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Ding Q, Loganathan S, Zhou P, Sayour AA, Brlecic P, Radovits T, Domain R, Korkmaz B, Karck M, Szabó G, Korkmaz-Icöz S. Alpha-1-Antitrypsin Protects Vascular Grafts of Brain-Dead Rats Against Ischemia/Reperfusion Injury. J Surg Res 2023; 283:953-964. [PMID: 36915024 DOI: 10.1016/j.jss.2022.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/04/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Endothelial dysfunction is a potential side effect of brain death (BD). Ischemia/reperfusion (IR) injury during heart transplantation may lead to further endothelial damage. Protective effects of alpha-1-antitrypsin (AAT), a human neutrophil serine protease inhibitor, have been demonstrated against IR injury. We hypothesized that AAT protects brain-dead rats' vascular grafts from IR injury. METHODS Donor rats were subjected to BD by inflation of a subdural balloon. After 5.5 h, aortic rings were immediately mounted in organ baths (BD, n = 6 rats) or preserved in saline, supplemented either with vehicle (BD-IR, n = 8 rats) or AAT (BD-IR + AAT, n = 14 rats) for 24 h. During organ bath experiment, rings from both IR groups were exposed to hypochlorite to simulate warm reperfusion-associated endothelial injury. Endothelial function was measured ex vivo. Immunohistochemical staining for caspases was carried out and DNA-strand breaks were evaluated using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling. Data are presented as median (interquartile range). RESULTS AAT improved IR-induced decreased maximum endothelium-dependent vasorelaxation to acetylcholine in the BD-IR + AAT aortas compared to the BD-IR group (BD: 83 (9-28) % versus BD-IR: 49 (39-60) % versus BD-IR + AAT: 64 (24-42) %, P < 0.05). Additionally, an increase in the rings' sensitivity to acetylcholine was noted after AAT (pD2-value: BD-IR + AAT: 7.35 (7.06-7.89) versus BD-IR: 6.96 (6.65-7.21), P < 0.05). Caspase-3, -8, -9, and -12 immunoreactivity and the number of terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling-positive cells were significantly decreased by AAT. CONCLUSIONS AAT alleviates endothelial dysfunction, prevents increased caspase-3, -8, -9, and -12 levels, and decreases apoptotic DNA breakage due to BD and IR injury. This suggests that AAT treatment may be therapeutically beneficial to reduce IR-induced vascular damage.
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Affiliation(s)
- Qingwei Ding
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, Germany
| | - Pengyu Zhou
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Alex Ali Sayour
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany; Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Paige Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Roxane Domain
- INSERM UMR-1100, "Research Center for Respiratory Diseases" and University of Tours, Tours, France
| | - Brice Korkmaz
- INSERM UMR-1100, "Research Center for Respiratory Diseases" and University of Tours, Tours, France
| | - Matthias Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, Germany
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany; Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, Germany.
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Szabó G, Brlecic P, Loganathan S, Wagner F, Rastan A, Doenst T, Karck M, Veres G. Custodiol-N versus Custodiol: a prospective randomized double-blind multicenter phase III trial in patients undergoing elective coronary bypass surgery. Eur J Cardiothorac Surg 2022; 62:6586795. [PMID: 35579350 DOI: 10.1093/ejcts/ezac287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 04/18/2022] [Accepted: 05/12/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE HTK-Solution (Custodiol) is a well-established cardioplegic and organ preservation solution. We currently developed a novel HTK-based solution, Custodiol-N, which includes iron chelators to reduce oxidative injury, as well as L-arginine, to improve endothelial function. In this first in-human study, Custodiol-N compared to Custodiol in patients undergoing elective coronary artery bypass surgery. The aim of this comparison was to evaluate the safety and ability of Custodiol-N to protect cardiac tissue. METHODS The study was designed as a prospective randomized double-blind non-inferiority trial. Primary end-point was area under the curve (AUC) of creatine kinase MB (CK-MB) within the first 24 h after surgery. Secondary end-points included peak CK-MB and troponin-T and AUC of troponin-T release, cardiac index, cumulative catecholamine dose, ICU-stay and mortality. All values in the abstract are given as mean ± SD, p < 0.05 was considered statistically significant. RESULTS Early termination of the trial was performed per protocol as the primary non-inferiority end-point was reached after inclusion of 101 patients. CK-MB AUC (878 ± 549 vs 779 ± 439 h* U/l, non-inferiority p < 0.001, Custodiol vs Custodiol-N) and troponin-T AUC (12990 ± 8347 vs 13498 ± 6513 h*pg/ml, noninferiority p < 0.001, Custodiol vs Custodiol-N) were similar in both groups. Although the trial was designed for non-inferiority, peak CK-MB (52 ± 40 vs. 42 ± 28 U/l, superiority p < 0.03, Custodiol vs Custodiol-N) was significantly lower in the Custodiol-N group. CONCLUSION This study shows that Custodiol-N is safe and provides similar cardiac protection as the established HTK-Custodiol solution. Significantly reduced peak CK-MB levels in the Custodiol-N group in the full analysis set may implicate a beneficial effect on ischaemia/reperfusion injury in the setting of coronary bypass surgery.
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Affiliation(s)
- Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, 69120, Germany.,Department of Cardiac Surgery, University of Halle, Halle (Saale), 06120, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, 69120, Germany
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, 69120, Germany.,Department of Cardiac Surgery, University of Halle, Halle (Saale), 06120, Germany
| | - Florian Wagner
- Department of Cardiac Surgery, University of Hamburg, Hamburg, 20251, Germany
| | - Ardawan Rastan
- Cardiac Surgery, Heart Center Rotenburg, Rotenburg, 36199, Germany
| | - Torsten Doenst
- Department of Cardiac Surgery, University of Jena, Jena, 07747, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, 69120, Germany
| | - Gábor Veres
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, 69120, Germany.,Department of Cardiac Surgery, University of Halle, Halle (Saale), 06120, Germany
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Korkmaz-Icöz S, Akca D, Li S, Loganathan S, Brlecic P, Ruppert M, Sayour AA, Simm A, Brune M, Radovits T, Karck M, Szabó G. Left-ventricular hypertrophy in 18-month-old donor rat hearts was not associated with graft dysfunction in the early phase of reperfusion after cardiac transplantation-gene expression profiling. GeroScience 2021; 43:1995-2013. [PMID: 33871784 PMCID: PMC8492839 DOI: 10.1007/s11357-021-00348-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/24/2021] [Indexed: 11/27/2022] Open
Abstract
The use of hearts with left-ventricular (LV) hypertrophy (LVH) could offer an opportunity to extend the donor pool for cardiac transplantation. We assessed the effects of LVH in 18-month-old spontaneously hypertensive stroke-prone (SHRSP) donor rats and following transplantation. In donors, cardiac function and structural alterations were assessed. Then, the hearts were transplanted into young normotensive-rats. We evaluated LV graft function 1 h after transplantation. The myocardial expression of 92 genes involved in apoptosis, inflammation, and oxidative-stress was profiled using PCR-array. Compared to controls, SHRSP-rats developed LVH, had increased LV systolic performance (slope of the end-diastolic pressure-volume (PV) relationship: 1.6±0.2 vs 0.8±0.1mmHg/μl, p<0.05) accompanied by diastolic dysfunction [prolonged time constant of LV pressure decay (Tau: 15.8±0.6 vs 12.3±0.5ms) and augmented diastolic stiffness (LV end-diastolic PV relationship: 0.103±0.012 vs 0.045±0.006mmHg/ml), p<0.05]. They presented ECG changes, myocardial fibrosis, and increased nitrotyrosine immunoreactivity and plasma troponin-T and creatine kinase-CM levels. After transplantation, even though the graft contractility was better in SHRSP rats compared to controls, the adverse impact of ischemia/reperfusion-injury on contractility was not altered (Ees ratio after versus before transplantation: 32% vs 29%, p>0.05). Whereas nitrotyrosine immunoreactivity was higher, myeloperoxidase-positive cell infiltration was decreased in the SHRSP+transplanted compared to control+transplanted. Among the tested genes, LVH was associated with altered expression of 38 genes in donors, while transplantation of these hearts resulted in the change of four genes. Alterations in 18-month-old donor hearts, as a consequence of hypertension and LVH, were not associated with graft dysfunction in the early phase of reperfusion after transplantation.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
