Changes in rat myocardium associated with modulation of ischemic tolerance by diazoxide.

Pretreatment with diazoxide, mitochondrial K(ATP) channel opener, was found to protect the rat heart against ischemia/reperfusion injury. Our aim was also to characterize the effects of diazoxide on the alterations of regulatory myocardial proteins, on mitochondrial ultrastructure, integrity and induction of apoptotic responses. Isolated rat hearts were Langendorff perfused and subjected to index ischemia (II) induced by 25 min global ischemia and 35 min reperfusion. In diazoxide- treated hearts, diazoxide (50 micromol/l) was applied 15 min before II. The levels and activation of specific proteins were determined using specific antibodies, activities of matrix metalloproteinases by zymography using gelatin as a substrate. The ultrastructure of mitochondria was investigated by electron microscopy of ultrathin sections of mitochondrial fractions embedded in Epon812. In rat hearts pretreated with diazoxide we found better recovery of contractile function after II. Electron microscopy studies revealed that application of diazoxide was connected with better preservation of mitochondrial integrity at basal conditions and after II in comparison to control hearts. Ischemia induced activation of caspase-3 as well as decrease of mitochondria-associated Bcl-2 levels but diazoxide treatment did not significantly influence these changes. On the other hand, diazoxide pretreatment reduced the cytosolic levels of pro-apoptotic Bax protein. Western blot analysis revealed that application of diazoxide increased activation of both ERK-1 and ERK-2 as compared with control hearts. ERK-2 activities were also higher in diazoxide-treated hearts after II when compared to control hearts. Moreover, application of diazoxide inhibited the activities of tissue matrix metalloproteinases (MMP-2). The results suggest that the cardioprotection mediated by diazoxide in rats is associated with preservation of mitochondrial integrity and function. The effect of diazoxide on ERK pathway points to the involvement of this signaling cascade in diazoxide-mediated adaptive responses of myocardium to ischemia.