mice have normal cardiac structure and function. These mice are currently being backcrossed onto a pure C57BL/6 background for further studies in models of heart disease. In addition to CKmt, transgenic mice overexpressing the cytosolic CK isoenzymes, CK-M and CK-B, were generated. Due to the modest level of expression observed at ROSA26, random-integration transgenesis was used, and multiple lines were generated for each construct (carrying 2 or 6 transgene copies in the CK-M line; 2, 3, or ~30 in CK-B). Transgene expression was validated at the mRNA, protein, and activity levels. These lines are currently being expanded for further validation and phenotyping studies. Previous experiments in our group have demonstrated that increasing intracellular creatine (Cr) reduces ischemia/reperfusion injury, and a series of in vitro experiments was performed to determine whether this effect may be mediated by inhibition of the mitochondrial permeability transition pore (mPTP). The mPTP plays a significant role in ischemia/reperfusion, and there is evidence linking the CK system to regulation of the mPTP. Therefore, a model was developed to test whether Cr affects mPTP opening in cardiac-derived HL-1 cells, as this mechanism may contribute to the protective effect observed in vivo. Cr incubation conditions were determined empirically, and 24-hour incubation with 5mM or 10mM Cr was found to significantly delay mPTP opening, to a similar degree to the established mPTP inhibitor, cyclosporin A. This provides evidence that Cr may exert protective effects in the heart by a variety of mechanisms, in addition to its traditional role in energy metabolism. In summary, the experiments conducted in this thesis have produced a range of tools for studying augmentation of the creatine kinase system as a therapeutic target in heart disease. The results of in vitro assays indicate that mitochondrial CK may be a particularly promising target, and that inhibition of the mitochondrial permeability transition pore may contribute to the cardioprotective effect of creatine. Finally, the transgenic models generated and validated over the course of this project will allow for a wide range of future studies into the potential benefits of CK overexpression in the mammalian heart.

L’ischémie reperfusion pulmonaire et sa traduction clinique la dysfonction primaire du greffon sont responsables d’une morbi-mortalité importante en transplantation pulmonaire aussi bien à court terme qu’à long terme. Nous avons voulu faire la démonstration de la pertinence des microparticules comme marqueur de l’ischémie reperfusion pulmonaire. Nous avons reproduit et validé la stabilité d’un modèle de perfusion ventilation ex vivo de poumon de rat aussi bien en conditions normales (pas d’ischémie pulmonaire avant reperfusion) qu’en conditions extrêmes (1 h d’ischémie chaude avant reperfusion pulmonaire). Nous avons étudié la génération de microparticules par des poumons soumis à des conditions variables d’ischémie froide et d’ischémie chaude. Les poumons soumis à de fortes conditions d’ischémie froide (20h) produisent un pic précoce de microparticules d’origine épithéliale alvéolaire, leucocytaire et endothéliale. Nous en concluons que le modèle de perfusion ventilation ex vivo de poumons de rats est un modèle pertinent pour l’étude des réactions d’ischémie reperfusion. Les microparticules apparaissent comme un marqueur précoce des lésions d’ischémie reperfusion pulmonaires dans ce modèle. / Lung ischemia reperfusion and its clinical expression as primary graft dysfunction are provider of immediate and long term morbidity and mortality for patients. We aimed at demonstrating the usefulness and relevance of microparticles as biomarkers for lung ischemia reperfusion injury. We first reproduced an ex vivo rat lung perfusion and ventilation experimental model. Stability of the model was validated for normal conditions (no ischemia before reperfusion) as well as for extreme conditions (1 hour warm ischemia before reperfusion). The generation of microparticles was studied in that model for variable conditions of cold ischemia and for warm ischemia. Lung submitted to strong ischemic injury (20hours cold ischemia) generate an early pike of microparticles originated from leukocyes, endothelial cells, and epithelial alveolar cells. We may conclude the ex vivo model of rat lung perfusion and ventilation is relevant for the study of lung ischemia reperfusion injury. Microparticles are relevant markers of rat lung ischemia reperfusion injury in our model.

Le muscle strié squelettique subit de graves lésions d’ischémie-reperfusion (IR) au cours de la progression de l’artériopathie oblitérante des membres inférieurs et lors d’interventions chirurgicales qui nécessitent l’interruption transitoire du flux sanguin dans les artères des membres. Dans ce contexte, nos objectifs étaient de mettre à profit deux modèles expérimentaux d’IR des membres inférieurs par clampage aortique et garrotage unilatéral pour : ° tester l’efficacité d’une alternative médicamenteuse au postconditionnement ischémique par l’utilisation de la cyclosporine A (CsA). En se liant à la cyclophiline D, la CsA empêche l’ouverture du pore de transition mitochondrial (mPTP) à un niveau très distal de la cascade d’évènements qui conduit à la nécrose après IR. ° déterminer de quelle façon deux comorbidités fréquemment retrouvées chez des patients souffrant d’atteinte artérielle (le diabète et l’âge) influencent l’effet de la cyclosporine. Avec les protocoles de conditionnement et aux doses que nous avons utilisées, la cyclosporine a des effets différents sur les conséquences musculaires de l’ischémie-reperfusion des membres inférieurs, dépendant de la pathologie sous-jacente des animaux étudiés. Il semble intéressant d’étudier l’effet dose-réponse de la cyclosporine A pour déterminer l’intervalle thérapeutique optimal, celui-ci pouvant être différent chez l’animal sain et pathologique. D’autre part, étant donné l’importance considérable du stress oxydant chez les animaux diabétiques et sénescents, la co-administration de cyclosporine et d’un antioxydant au moment de la reperfusion pourrait rétablir une protection. / Peripheral arterial disease and many surgical procedures (requiring vascular clamping or tourniquet application) induce severe skeletal muscle ischemia-reperfusion (IR) injuries. As a result, using experimental hind limb ischemia-reperfusion models, our goals were: ° To test a pharmacologic substitute to ischemic postconditioning by using cyclosporine A, that acts on a very downstream step of IR injury cascade by binding to cyclophilin D and inhibiting mitochondrial transition pore opening. We wondered if cyclosporine could alleviate mitochondrial dysfunction and reduce ROS production in skeletal muscles submitted to IR. ° To determine how diabetes and senescence would influence cyclosporine A protective effects. In conclusion, the protective effects of pharmacologic postconditioning with cyclosporine A seem to critically depend on the model under study. A variable and narrow dose-effect relationship is likely and makes it necessary to perform a dose finding study in every pathologic model. Considering the narrow relationships between mitochondrial protection and oxidative stress, combing cyclosporine A postconditioning with antioxidant therapy may restore a more robust protective effect but this hypothesis has to be validated.