| | - Deniz Akca
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Shiliang Li
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Sivakkanan Loganathan
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120, Halle, Germany
| | - Paige Brlecic
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Mihály Ruppert
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Heart and Vascular Center, Semmelweis University, 1122, Budapest, Hungary
| | - Alex Ali Sayour
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Heart and Vascular Center, Semmelweis University, 1122, Budapest, Hungary
| | - Andreas Simm
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120, Halle, Germany
| | - Maik Brune
- Department of Medicine I and Clinical Chemistry, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122, Budapest, Hungary
| | - Matthias Karck
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Gábor Szabó
- Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120, Halle, Germany
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Korkmaz-Icöz S, Kocer C, Sayour AA, Kraft P, Benker MI, Abulizi S, Georgevici AI, Brlecic P, Radovits T, Loganathan S, Karck M, Szabó G. The Sodium-Glucose Cotransporter-2 Inhibitor Canagliflozin Alleviates Endothelial Dysfunction Following In Vitro Vascular Ischemia/Reperfusion Injury in Rats. Int J Mol Sci 2021; 22:ijms22157774. [PMID: 34360539 PMCID: PMC8345991 DOI: 10.3390/ijms22157774] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/15/2021] [Indexed: 01/10/2023] Open
Abstract
Vascular ischemia/reperfusion injury (IRI) contributes to graft failure and adverse clinical outcomes following coronary artery bypass grafting. Sodium-glucose-cotransporter (SGLT)-2-inhibitors have been shown to protect against myocardial IRI, irrespective of diabetes. We hypothesized that adding canagliflozin (CANA) (an SGLT-2-inhibitor) to saline protects vascular grafts from IRI. Aortic rings from non-diabetic rats were isolated and immediately mounted in organ bath chambers (control, n = 9–10 rats) or underwent cold ischemic preservation in saline, supplemented either with a DMSO vehicle (IR, n = 8–10 rats) or 50µM CANA (IR + CANA, n = 9–11 rats). Vascular function was measured, the expression of 88 genes using PCR-array was analyzed, and feature selection using machine learning was applied. Impaired maximal vasorelaxation to acetylcholine in the IR-group compared to controls was significantly ameliorated by CANA (IR 31.7 ± 3.2% vs. IR + CANA 51.9 ± 2.5%, p < 0.05). IR altered the expression of 17 genes. Ccl2, Ccl3, Ccl4, CxCr4, Fos, Icam1, Il10, Il1a and Il1b have been found to have the highest interaction. Compared to controls, IR significantly upregulated the mRNA expressions of Il1a and Il6, which were reduced by 1.5- and 1.75-fold with CANA, respectively. CANA significantly prevented the upregulation of Cd40, downregulated NoxO1 gene expression, decreased ICAM-1 and nitrotyrosine, and increased PECAM-1 immunoreactivity. CANA alleviates endothelial dysfunction following IRI.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
- Correspondence: ; Tel.: +49-6221-566246; Fax: +49-6221-564571
| | - Cenk Kocer
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Alex A. Sayour
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Patricia Kraft
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Mona I. Benker
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Sophia Abulizi
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Adrian-Iustin Georgevici
- Department of Anesthesiology, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany;
| | - Paige Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (C.K.); (A.A.S.); (P.K.); (M.I.B.); (S.A.); (P.B.); (S.L.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
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Korkmaz-Icöz S, Sun X, Li S, Brlecic P, Loganathan S, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Alleviates Endothelial Dysfunction of Vascular Grafts Submitted to Ischemia/Reperfusion Injury in 15-Month-Old Rats. Cells 2021; 10:1231. [PMID: 34067928 PMCID: PMC8155879 DOI: 10.3390/cells10051231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 01/09/2023] Open
Abstract
In patients undergoing coronary artery bypass grafting (CABG), ischemia/reperfusion injury (IRI) is the main contributor to organ dysfunction. Aging-induced vascular damage may be further aggravated during CABG. Favorable effects of conditioned medium (CM) from mesenchymal stem cells (MSCs) have been suggested against IRI. We hypothesized that adding CM to saline protects vascular grafts from IRI in rats. We found that CM contains 28 factors involved in apoptosis, inflammation, and oxidative stress. Thoracic aortic rings from 15-month-old rats were explanted and immediately mounted in organ bath chambers (aged group) or underwent 24 h of cold ischemic preservation in saline-supplemented either with vehicle (aged-IR group) or CM (aged-IR+CM group), prior to mounting. Three-month-old rats were used as referent young animals. Aging was associated with an increase in intima-to-media thickness, an increase in collagen content, higher caspase-12 mRNA levels, and immunoreactivity compared to young rats. Impaired endothelium-dependent vasorelaxation to acetylcholine in the aged-IR group compared to the aged-aorta was improved by CM (aged 61 ± 2% vs. aged-IR 38 ± 2% vs. aged-IR+CM 50 ± 3%, p < 0.05). In the aged-IR group, the already high mRNA levels of caspase-12 were decreased by CM. CM alleviates endothelial dysfunction following IRI in 15-month-old rats. The protective effect may be related to the inhibition of caspase-12 expression.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Xiaoxin Sun
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Shiliang Li
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Paige Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Alex Ali Sayour
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary;
| | - Matthias Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; (X.S.); (S.L.); (P.B.); (S.L.); (M.R.); (A.A.S.); (M.K.); (G.S.)
- Department of Cardiac Surgery, University Hospital Halle (Saale), 06120 Halle, Germany
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Korkmaz-Icöz S, Zhou P, Guo Y, Loganathan S, Brlecic P, Radovits T, Sayour AA, Ruppert M, Veres G, Karck M, Szabó G. Mesenchymal stem cell-derived conditioned medium protects vascular grafts of brain-dead rats against in vitro ischemia/reperfusion injury. Stem Cell Res Ther 2021; 12:144. [PMID: 33627181 PMCID: PMC7905634 DOI: 10.1186/s13287-021-02166-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Brain death (BD) has been suggested to induce coronary endothelial dysfunction. Ischemia/reperfusion (IR) injury during heart transplantation may lead to further damage of the endothelium. Previous studies have shown protective effects of conditioned medium (CM) from bone marrow-derived mesenchymal stem cells (MSCs) against IR injury. We hypothesized that physiological saline-supplemented CM protects BD rats' vascular grafts from IR injury. METHODS The CM from rat MSCs, used for conservation purposes, indicates the presence of 23 factors involved in apoptosis, inflammation, and oxidative stress. BD was induced by an intracranial-balloon. Controls were subjected to a sham operation. After 5.5 h, arterial pressures were measured in vivo. Aortic rings from BD rats were harvested and immediately mounted in organ bath chambers (BD group, n = 7) or preserved for 24 h in 4 °C saline-supplemented either with a vehicle (BD-IR group, n = 8) or CM (BD-IR+CM group, n = 8), prior to mounting. Vascular function was measured in vitro. Furthermore, immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR) have been performed. RESULTS BD in donors was associated with significantly impaired hemodynamic parameters and higher immunoreactivity of aortic myeloperoxidase (MPO), nitrotyrosine, caspase-3, caspase-8, caspase-9, and caspase-12 compared to sham-operated rats. In organ bath experiments, impaired endothelium-dependent vasorelaxation to acetylcholine in the BD-IR group compared to BD rats was significantly improved by CM (maximum relaxation to acetylcholine: BD 81 ± 2% vs. BD-IR 50 ± 3% vs. BD-IR + CM 72 ± 2%, p < 0.05). Additionally, the preservation of BD-IR aortic rings with CM significantly lowered MPO, caspase-3, caspase-8, and caspase-9 immunoreactivity compared with the BD-IR group. Furthermore, increased mRNA expression of vascular cell adhesion molecule (VCAM)-1 and intercellular adhesion molecule (ICAM)-1 in the aortas from the BD-IR rats compared to BD group were significantly decreased by CM. CONCLUSIONS The preservation of BD rats' vascular grafts with CM alleviates endothelial dysfunction following IR injury, in part, by reducing levels of inflammatory response and caspase-mediated apoptosis.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany.
