Heterotopic rat heart transplantation (Lewis to F344): early ICAM-1 expression after 8 hours of cold ischemia

St. Thomas and del Nido cardioplegia are superior to Custodiol cardioplegia in a rat model of donor heart

OBJECTIVES

Cardiac transplantation is an effective treatment for advanced heart disease and protection of the donor organ is directly associated with post-transplantation outcomes. Cardioplegic strategies intend to protect the donor heart against ischemic injury during transplantation procedures. In our study, the effects of three different cardioplegia solutions were evaluated in a rat heart donor model in terms of cellular base. Design. Cardioplegia solutions as St. Thomas, del Nido or Custodiol were administered to male Wistar albino rats until cardiac arrest. Arrested hearts were excised and incubated in cold cardioplegia solutions for 4 h. Organ bath experiments were performed using the right ventricular free wall strips of the heart tissues. ATP, sialic acid, TNF-α levels and MMP-9 activities were measured in heart tissues. Incubation media were also used to measure TNF-α and troponin-I levels following organ baths experiments. Results. Custodiol administration led to reduced myocardial contraction (p < .05), decreased ATP levels (p < .001) and increased both TNF-α levels (p < .05), and MMP-9 activity (p < .05). Additionally, troponin-I and TNF-α levels in media were significantly increased (p < .05), TNF-α levels were positively correlated with MMP-9 activities (r = .93, p = .007) and negatively correlated with ATP levels (r = -.91, p = .01) in the Custodiol group. Also, MMP-9 activities were negatively correlated with ATP levels (r = -.90, p = .01) Conclusion. Custodiol cardioplegia cannot prevent functional and cellular damage in donor heart tissue. St. Thomas or del Nido cardioplegia could result in superior functional and biochemical improvement during transplantation procedures. In this respect, these cardioplegic solutions may be more advantageous as cellular and functional.

Graft rejection - endogenous or allogeneic?

The presence and persistence of alloantigen is necessary for graft-specific T-cell-mediated immunity. However, specificity comprises only a single facet of an extremely complex process. Evidence is accruing to suggest that immunogenicity could be manipulated by endogenous ligands released during tissue injury. Stress molecules are significantly up-regulated following transplantation and stimulate conserved receptors on a range of leucocytes, including dendritic cells (DCs). The DCs are essential for co-stimulation and the induction of adaptive immunity. Stress signals can act as an adjuvant leading to DC maturation and activation. DCs stimulated by endogens exhibit enhanced alloantigen presentation, co-stimulation and production of pro-inflammatory cytokines, such as interleukin-1β (IL-1β) and IL-18. Inflammasomes have a major role in IL-1β/IL-18 production and secretion, and can be stimulated by endogens. Importantly, the polarization toward inflammatory T helper type 17 cells as opposed to regulatory T cells is dependent upon, among other factors, IL-1β. This highlights an important differentiation pathway that may be influenced by endogenous signals. Minimizing graft damage and stress expression should hypothetically be advantageous, and we feel that this area warrants further research, and may provide novel treatment modalities with potential clinical benefit.

Transcriptional changes in adhesion-related genes are site-specific during noise-induced cochlear pathogenesis

Cell-cell junctions and junctions between cells and extracellular matrix are essential for maintenance of the structural and functional integrity of the cochlea, and are also a major target of acoustic trauma. While morphological assessments have revealed adhesion dysfunction in noise-traumatized cochleae, the molecular mechanisms responsible for adhesion disruption are not clear. Here, we screened the transcriptional expression of 49 adhesion-related genes in normal rat cochleae and measured the expression changes in the early phases of cochlear pathogenesis after acoustic trauma. We found that genes from four adhesion families, including the immunoglobulin superfamily and the integrin, cadherin, and selectin families, are expressed in the normal cochlea. Exposure to an intense noise at 120dB sound pressure level (SPL) for 2h caused site-specific changes in expression levels in the apical and the basal sections of the sensory epithelium. Expression changes that occurred in the cochlear sensory epithelium were biphasic, with early upregulation at 2h post-noise exposure and subsequent downregulation at 1day post-exposure. Importantly, the altered expression level of seven genes (Sgce, Sell, Itga5, Itgal, Selp, Cntn1 and Col5a1) is related to the level of threshold shift of the auditory brainstem response (ABR), an index reflecting functional change in the cochlea. Notably, the genes showing expression changes exhibited diverse constitutive expression levels and belong to multiple adhesion gene families. The finding of expression changes in multiple families of adhesion genes in a temporal fashion (2h vs. 1day) and a spatial fashion (the apical and the basal sensory epithelia as well as the lateral wall tissue) suggests that acoustic overstimulation provokes a complex response in adhesion genes, which likely involves multiple adhesion-related signaling pathways.

Acoustic overstimulation modifies Mcl-1 expression in cochlear sensory epithelial cells

Acoustic overstimulation causes apoptotic cell death in the cochlea. This death process is mediated, in part, by the mitochondrial signaling pathway involving Bcl-2 family proteins. Myeloid cell leukemia sequence 1 (Mcl-l) is an antiapoptotic member of the Bcl-2 family. Its involvement in noise-induced hair cell death has not been characterized. Here we report the endogenous expression and the noise-induced expression of Mcl-1 in Sprague Dawley rat cochleae. In the sensory epithelia of normal cochleae, there is strong constitutive expression of Mcl-1 mRNA, with an expression level higher than that of many other Bcl-2 family genes. The Mcl-1 protein is preferentially expressed in outer hair cells. After exposure to a high level of continuous noise at 115-dB sound pressure level for 1 hr, Mcl-1 expression displays a time-dependent alteration, with up-regulation of Mcl-1 mRNA at 4 hr postexposure and protein up-regulation at 1 day postexposure. Western blot analysis reveals the up-regulated Mcl-1 as the full-length form of Mcl-1. Immunolabeling of the Mcl-1 protein reveals the early increase in Mcl-1 immunoreactivity in the nuclear region of the hair cells displaying apoptotic phenotypes and a subsequent increase in survival hair cells. These results suggest that Mcl-1 is involved in the regulation of hair cell pathogenesis resulting from acoustic stress, possibly by influencing the nuclear events of apoptosis.