Protective effect of nicorandil against myocardial ischemia/reperfusion injury mediated via IL33/ST2 signaling pathway

Prediction of myocardial ischemia-reperfusion injury post-PCI: role of sST2 levels in STEMI patients

BACKGROUND

Myocardial ischemia-reperfusion injury (MIRI) after ST-segment elevation myocardial infarction (STEMI) significantly impacts clinical outcomes. However, only a few studies have examined its clinical predictors and prognostic biomarkers.

METHODS

Patients with STEMI who received percutaneous coronary intervention (PCI) at Liaoning Provincial People's Hospital between 2020 and 2021 were enrolled in the study. Based on a thorough evaluation of clinical features, which included data obtained from intraoperative angiography and inpatient monitoring, patients were divided into the MIRI group and the non-MIRI group. Upon admission, serum solube growth stimulation expressed gene 2 protein (sST2) levels were assessed, and follow-up examinations were conducted for the patients.

RESULTS

Patients with MIRI who were admitted to the hospital present elevated serum sST2 levels (P < 0.001). Serum sST2 was recognized as a standalone risk factor contributing to the occurrence of MIRI in STEMI patients who are undergoing PCI (P < 0.001). Throughout the follow-up duration, 37 (17.0%) patients encountered major adverse cardiovascular and cerebrovascular incidents (MACCEs), which included eight (3.6%) deaths from all causes. The Kaplan-Meier assessment revealed that individuals in the MIRI group had an unfavorable prognosis (all log-rank P < 0.05). Both univariable and multivariable Cox regression models were established using MIRI patients as the study cohort. The findings indicated that sST2 levels exceeding 68.98 ng/mL served as one of independent risk factors for predicting MACCEs (all P < 0.001). The model was evaluated using the C-index, AUC, calibration plot, and Decision Curve Analysis (DCA) curve.

CONCLUSION

Elevated levels of serum sST2 may accurately predict the onset of MIRI following PCI in STEMI patients. Specifically, a serum sST2 concentration > 68.98 ng/mL is a prominent independent risk predictor for overall mortality and MACCE in individuals experiencing MIRI.

The pathological mechanisms and potential therapeutic drugs for myocardial ischemia reperfusion injury

BACKGROUND

Cardiovascular disease is the main cause of death and disability, with myocardial ischemia being the predominant type that poses a significant threat to humans. Reperfusion, an essential therapeutic approach, promptly reinstates blood circulation to the ischemic myocardium and stands as the most efficacious clinical method for myocardial preservation. Nevertheless, the restoration of blood flow associated with this process can potentially induce myocardial ischemia-reperfusion injury (MIRI), thereby diminishing the effectiveness of reperfusion and impacting patient prognosis. Therefore, it is of great significance to prevent and treat MIRI.

PURPOSE

MIRI is an important factor affecting the prognosis of patients, and there is no specific in-clinic treatment plan. In this review, we have endeavored to summarize its pathological mechanisms and therapeutic drugs to provide more powerful evidence for clinical application.

METHODS

A comprehensive literature review was conducted using PubMed, Web of Science, Embase, Medline and Google Scholar with a core focus on the pathological mechanisms and potential therapeutic drugs of MIRI.

RESULTS

Accumulated evidence revealed that oxidative stress, calcium overload, mitochondrial dysfunction, energy metabolism disorder, ferroptosis, inflammatory reaction, endoplasmic reticulum stress, pyroptosis and autophagy regulation have been shown to participate in the process, and that the occurrence and development of MIRI are related to plenty of signaling pathways. Currently, a range of chemical drugs, natural products, and traditional Chinese medicine (TCM) preparations have demonstrated the ability to mitigate MIRI by targeting various mechanisms.

CONCLUSIONS

At present, most of the research focuses on animal and cell experiments, and the regulatory mechanisms of each signaling pathway are still unclear. The translation of experimental findings into clinical practice remains incomplete, necessitating further exploration through large-scale, multi-center randomized controlled trials. Given the absence of a specific drug for MIRI, the identification of therapeutic agents to reduce myocardial ischemia is of utmost significance. For the future, it is imperative to enhance our understanding of the pathological mechanism underlying MIRI, continuously investigate and develop novel pharmaceutical agents, expedite the clinical translation of these drugs, and foster innovative approaches that integrate TCM with Western medicine. These efforts will facilitate the emergence of fresh perspectives for the clinical management of MIRI.

Peptide Characterization of Bovine Myocardium Hydrolysates and Its Ameliorative Effects on Doxorubicin-Induced Myocardial Injury in H9c2 Cells and in Mice

The prevalence and mortality of heart disease have a persistent existence, and it is important to develop active substances with cardioprotective properties. It has been reported that peptides from animal heart hydrolysates possess cardioprotective activity, but those mechanisms and the sequence of peptides are still unrevealed. In the present study, the extracts of bovine myocardium were prepared by enzymatic hydrolysis (BHH-A) and water extraction (BHH-W). The cardioprotective function of peptides was verified in the DOX-induced H9c2 cells and myocardial injury mice. The mass spectrometry was used to contrast the differences of active ingredients between BHH-W and BHH-A. Results suggested that both BHH-A and BHH-W could increase the activity of antioxidant enzymes in cardiomyocytes and reduce the inflammatory level and apoptosis of myocardial cells. The improvement effects of BHH-A on myocardial injury in mice were better than those of BHH-W. The analysis of peptide composition demonstrated that the contents with N-segment hydrophobic amino acids were higher in the peptides identified in BHH-A. Hence, BHH-A could be used as a potential active substance to improve DOX-induced myocardial injury by reducing oxidative damage, inflammation, and cardiomyocyte apoptosis, and its activity may be related to the richness of small molecular peptides and hydrophobic amino acids.

Mechanisms of the "No-Reflow" Phenomenon After Acute Myocardial Infarction: Potential Role of Pericytes

Pericytes contract during myocardial ischemia resulting in capillary constriction and no reflow. Reversing pericyte contraction pharmacologically reduces no reflow and infarct size. These findings open up an entire new venue of research aimed at altering pericyte function in myocardial ischemia and infarction.

Neu3 Sialidase Activates the RISK Cardioprotective Signaling Pathway during Ischemia and Reperfusion Injury (IRI)

Coronary reperfusion strategies are life-saving approaches to restore blood flow to cardiac tissue after acute myocardial infarction (AMI). However, the sudden restoration of normal blood flow leads to ischemia and reperfusion injury (IRI), which results in cardiomyoblast death, irreversible tissue degeneration, and heart failure. The molecular mechanism of IRI is not fully understood, and there are no effective cardioprotective strategies to prevent it. In this study, we show that activation of sialidase-3, a glycohydrolytic enzyme that cleaves sialic acid residues from glycoconjugates, is cardioprotective by triggering RISK pro-survival signaling pathways. We found that overexpression of Neu3 significantly increased cardiomyoblast resistance to IRI through activation of HIF-1α and Akt/Erk signaling pathways. This raises the possibility of using Sialidase-3 activation as a cardioprotective reperfusion strategy after myocardial infarction.