| | - Pengyu Zhou
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany
| | - Yuxing Guo
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, 06120, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, 1122, Hungary
| | - Alex Ali Sayour
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany.,Heart and Vascular Center, Semmelweis University, Budapest, 1122, Hungary
| | - Mihály Ruppert
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany.,Heart and Vascular Center, Semmelweis University, Budapest, 1122, Hungary
| | - Gábor Veres
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany.,Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, 06120, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, Laboratory of Cardiac Surgery, University Hospital Heidelberg, INF 326, 69120, Heidelberg, Germany.,Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, 06120, Germany
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Ding Q, Loganathan S, Brlecic P, Sayour AA, Ruppert M, Radovits T, Korkmaz B, Karck M, Szabó G, Korkmaz-Icöz S. ALPHA-1-Antitrypsin Protects Vascular Grafts of Brain-Dead Rats against In Vitro Ischemia/Reperfusion Injury. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Korkmaz-Icöz S, Abulizi S, Li K, Loganathan S, Korkmaz B, Brlecic P, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Preservation with Custodiol Solution Containing Alpha-1-Antitrypsin Improves Graft Function after Prolonged Cold Ischemic Storage in a Rat Model of Heart Transplantation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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9
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Korkmaz-Icöz S, Kocer C, Sayour AA, Benker MI, Abulizi S, Loganathan S, Brlecic P, Ruppert M, Radovits T, Karck M, Szabó G. The Sodium-Glucose Cotransporter-2 Inhibitor Canagliflozin Alleviates Endothelial Dysfunction of Vascular Grafts Submitted to In-Vitro Ischemia/Reperfusion Injury in Nondiabetic Rats. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Loganathan S, Fiegen S, Guo Y, Ritscher E, Brlecic P, Sayour AA, Radovits T, Georgevici AI, Korkmaz B, Korkmaz-Icöz S, Karck M, Szabó G. ALPHA-1-Antitrypsin Preserves Cardiac Function and Reduces Damages Linked to Warm Ischemia/Reperfusion Injury in a Rodent Model of Cardiac Arrest and Resuscitation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Korkmaz-Icöz S, Benker MI, Li S, Loganathan S, Brlecic P, Ruppert M, Sayour AA, Radovits T, Karck M, Szabó G. Vascular Reactivity in Old Spontaneously Hypertensive Stroke-Prone Rats: Effects of Prolonged Ischemia followed by Reperfusion. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Korkmaz-Icöz S, Li K, Loganathan S, Ding Q, Ruppert M, Radovits T, Brlecic P, Sayour AA, Karck M, Szabó G. Brain-dead donor heart conservation with a preservation solution supplemented by a conditioned medium from mesenchymal stem cells improves graft contractility after transplantation. Am J Transplant 2020; 20:2847-2856. [PMID: 32162462 DOI: 10.1111/ajt.15843] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023]
Abstract
Hearts are usually procured from brain-dead (BD) donors. However, brain death may induce hemodynamic instability, which may contribute to posttransplant graft dysfunction. We hypothesized that BD-donor heart preservation with a conditioned medium (CM) from mesenchymal stem cells (MSCs) would improve graft function after transplantation. Additionally, we explored the PI3K pathway's potential role. Rat MSCs-derived CM was used for conservation purposes. Donor rats were either exposed to sham operation or brain death by inflation of a subdural balloon-catheter for 5.5 hours. Then, the hearts were explanted, stored in cardioplegic solution-supplemented with either a medium vehicle (BD and sham), CM (BD + CM), or LY294002, an inhibitor of PI3K (BD + CM + LY), and finally transplanted. Systolic performance and relaxation parameters were significantly reduced in BD-donors compared to sham. After transplantation, systolic and diastolic functions were significantly decreased, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL)-positive cells and endonuclease G positive cells were increased in the BD-group compared to sham. Preservation of BD-donor hearts with CM resulted in a recovery of systolic graft function (dP/dtmax : BD + CM: 3148 ± 178 vs BD: 2192 ± 94 mm Hg/s at 110 µL, P < .05) and reduced apoptosis. LY294002 partially lowered graft protection afforded by CM in the BD group. Our data suggest that PI3K/Akt pathway is not the primary mechanism of action of CM in improving posttransplant cardiac contractility and preventing caspase-independent apoptosis.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Kunsheng Li
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anesthesiology, Ruhr-University Bochum, St. Josef- and St. Elisabeth Hospital, Bochum, Germany.,Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, Germany
| | - Qingwei Ding
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Paige Brlecic
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Alex A Sayour
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Matthias Karck
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Department of Cardiac Surgery, University Hospital Halle (Saale), Halle, Germany
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Soso P, Brlecic P, Möbius A, Korkmaz-Icöz S, Brune M, Karck M, Szabó G. Comparison of Continuous Hypothermic Oxygenated Crystalloid Perfusion with the Novel Solution “Custodiol N ” and Warm Blood Perfusion in a Porcine DCD Donation Model. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Zhou P, Guo Y, Loganathan S, Radovits T, Brlecic P, Ruppert M, Sayour AA, Karck M, Korkmaz-Icöz S, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Reduced Ischemia/Reperfusion Injury-Induced Endothelial Dysfunction in Rats’ Vascular Grafts. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Guo Y, Korkmaz-Icöz S, Jiang W, Brlecic P, Radovits T, Brune M, Yard B, Karck M, Loganathan S, Szabó G. N-Octanoyl Dopamine Is Superior to Dopamine in Protecting Graft Contractile Function when Administered to the Heart Transplant Recipients from Brain-Dead Donors. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Korkmaz-Icöz S, Akca D, Shiliang L, Loganathan S, Brlecic P, Ruppert M, Brune M, Radovits T, Karck M, Szabó G. Left-Ventricular Hypertrophy in 18-Month-Old Donor Hearts Was Not Associated with Graft Dysfunction in the Early Phase of Reperfusion after Cardiac Transplantation: Gene Expression Profiling. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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17
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Loganathan S, Guo Y, Jiang W, Radovits T, Ruppert M, Sayour AA, Brune M, Brlecic P, Gude P, Georgevici AI, Yard B, Karck M, Korkmaz-Icöz S, Szabó G. N-octanoyl dopamine is superior to dopamine in protecting graft contractile function when administered to the heart transplant recipients from brain-dead donors. Pharmacol Res 2019; 150:104503. [PMID: 31629091 DOI: 10.1016/j.phrs.2019.104503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022]
Abstract
The major source of heart transplantation comes from brain-dead (BD) donors. However, brain death and myocardial ischemia/reperfusion injury during transplantation may lead to cardiac dysfunction and hemodynamic instability. A previous work demonstrated that pre-treatment of BD donors with dopamine improved the graft survival of heart allograft in recipient after transplantation. However, low-dose dopamine treatment might result in tachycardia and hypertension. Our previous experimental study showed that pre-treatment of BD donor rats with the dopamine derivate N-octanoyl dopamine (NOD), devoid of any hemodynamic effects, improved graft function after transplantation. Herein, we hypothesized that NOD confers superior myocardial protection than dopamine, in terms of graft function. Male Lewis donor rats were either subjected to sham-operation or brain death via a subdurally placed balloon followed by 5.5 h monitoring. Then, the hearts were explanted and heterotopically transplanted into Lewis recipient rats. Shortly before the onset of reperfusion, continuous intravenous infusion of either NOD (14.7 μg/kg/min, BD + NOD group, n = 9), dopamine (10 μg/kg/min, BD + Dopamine group, n = 8) or physiological saline vehicle (sham, n = 9 and BD group, n = 9) were administered to the recipient rats. In vivo left-ventricular (LV) graft function was evaluated after 1.5 h reperfusion. Additionally, immunohistochemical detection of 4-hydroxy-2-nonenal (HNE, an indicator of oxidative stress) and nitrotyrosine (a nitro-oxidative stress marker), was performed. After heart transplantation, systolic and diastolic functions were significantly decreased in the BD group compared to sham. Treatment with NOD but not dopamine, resulted in better LV graft systolic functional recovery (LV systolic pressure BD + NOD 90 ± 8 vs BD + Dopamine 66 ± 5 vs BD 65 ± 4 mmHg; maximum rate of rise of LV pressure dP/dtmax BD + NOD 2686 ± 225 vs BD + Dopamine 2243 ± 70 vs BD 1999 ± 147 mmHg/s, at an intraventricular volume of 140 μl, p < 0.05) and myocardial work compared to BD group. The re-beating time (time to restoration of heartbeat) was significantly shorter in BD + NOD group than that of BD hearts (32 ± 4 s vs. 48 ± 6 s, p < 0.05), Dopamine treatment had no impact on all of these parameters. Furthermore, NOD as well as dopamine decreased HNE and nitrotyrosine immunoreactivity to the same level. NOD is superior to dopamine in terms of protecting LV graft contractile function when administered to the heart transplant recipients from BD donors.
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Affiliation(s)
- Sivakkanan Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; Department of Anaesthesiology, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany.
| | - Yuxing Guo
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Weipeng Jiang
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Mihály Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Alex Ali Sayour
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany; Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Maik Brune
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Phillipp Gude
- Department of Anaesthesiology, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Adrian-Iustin Georgevici
- Department of Anaesthesiology, St. Josef Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Benito Yard
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, 68167 Mannheim, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, 69120 Heidelberg, Germany
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18
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Korkmaz-Icöz S, Li S, Loganathan S, Radovits T, Ruppert M, Brlecic P, Sayour AA, Veres G, Fleming T, Brune M, Most P, Karck M, Szabó G. Impairment of the Akt pathway in transplanted Type 1 diabetic hearts is associated with post-transplant graft injury. Interact Cardiovasc Thorac Surg 2019; 27:884-894. [PMID: 29912386 DOI: 10.1093/icvts/ivy188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 05/13/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The use of 'marginal' hearts, such as from donors with diabetes mellitus (DM), could offer an opportunity to expand the donor pool in cardiac transplantation. Previous studies have shown that the phosphatidylinositol-3-kinase (PI3K)/Akt pathway is altered after ischaemia/reperfusion injury in the diabetic myocardium. We hypothesized that DM-induced cardiac dysfunction in donors is further impaired after heart transplantation and that PI3K/Akt-pathway alterations may be one of the underlying pathomechanisms. METHODS In the donor rats, DM was induced with a single dose of streptozotocin. Non-diabetic rats only received citrate buffer. After 8 weeks, the donor left ventricular (LV) cardiac function was measured. Then, the hearts were heterotopically transplanted into non-diabetic recipients. We evaluated LV graft function 1.5 h after transplantation via a Millar catheter system at different LV volumes. Histological analyses were performed, and the expression of 84 genes involved in PI3K/Akt signalling was profiled. RESULTS DM was associated with significantly decreased LV contractility and impaired relaxation. After transplantation, in the DM group, the grafts' systolic function (LV systolic pressure 112 ± 31 vs 155 ± 60 mmHg; dP/dtmax 2676 ± 896 vs 3584 ± 1779 mmHg/s, P < 0.05) and diastolic function (dP/dtmin 924 ± 205 vs 1748 ± 512 mmHg/s, P < 0.05) were significantly reduced at an intraventricular volume of 170 µl. The expression of 10 genes involved in PI3K/Akt signalling, as well as the phosphorylated Akt/total Akt protein expression ratio, were significantly down-regulated in the diabetic heart after transplantation. CONCLUSIONS DM-induced cardiac dysfunction is further impaired after transplantation. Targeting the PI3K/Akt pathway may result in a functional amelioration of the a priori-diseased myocardia, which could increase the number of potential cardiac donors.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Shiliang Li
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Tamás Radovits
- Heart and Vascular Center, Department of Cardiology, Semmelweis University, Budapest, Hungary
| | - Mihály Ruppert
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Alex Ali Sayour
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gábor Veres
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Fleming
- Department of Medicine I and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Maik Brune
- Department of Medicine I and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Patrick Most
- Department of Internal Medicine III, Molecular and Translational Cardiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Korkmaz-Icöz S, Zhou P, Guo Y, Loganathan S, Brlecic P, Radovits T, Ruppert M, Sayour A, Karck M, Szabó G. Conditioned Medium from Mesenchymal Stem Cells Protects Vascular Grafts of Brain-Dead Rats against In Vitro Ischemia/Reperfusion Injury. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Ruppert M, Korkmaz-Icöz S, Li S, Brlecic P, Németh BT, Oláh A, Horváth EM, Veres G, Pleger S, Grabe N, Merkely B, Karck M, Radovits T, Szabó G. Comparison of the Reverse-Remodeling Effect of Pharmacological Soluble Guanylate Cyclase Activation With Pressure Unloading in Pathological Myocardial Left Ventricular Hypertrophy. Front Physiol 2019; 9:1869. [PMID: 30670980 PMCID: PMC6331535 DOI: 10.3389/fphys.2018.01869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/11/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Pressure unloading induces the regression of left ventricular myocardial hypertrophy (LVH). Recent findings indicate that pharmacological activation of the soluble guanylate cyclase (sGC) – cyclic guanosine monophosphate (cGMP) pathway may also exert reverse-remodeling properties in the myocardium. Therefore, we aimed to investigate the effects of the sGC activator cinaciguat in a rat model of LVH and compare it to the “gold standard” pressure unloading therapy. Methods: Abdominal aortic banding was performed for 6 or 12 weeks. Sham operated animals served as controls. Pressure unloading was induced by removing the aortic constriction after week 6. The animals were treated from week 7 to 12, with 10 mg/kg/day cinaciguat or with placebo p.o., respectively. Cardiac function and morphology were assessed by left ventricular pressure-volume analysis and echocardiography. Additionally, key markers of myocardial hypertrophy, fibrosis, nitro-oxidative stress, apoptosis and cGMP signaling were analyzed. Results: Pressure unloading effectively reversed LVH, decreased collagen accumulation and provided protection against oxidative stress and apoptosis. Regression of LVH was also associated with a full recovery of cardiac function. In contrast, chronic activation of the sGC enzyme by cinaciguat at sustained pressure overload only slightly influenced pre-established hypertrophy. However, it led to increased PKG activity and had a significant impact on interstitial fibrosis, nitro-oxidative stress and apoptosis. Amelioration of the pathological structural alterations prevented the deterioration of LV systolic function (contractility and ejection fraction) and improved myocardial stiffness. Conclusion: Our results indicate that both cinaciguat treatment and pressure unloading evoked anti-remodeling effects and improved LV function, however in a differing manners.
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Affiliation(s)
- Mihály Ruppert
- Experimental Research Laboratory, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.,Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Sevil Korkmaz-Icöz
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Shiliang Li
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Paige Brlecic
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Balázs Tamás Németh
- Experimental Research Laboratory, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Attila Oláh
- Experimental Research Laboratory, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Eszter M Horváth
- Laboratory of Oxidative Stress, Department of Physiology, Institute of Clinical Experimental Research, Semmelweis University, Budapest, Hungary
| | - Gábor Veres
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Sven Pleger
- Laboratory for Molecular and Translational Cardiology, Department of Cardiology, Angiology and Pulmonology, University Hospital Heidelberg, Heidelberg, Germany
| | - Niels Grabe
- Research Group on Epidermal Systems Biology, Hamamatsu Tissue Imaging and Analysis Center, Bioquant, Heidelberg University, Heidelberg, Germany.,National Center for Tumor Diseases, Medical Oncology, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Béla Merkely
- Experimental Research Laboratory, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Matthias Karck
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
| | - Tamás Radovits
- Experimental Research Laboratory, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gábor Szabó
- Laboratory of Experimental Cardiac Surgery, Department of Cardiac Surgery, Heidelberg University, Heidelberg, Germany
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21
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Loganathan S, Guo Y, Korkmaz-Icöz S, Zhou P, Radovits T, Brlecic P, Ruppert M, Sayour A, Karck M, Szabo G. Dopamine Derivate N-Octanoyl Dopamine Administration to the Transplant Recipient before the Onset of Reperfusion Improves Posttransplant Graft Function from Brain-Dead Donors in Rats. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Loganathan
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - Y. Guo
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - S. Korkmaz-Icöz
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - P. Zhou
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - T. Radovits
- University Semmelweis, Heart and Vascular Center, Budapest, Hungary
| | - P. Brlecic
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Ruppert
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - A. Sayour
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Karck
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - G. Szabo
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
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22
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Korkmaz-Icöz S, Jiang W, Ruppert M, Radovits T, Loganathan S, Brlecic P, Karck M, Szabo G. Time Course of Changes in Aortic Endothelial Function in Hypertensive Rats: Effects of a Mechanical Pressure Unloading Therapy. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - W. Jiang
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T. Radovits
- University Semmelweis, Heart and Vascular Center, Budapest, Hungary
| | - S. Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - P. Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - G. Szabo
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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23
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Korkmaz-Icöz S, Li S, Hüttner R, Ruppert M, Radovits T, Loganathan S, Sayour AA, Brlecic P, Lasitschka F, Karck M, Szabó G. Hypothermic perfusion of donor heart with a preservation solution supplemented by mesenchymal stem cells. J Heart Lung Transplant 2018; 38:315-326. [PMID: 30638838 DOI: 10.1016/j.healun.2018.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/26/2018] [Accepted: 12/05/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Heart transplantation is the definitive treatment for end-stage heart failure. A shortage of donor hearts forced transplant programs to accept older donors and longer ischemic times. Previous studies have suggested that administration of mesenchymal stem cells (MSCs) or their conditioned medium (CM) protects the heart against ischemia/reperfusion injury (IRI). We hypothesized that the preservation of donor hearts with a CM would protect the graft from IRI after prolonged storage in 15-month-old rats and investigated mRNA changes attributable to CM. METHODS Rat MSCs were isolated and cultured. The CM was used and characterized by a 90-antibody array, revealing the presence of 28 factors involved in apoptosis, inflammation, and oxidative stress. Hearts from 15-month-old donor rats were explanted and continuously perfused for 5 hours with oxygenated, 4°C cardioplegic solution, and supplemented with either regular cell culture medium (control group) or CM. The hearts were then heterotopically transplanted. We evaluated in-vivo left ventricular graft function 1.5 hours after transplantation and the myocardial expression of 120 genes using polymerase chain reaction arrays. RESULTS Systolic contractility and relaxation parameters were significantly reduced in 15-month-old rats compared with the young rats. After transplantation, systolic function (dP/dtmax: 1,197 ± 94 vs 1,825 ± 279 mm Hg/s at 140 µl; p < 0.05) and diastolic function (dP/dtmin: 737 ± 168 vs 1,200 ± 166 mm Hg/s at 140 µl, p < 0.05) were significantly improved in the CM group compared with controls. Among the genes surveyed, the expressions of 66 were altered. Genes of pro-inflammatory cytokines and interleukins were down-regulated, whereas expression of the anti-oxidant gene superoxide dismutase-2 was up-regulated in the CM-treated grafts compared with the control group grafts. CONCLUSIONS Perfusion of donor hearts with CM protects against myocardial IRI in 15-month-old rats.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Shiliang Li
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Regina Hüttner
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany; Department of Anesthesiology, Ruhr University Bochum, St. Josef- and St. Elisabeth Hospital, Bochum, Germany
| | - Alex Ali Sayour
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Lasitschka
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Veres G, Schmidt H, Hegedűs P, Korkmaz-Icöz S, Radovits T, Loganathan S, Brlecic P, Li S, Karck M, Szabó G. Is internal thoracic artery resistant to reperfusion injury? Evaluation of the storage of free internal thoracic artery grafts. J Thorac Cardiovasc Surg 2018; 156:1460-1469. [DOI: 10.1016/j.jtcvs.2018.05.079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/27/2018] [Accepted: 05/02/2018] [Indexed: 10/14/2022]
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Veres G, Hagenhoff M, Schmidt H, Radovits T, Loganathan S, Bai Y, Korkmaz-Icöz S, Brlecic P, Sayour A, Karck M, Szabó G. Targeting Phosphodiesterase-5 by Vardenafil Improves Vascular Graft Function. J Vasc Surg 2018. [DOI: 10.1016/j.jvs.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sayour A, Ruppert M, Korkmaz-Icöz S, Li S, Brlecic P, Németh B, Oláh A, Horváth E, Merkely B, Karck M, Szabó G, Radovits T. Comparison of the anti-remodeling effect of pressure unloading and chronic soluble guanylate cyclase activation in rats with left ventricular myocardial hypertrophy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Korkmaz-Icöz S, Li S, Loganathan S, Radovits T, Ruppert M, Brlecic P, Sayour A, Veres G, Fleming T, Brune M, Most P, Karck M, Szabó G. PI3K/Akt pathway alterations in transplanted diabetic hearts are involved in left-ventricular graft dysfunction. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Veres G, Hagenhoff M, Schmidt H, Radovits T, Loganathan S, Bai Y, Korkmaz-Icöz S, Brlecic P, Sayour AA, Karck M, Szabó G. Targeting Phosphodiesterase-5 by Vardenafil Improves Vascular Graft Function. Eur J Vasc Endovasc Surg 2018; 56:256-263. [PMID: 29724533 DOI: 10.1016/j.ejvs.2018.03.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 03/24/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Ischaemia reperfusion (IR) injury occurs during vascular graft harvesting and implantation during vascular/cardiac surgery. Elevated intracellular cyclic guanosine monophosphate (cGMP) levels contribute to an effective endothelial protection in different pathophysiological conditions. The hypothesis that the phosphodiesterase-5 inhibitor vardenafil would protect vascular grafts against IR injury by upregulating the nitric oxide-cGMP pathway in the vessel wall of the bypass graft was investigated. METHODS Lewis rats (n = 6-7/group) were divided into Group 1, control; Group 2, donor rats received intravenous saline; Group 3, received intravenous vardenafil (30 μg/kg) 2 h before explantation. Whereas aortic arches of Group 1 were immediately mounted in an organ bath, aortic segments of Groups 2 and 3 were stored for 2 h in saline and transplanted into the abdominal aorta of the recipient. Two hours after transplantation, the implanted grafts were harvested. Endothelium dependent and independent vasorelaxations were investigated. TUNEL, CD-31, ICAM-1, VCAM-1, α-SMA, nitrotyrosine, dihydroethidium and cGMP immunochemistry were also performed. RESULTS Compared with the control, the saline group showed significantly attenuated endothelium dependent maximal relaxation (Rmax) 2 h after reperfusion, which was significantly improved by vardenafil supplementation (Rmax control, 91 ± 2%; saline 22 ± 2% vs. vardenafil 39 ± 4%, p < .001). Vardenafil pre-treatment significantly reduced DNA fragmentation (control 9 ± 1%, saline 66 ± 8% vs. vardenafil 13 ± 1%, p < .001), nitro-oxidative stress (control 0.8 ± 0.3, saline 7.6 ± 1.3 vs. vardenafil 3.8 ± 1, p = .036), reactive oxygen species level (vardenafil 36 ± 4, control 34 ± 2 vs. saline 43 ± 2, p = .049), prevented vascular smooth muscle cell damage (control 8.5 ± 0.7, saline 4.3 ± 0.6 vs. vardenafil 6.7 ± 0.6, p = .013), decreased ICAM-1 (control 4.1 ± 0.5, saline 7.0 ± 0.9 vs. vardenafil 4.4 ± 0.6, p = .031), and VCAM-1 score (control 4.4 ± 0.4, saline 7.3 ± 1.0 vs. vardenafil 5.2 ± 0.4, p = .046) and increased cGMP score in the aortic wall (control 11.2 ± 0.8, saline 6.5 ± 0.8 vs. vardenafil 8.9 ± 0.6, p = .016). The marker for endothelial integrity (CD-31) was also higher in the vardenafil group (control 74 ± 4%, saline 22 ± 2% vs. vardenafil 40 ± 3%, p = .008). CONCLUSIONS The results support the view that impairment of intracellular cGMP signalling plays a role in the pathogenesis of the endothelial dysfunction of an arterial graft after bypass surgery, which can effectively be prevented by vardenafil. Its clinical use as preconditioning drug could be a novel approach in vascular/cardiac surgery.
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Affiliation(s)
- Gábor Veres
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Martin Hagenhoff
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Harald Schmidt
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | | | | | - Yang Bai
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | | | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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Korkmaz-Icöz S, Li K, Ruppert M, Loganathan S, Radovits T, Brlecic P, Karck M, Szabó G. Conservation of Hearts from Brain Dead Donors with a Preservation Solution Supplemented by a Conditioned Medium from Mesenchymal Stem Cells, Improves Graft Contractility After Heart Transplantation in Rats. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Korkmaz-Icöz S, Radovits T, Loganathan S, Li S, Ruppert M, Benke K, Brlecic P, Szabó C, Karck M, Szabó G. Prolonging hypothermic ischaemic cardiac and vascular storage by inhibiting the activation of the nuclear enzyme poly(adenosine diphosphate-ribose) polymerase. Eur J Cardiothorac Surg 2018; 51:829-835. [PMID: 28204209 DOI: 10.1093/ejcts/ezw426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/06/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Heart transplantation is the standard treatment in end-stage heart failure and at shortage of cardiac allografts is its major limiting factor. Striving to optimize the use of this limited resource, the aspect that long distance procurement may increase the available donor pool must be taken into consideration. As poly(ADP-ribose)polymerase (PARP)-activation has been identified as a key pathway of reperfusion injury, we assessed the hypothesis that its inhibition would allow an extension of cold preservation time and protect the graft against ischaemia/reperfusion injury. METHODS Hearts from donor rats were explanted, stored in a preservation solution (Custodiol) at 4 °C for 4 h or 8 h, and heterotopically transplanted. A vehicle or the PARP-inhibitor, INO-1001 (5 mg/kg), was administered during the reperfusion period. We evaluated post-transplant graft function with a Millar micromanometer at different left-ventricular volumes. Additionally, in organ bath experiments the effect of PARP-inhibition on endothelium-dependent and -independent vasorelaxation was evaluated after long-term cold ischaemic storage/warm reperfusion. RESULTS PARP-inhibition resulted in a better systolic functional recovery of grafts submitted to 4 h and 8 h ischaemia. Furthermore, INO-1001 decreased the left-ventricular end-diastolic pressure after 8 h of ischaemia. Coronary blood flow was significantly higher after PARP-inhibition in comparison to controls. Endothelium-dependent vasorelaxation was significantly better in the INO-1001-groups than in the vehicle-treated transplant groups. After 24-h hypothermic storage, treatment of aortic ring with INO-1001 during reoxygenation significantly improved endothelial dysfunction. CONCLUSIONS By inhibiting the PARP activation, INO-1001 can protect the graft and endothelium from the injury that is caused by prolonged cold myocardial ischaemia/reperfusion, thereby improving post-transplant graft function.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Sivakkanan Loganathan
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Department of Anesthesiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Shiliang Li
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.,Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Kálmán Benke
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Paige Brlecic
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Csaba Szabó
- Department of Anesthesiology, University of Texas Medical Branch Galveston, Galveston, TX, USA
| | - Matthias Karck
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany
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Li S, Korkmaz-Icöz S, Radovits T, Ruppert M, Spindler R, Loganathan S, Hegedűs P, Brlecic P, Theisinger B, Theisinger S, Höger S, Brune M, Lasitschka F, Karck M, Yard B, Szabó G. Donor Preconditioning After the Onset of Brain Death With Dopamine Derivate n-Octanoyl Dopamine Improves Early Posttransplant Graft Function in the Rat. Am J Transplant 2017; 17:1802-1812. [PMID: 28117941 DOI: 10.1111/ajt.14207] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/23/2016] [Accepted: 01/10/2017] [Indexed: 01/25/2023]
Abstract
Heart transplantation is the therapy of choice for end-stage heart failure. However, hemodynamic instability, which has been demonstrated in brain-dead donors (BDD), could also affect the posttransplant graft function. We tested the hypothesis that treatment of the BDD with the dopamine derivate n-octanoyl-dopamine (NOD) improves donor cardiac and graft function after transplantation. Donor rats were given a continuous intravenous infusion of either NOD (0.882 mg/kg/h, BDD+NOD, n = 6) or a physiological saline vehicle (BDD, n = 9) for 5 h after the induction of brain death by inflation of a subdural balloon catheter. Controls were sham-operated (n = 9). In BDD, decreased left-ventricular contractility (ejection fraction; maximum rate of rise of left-ventricular pressure; preload recruitable stroke work), relaxation (maximum rate of fall of left-ventricular pressure; Tau), and increased end-diastolic stiffness were significantly improved after the NOD treatment. Following the transplantation, the NOD-treatment of BDD improved impaired systolic function and ventricular relaxation. Additionally, after transplantation increased interleukin-6, tumor necrosis factor TNF-α, NF-kappaB-p65, and nuclear factor (NF)-kappaB-p105 gene expression, and increased caspase-3, TNF-α and NF-kappaB protein expression could be significantly downregulated by the NOD treatment compared to BDD. BDD postconditioning with NOD through downregulation of the pro-apoptotic factor caspase-3, pro-inflammatory cytokines, and NF-kappaB may protect the heart against the myocardial injuries associated with brain death and ischemia/reperfusion.
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Affiliation(s)
- S Li
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.,Department of Cardiovascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S Korkmaz-Icöz
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - M Ruppert
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - R Spindler
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany
| | - S Loganathan
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.,Department of Anesthesiology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - P Hegedűs
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - P Brlecic
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - S Höger
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany.,Department of Clinical Pharmacology, University Medical Centre Mannheim, Mannheim, Germany
| | - M Brune
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
| | - F Lasitschka
- Institute of Pathology, University Heidelberg, Heidelberg, Germany
| | - M Karck
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - B Yard
- Department of Medicine V (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, Mannheim, Germany
| | - G Szabó
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Li S, Korkmaz S, Ruppert M, Radovits T, Li K, Sun X, Brlecic P, Karck M, Szabó G. Continuous Hypothermic Perfusion of Old Donor Heart with a Preservation Solution Supplemented with Mesenchymal Stem Cell Conditioned Medium Improves Functional Graft Recovery During Prolonged Ischemic Time. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Korkmaz-Icöz S, Brlecic P, Ruppert M, Radovits T, Li S, Sun X, Li K, Karck M, Szabó G. Mechanical Pressure Unloading Therapy Reverses Thoracic Aortic Structural and Functional Changes in a Rat Model of Abdominal Aortic Constriction-Induced Arterial Hypertension. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Korkmaz-Icöz
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - P. Brlecic
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Ruppert
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - T. Radovits
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - S. Li
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - X. Sun
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - K. Li
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - M. Karck
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
| | - G. Szabó
- University Hospital Heidelberg, Cardiac Surgery, Heidelberg, Germany
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Li S, Korkmaz-Icöz S, Ruppert M, Radovits T, Li K, Sun X, Brlecic P, Karck M, Szabó G. Old Donor Heart Preservation by Continuous Perfusion with a Preservation Solution Supplemented with Mesenchymal Stem Cell Conditioned Medium Protects Graft Function from Prolonged Cold Storage Followed by Warm Reperfusion. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Li
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - S. Korkmaz-Icöz
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Ruppert
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - T. Radovits
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - K. Li
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - X. Sun
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - P. Brlecic
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M. Karck
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - G. Szabó
- Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Korkmaz-Icöz S, Lehner A, Li S, Vater A, Radovits T, Brune M, Ruppert M, Sun X, Brlecic P, Zorn M, Karck M, Szabó G. Left ventricular pressure-volume measurements and myocardial gene expression profile in type 2 diabetic Goto-Kakizaki rats. Am J Physiol Heart Circ Physiol 2016; 311:H958-H971. [DOI: 10.1152/ajpheart.00956.2015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 07/29/2016] [Indexed: 01/07/2023]
Abstract
The Goto-Kakizaki (GK) rat, a non-obese model of type 2 diabetes mellitus (T2DM), was generated by the selective inbreeding of glucose-intolerant Wistar rats. This is a convenient model for studying diabetes-induced cardiomyopathy independently from the effects of the metabolic syndrome. We investigated the myocardial functional and structural changes and underlying molecular pathomechanisms of short-term and mild T2DM. The presence of DM was confirmed by an impaired oral glucose tolerance in the GK rats compared with the age-matched nondiabetic Wistar rats. Data from cardiac catheterization showed that in GK rats, although the systolic indexes were not altered, the diastolic stiffness was increased compared with nondiabetics (end-diastolic-pressure-volume-relationship: 0.12 ± 0.04 vs. 0.05 ± 0.01 mmHg/μl, P < 0.05). Additionally, DM was associated with left-ventricular hypertrophy and histological evidence of increased myocardial fibrosis. The plasma pro-B-type natriuretic peptide, the cardiac troponin-T, glucose, and the urinary glucose concentrations were significantly higher in GK rats. Among the 125 genes surveyed using PCR arrays, DM significantly altered the expression of five genes [upregulation of natriuretic peptide precursor-A and connective tissue growth factor, downregulation of c-reactive protein, interleukin-1β, and tumor necrosis factor (TNF)-α mRNA-level]. Of the altered genes, which were evaluated by Western blot, only TNF-α protein expression was significantly decreased. The ECG recordings revealed no significant differences. In conclusion, while systolic dysfunction, myocardial inflammation, and abnormal electrical conduction remain absent, short-term and mild T2DM induce the alteration of cardiac TNF-α at both the mRNA and protein levels. Further assessments are required to reveal if TNF-α plays a role in the early stage of diabetic cardiomyopathy development.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Alice Lehner
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Adrian Vater
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Maik Brune
- Department of Internal Medicine I, University of Heidelberg, Heidelberg, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Xiaoxin Sun
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Markus Zorn
- Department of Internal Medicine I, University of Heidelberg, Heidelberg, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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Ruppert M, Korkmaz-Icöz S, Li S, Németh BT, Hegedűs P, Brlecic P, Mátyás C, Zorn M, Merkely B, Karck M, Radovits T, Szabó G. Myocardial reverse remodeling after pressure unloading is associated with maintained cardiac mechanoenergetics in a rat model of left ventricular hypertrophy. Am J Physiol Heart Circ Physiol 2016; 311:H592-603. [PMID: 27342874 DOI: 10.1152/ajpheart.00085.2016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/10/2016] [Indexed: 11/22/2022]
Abstract
Pressure unloading represents the only effective therapy in increased afterload-induced left ventricular hypertrophy (LVH) as it leads to myocardial reverse remodeling (reduction of increased left ventricular mass, attenuated myocardial fibrosis) and preserved cardiac function. However, the effect of myocardial reverse remodeling on cardiac mechanoenergetics has not been elucidated. Therefore, we aimed to provide a detailed hemodynamic characterization in a rat model of LVH undergoing pressure unloading. Pressure overload was induced in Sprague-Dawley rats by abdominal aortic banding for 6 (AB 6th wk) or 12 wk (AB 12th wk). Sham-operated animals served as controls. Aortic debanding procedure was performed after the 6th experimental week (debanded 12th wk) to investigate the regression of LVH. Pressure unloading resulted in significant reduction of LVH (heart weight-to-tibial length ratio: 0.38 ± 0.01 vs. 0.58 ± 0.02 g/mm, cardiomyocyte diameter: 18.3 ± 0.1 vs. 24.1 ± 0.8 μm debanded 12th wk vs. AB 12th wk, P < 0.05), attenuated the extracellular matrix remodeling (Masson's score: 1.37 ± 0.13 vs. 1.73 ± 0.10, debanded 12th wk vs. AB 12th wk, P < 0.05), provided protection against the diastolic dysfunction, and reversed the maladaptive contractility augmentation (slope of end-systolic pressure-volume relationship: 1.39 ± 0.24 vs. 2.04 ± 0.09 mmHg/μl, P < 0.05 debanded 12th wk vs. AB 6th wk, P < 0.05). In addition, myocardial reverse remodeling was also associated with preserved ventriculoarterial coupling and increased mechanical efficiency (50.6 ± 2.8 vs. 38.9 ± 2.5%, debanded 12th wk vs. AB 12th wk, P < 0.05), indicating a complete functional and mechanoenergetic recovery. According to our best knowledge, this is the first study demonstrating that the regression of LVH is accompanied by maintained cardiac mechanoenergetics.
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Affiliation(s)
- Mihály Ruppert
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | | | - Péter Hegedűs
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Csaba Mátyás
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Markus Zorn
- Department of Internal Medicine I, University of Heidelberg, Heidelberg, Germany
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; and
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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Korkmaz-Icöz S, Al Said S, Radovits T, Li S, Brune M, Hegedűs P, Atmanli A, Ruppert M, Brlecic P, Lehmann LH, Lahrmann B, Grabe N, Yoshikawa Y, Yasui H, Most P, Karck M, Szabó G. Oral treatment with a zinc complex of acetylsalicylic acid prevents diabetic cardiomyopathy in a rat model of type-2 diabetes: activation of the Akt pathway. Cardiovasc Diabetol 2016; 15:75. [PMID: 27153943 PMCID: PMC4858866 DOI: 10.1186/s12933-016-0383-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 04/05/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type-2 diabetics have an increased risk of cardiomyopathy, and heart failure is a major cause of death among these patients. Growing evidence indicates that proinflammatory cytokines may induce the development of insulin resistance, and that anti-inflammatory medications may reverse this process. We investigated the effects of the oral administration of zinc and acetylsalicylic acid, in the form of bis(aspirinato)zinc(II)-complex Zn(ASA)2, on different aspects of cardiac damage in Zucker diabetic fatty (ZDF) rats, an experimental model of type-2 diabetic cardiomyopathy. METHODS Nondiabetic control (ZL) and ZDF rats were treated orally with vehicle or Zn(ASA)2 for 24 days. At the age of 29-30 weeks, the electrical activities, left-ventricular functional parameters and left-ventricular wall thicknesses were assessed. Nitrotyrosine immunohistochemistry, TUNEL-assay, and hematoxylin-eosin staining were performed. The protein expression of the insulin-receptor and PI3K/AKT pathway were quantified by Western blot. RESULTS Zn(ASA)2-treatment significantly decreased plasma glucose concentration in ZDF rats (39.0 ± 3.6 vs 49.4 ± 2.8 mM, P < 0.05) while serum insulin-levels were similar among the groups. Data from cardiac catheterization showed that Zn(ASA)2 normalized the increased left-ventricular diastolic stiffness (end-diastolic pressure-volume relationship: 0.064 ± 0.008 vs 0.084 ± 0.014 mmHg/µl; end-diastolic pressure: 6.5 ± 0.6 vs 7.9 ± 0.7 mmHg, P < 0.05). Furthermore, ECG-recordings revealed a restoration of prolonged QT-intervals (63 ± 3 vs 83 ± 4 ms, P < 0.05) with Zn(ASA)2. Left-ventricular wall thickness, assessed by echocardiography, did not differ among the groups. However histological examination revealed an increase in the cardiomyocytes' transverse cross-section area in ZDF compared to the ZL rats, which was significantly decreased after Zn(ASA)2-treatment. Additionally, a significant fibrotic remodeling was observed in the diabetic rats compared to ZL rats, and Zn(ASA)2-administered ZDF rats showed a similar collagen content as ZL animals. In diabetic hearts Zn(ASA)2 significantly decreased DNA-fragmentation, and nitro-oxidative stress, and up-regulated myocardial phosphorylated-AKT/AKT protein expression. Zn(ASA)2 reduced cardiomyocyte death in a cellular model of oxidative stress. Zn(ASA)2 had no effects on altered myocardial CD36, GLUT-4, and PI3K protein expression. CONCLUSIONS We demonstrated that treatment of type-2 diabetic rats with Zn(ASA)2 reduced plasma glucose-levels and prevented diabetic cardiomyopathy. The increased myocardial AKT activation could, in part, help to explain the cardioprotective effects of Zn(ASA)2. The oral administration of Zn(ASA)2 may have therapeutic potential, aiming to prevent/treat cardiac complications in type-2 diabetic patients.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Samer Al Said
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Tamás Radovits
- />Heart and Vascular Center, Semmelweis University, Városmajor u. 68, Budapest, 1122 Hungary
| | - Shiliang Li
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Maik Brune
- />Department of Internal Medicine I and Clinical Chemistry, University Hospital Heidelberg, Im Neuenheimer Feld 671, 69120 Heidelberg, Germany
| | - Péter Hegedűs
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Ayhan Atmanli
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Mihály Ruppert
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
- />Heart and Vascular Center, Semmelweis University, Városmajor u. 68, Budapest, 1122 Hungary
| | - Paige Brlecic
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Lorenz Heyne Lehmann
- />Department of Cardiology, Angiology and Pulmonology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Bernd Lahrmann
- />Hamamatsu Tissue Imaging and Analysis Center (TIGA), Bioquant, University of Heidelberg, 69120 Heidelberg, Germany
- />Steinbeis Transfer Center for Medical Systems Biology, 69124 Heidelberg, Germany
| | - Niels Grabe
- />Hamamatsu Tissue Imaging and Analysis Center (TIGA), Bioquant, University of Heidelberg, 69120 Heidelberg, Germany
- />Steinbeis Transfer Center for Medical Systems Biology, 69124 Heidelberg, Germany
- />Department of Medical Oncology, National Center for Tumor Diseases, University of Heidelberg, 69120 Heidelberg, Germany
| | - Yutaka Yoshikawa
- />Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto, 607-8414 Japan
| | - Hiroyuki Yasui
- />Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto, 607-8414 Japan
| | - Patrick Most
- />Molecular and Translational Cardiology, Department of Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg Germany
| | - Matthias Karck
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
| | - Gábor Szabó
- />Laboratory of Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 326, 69120 Heidelberg, Germany
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Korkmaz-Icöz S, Atmanli A, Radovits T, Li S, Hegedüs P, Ruppert M, Brlecic P, Yoshikawa Y, Yasui H, Karck M, Szabó G. Administration of zinc complex of acetylsalicylic acid after the onset of myocardial injury protects the heart by upregulation of antioxidant enzymes. J Physiol Sci 2016; 66:113-25. [PMID: 26497333 PMCID: PMC10717564 DOI: 10.1007/s12576-015-0403-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/13/2015] [Indexed: 01/20/2023]
Abstract
We recently demonstrated that the pre-treatment of rats with zinc and acetylsalicylic acid complex in the form of bis(aspirinato)zinc(II) [Zn(ASA)2] is superior to acetylsalicylic acid in protecting the heart from acute myocardial ischemia. Herein, we hypothesized that Zn(ASA)2 treatment after the onset of an acute myocardial injury could protect the heart. The rats were treated with a vehicle or Zn(ASA)2 after an isoproterenol injection. Isoproterenol-induced cardiac damage [inflammatory infiltration into myocardial tissue, DNA-strand breakage evidenced by TUNEL-assay, increased 11-dehydro thromboxane (TX)B2-levels, elevated ST-segment, widened QRS complex and prolonged QT-interval] was prevented by the Zn(ASA)2 treatment. In isoproterenol-treated rats, load-independent left ventricular contractility parameters were significantly improved after Zn(ASA)2. Furthermore, Zn(ASA)2 significantly increased the myocardial mRNA-expression of superoxide dismutase-1, glutathione peroxidase-4 and decreased the level of Na(+)/K(+)/ATPase. Postconditioning with Zn(ASA)2 protects the heart from acute myocardial ischemia. Its mechanisms of action might involve inhibition of pro-inflammatory prostanoids and upregulation of antioxidant enzymes.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany.
| | - Ayhan Atmanli
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122, Budapest, Hungary
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
| | - Peter Hegedüs
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
| | - Mihály Ruppert
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
- Heart and Vascular Center, Semmelweis University, 1122, Budapest, Hungary
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
| | - Yutaka Yoshikawa
- Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Hiroyuki Yasui
- Department of Analytical and Bioinorganic Chemistry, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, INF 326 (2. OG), 69120, Heidelberg, Germany
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Korkmaz-Icöz S, Vater A, Li S, Lehner A, Radovits T, Hegedűs P, Ruppert M, Brlecic P, Zorn M, Karck M, Szabó G. Mild type 2 diabetes mellitus improves remote endothelial dysfunction after acute myocardial infarction. J Diabetes Complications 2015. [PMID: 26219999 DOI: 10.1016/j.jdiacomp.2015.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIMS Myocardial infarction (MI) is a common cause of mortality in patients with diabetes mellitus (DM) and vascular dysfunction is a major component of diabetic cardiomyopathy. We investigated the systemic influence of acute MI on the diabetes-induced pathogenic changes in the rat aorta. METHODS Nondiabetic Wistar (W) and type-2 diabetic Goto-Kakizaki (GK) rats underwent 45min of left anterior descending coronary artery occlusion followed by 24h of reperfusion. Isometric force was measured using organ bath. RESULTS Plasma glucose-levels were significantly higher in diabetic rats (GK+sham: 13±2mM; GK+MI: 19±2mM) compared to nondiabetic rats (W+sham: 8±0mM; W+MI: 8±1mM). Acetylcholine-induced relaxation was significantly weaker in rings from W+MI and GK+MI rats compared to corresponding sham-operated animals. Myocardial reperfusion injury was smaller in GK+MI than W+MI rats, and the concentration-response curves to acetylcholine were significantly enhanced in rings from GK+MI than W+MI rats. Nevertheless, the relaxation response to acetylcholine was similar in W+sham and GK+sham. Densitometric analysis of bands for endothelial nitric oxide synthase showed a significant decrease in W+MI rats compared to W+sham and GK+sham animals. Aortas from both GK+sham and GK+MI rats showed impaired contractile responses to phenylephrine in comparison with the nondiabetics. CONCLUSIONS For the first time we showed that short-term and mild type-2 DM improved remote endothelial dysfunction after reperfused acute MI.
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MESH Headings
- Animals
- Aorta
- Blood Glucose/analysis
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/physiopathology
- Diabetic Angiopathies/complications
- Diabetic Angiopathies/physiopathology
- Diabetic Cardiomyopathies/complications
- Diabetic Cardiomyopathies/physiopathology
- Disease Resistance
- Drug Resistance
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/pathology
- Endothelium, Vascular/physiopathology
- Male
- Myocardial Infarction/complications
- Myocardial Infarction/physiopathology
- Myocardial Reperfusion Injury/etiology
- Myocardial Reperfusion Injury/prevention & control
- Nitric Oxide Synthase Type III/metabolism
- Phosphorylation
- Protein Processing, Post-Translational
- Rats
- Rats, Inbred Strains
- Rats, Wistar
- Vasoconstriction/drug effects
- Vasoconstrictor Agents/pharmacology
- Vasodilation/drug effects
- Vasodilator Agents/pharmacology
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Adrian Vater
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Alice Lehner
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | | | - Péter Hegedűs
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Heart Center, Semmelweis University, Budapest, Hungary.
| | - Mihály Ruppert
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Heart Center, Semmelweis University, Budapest, Hungary.
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Markus Zorn
- Department of Internal Medicine I, University of Heidelberg, Heidelberg, Germany.
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany.
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Hegedűs P, Li S, Korkmaz-Icöz S, Radovits T, Mayer T, Al Said S, Brlecic P, Karck M, Merkely B, Szabó G. Dimethyloxalylglycine treatment of brain-dead donor rats improves both donor and graft left ventricular function after heart transplantation. J Heart Lung Transplant 2015; 35:99-107. [PMID: 26255815 DOI: 10.1016/j.healun.2015.06.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 06/06/2015] [Accepted: 06/24/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Hypoxia inducible factor (HIF)-1 pathway signalling has a protective effect against ischemia/reperfusion injury. The prolyl-hydroxylase inhibitor dimethyloxalylglycine (DMOG) activates the HIF-1 pathway by stabilizing HIF-1α. In a rat model of brain death (BD)-associated donor heart dysfunction we tested the hypothesis that pre-treatment of brain-dead donors with DMOG would result in a better graft heart condition. METHODS BD was induced in anesthetized Lewis rats by inflating a subdurally placed balloon catheter. Controls underwent sham operations. Then, rats were injected with an intravenous dose of DMOG (30 mg/kg) or an equal volume of physiologic saline. After 5 hours of BD or sham operation, hearts were perfused with a cold (4°C) preservation solution (Custodiol; Dr. Franz Köhler Chemie GmbH; Germany), explanted, stored at 4°C in Custodiol, and heterotopically transplanted. Graft function was evaluated 1.5 hours after transplantation. RESULTS Compared with control, BD was associated with decreased left ventricular systolic and diastolic function. DMOG treatment after BD improved contractility (end-systolic pressure volume relationship E'max: 3.7 ± 0.6 vs 3.1 ± 0.5 mm Hg/µ1; p < 0.05) and left ventricular stiffness (end-diastolic pressure volume relationship: 0.13 ± 0.03 vs 0.31 ± 0.06 mm Hg/µ1; p < 0.05) 5 hours later compared with the brain-dead group. After heart transplantation, DMOG treatment of brain-dead donors significantly improved the altered systolic function and decreased inflammatory infiltration, cardiomyocyte necrosis, and DNA strand breakage. In addition, compared with the brain-dead group, DMOG treatment moderated the pro-apoptotic changes in the gene and protein expression. CONCLUSIONS In a rat model of potential brain-dead heart donors, pre-treatment with DMOG resulted in improved early recovery of graft function after transplantation. These results support the hypothesis that activation of the HIF-1 pathway has a protective role against BD-associated cardiac dysfunction.
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Affiliation(s)
- Péter Hegedűs
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Tobias Mayer
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Samer Al Said
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
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Korkmaz-Icöz S, Lehner A, Li S, Vater A, Radovits T, Hegedűs P, Ruppert M, Brlecic P, Zorn M, Karck M, Szabó G. Mild Type 2 Diabetes Mellitus Reduces the Susceptibility of the Heart to Ischemia/Reperfusion Injury: Identification of Underlying Gene Expression Changes. J Diabetes Res 2015; 2015:396414. [PMID: 26229969 PMCID: PMC4502305 DOI: 10.1155/2015/396414] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/18/2015] [Accepted: 05/26/2015] [Indexed: 01/11/2023] Open
Abstract
Despite clinical studies indicating that diabetic hearts are more sensitive to ischemia/reperfusion injury, experimental data is contradictory. Although mild diabetes prior to ischemia/reperfusion may induce a myocardial adaptation, further research is still needed. Nondiabetic Wistar (W) and type 2 diabetic Goto-Kakizaki (GK) rats (16-week-old) underwent 45 min occlusion of the left anterior descending coronary artery and 24 h reperfusion. The plasma glucose level was significantly higher in diabetic rats compared to the nondiabetics. Diabetes mellitus was associated with ventricular hypertrophy and increased interstitial fibrosis. Inducing myocardial infarction increased the glucose levels in diabetic compared to nondiabetic rats. Furthermore, the infarct size was smaller in GK rats than in the control group. Systolic and diastolic functions were impaired in W + MI and did not reach statistical significance in GK + MI animals compared to the corresponding controls. Among the 125 genes surveyed, 35 genes showed a significant change in expression in GK + MI compared to W + MI rats. Short-term diabetes promotes compensatory mechanisms that may provide cardioprotection against ischemia/reperfusion injury, at least in part, by increased antioxidants and the upregulation of the prosurvival PI3K/Akt pathway, by the downregulation of apoptotic genes, proinflammatory cytokine TNF-α, profibrogenic TGF-β, and hypertrophic marker α-actin-1.
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Affiliation(s)
- Sevil Korkmaz-Icöz
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
- *Sevil Korkmaz-Icöz:
| | - Alice Lehner
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Shiliang Li
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Adrian Vater
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Tamás Radovits
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Péter Hegedűs
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
- Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary
| | - Mihály Ruppert
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Paige Brlecic
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Markus Zorn
- Department of Internal Medicine I, University of Heidelberg, 69120 Heidelberg, Germany
| | - Matthias Karck
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
| | - Gábor Szabó
- Department of Cardiac Surgery, University of Heidelberg, 69120 Heidelberg, Germany
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