Mersmann Jan, Zacharowski Paula A, Schmitz Ingo, Zacharowski Kai
Department of Anaesthesiology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Resuscitation. 2008 Dec;79(3):468-74. doi: 10.1016/j.resuscitation.2008.07.008. Epub 2008 Sep 20.
Apoptosis of cardiomyocytes has been suggested to contribute to outcome following myocardial ischaemia and reperfusion (MI/R). Caspase inhibitors were developed as potential therapeutics for MI/R. However, various reports using the broad-spectrum caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (zVAD.fmk) in the latter setting present conflicting results. Therefore, it is still unclear whether inhibition of apoptosis by caspase inhibitors promotes cardioprotection.
This study evaluated whether zVAD.fmk or novel caspase inhibitor quinoline-Val-Asp(Ome)-CH2-O-phenoxy (Q-VD-OPh) reduce myocardial infarct size in mice. Secondly, we tested zVAD.fmk's potential infarct-sparing effects in rats and whether these are accompanied by improved left ventricular function.
In mice neither zVAD.fmk nor Q-VD-OPh reduced infarct size. In rats, however, zVAD.fmk reduced infarct size following ischaemia (25min) and reperfusion (7 days) by approximately 53%. This was, however, accompanied by an increase in left ventricular end-diastolic pressure.
This study provides further evidence that abrogation of apoptosis via caspase inhibition might not be sufficient to effectively limit infarct size following MI/R.
心肌细胞凋亡被认为与心肌缺血再灌注(MI/R)后的结局有关。半胱天冬酶抑制剂已被开发为MI/R的潜在治疗药物。然而,在后一种情况下使用广谱半胱天冬酶抑制剂N-苄氧羰基-Val-Ala-Asp-氟甲基酮(zVAD.fmk)的各种报告呈现出相互矛盾的结果。因此,半胱天冬酶抑制剂抑制细胞凋亡是否能促进心脏保护仍不清楚。
本研究评估了zVAD.fmk或新型半胱天冬酶抑制剂喹啉-Val-Asp(Ome)-CH2-O-苯氧基(Q-VD-OPh)是否能减小小鼠的心肌梗死面积。其次,我们测试了zVAD.fmk在大鼠中的潜在梗死面积减少作用,以及这些作用是否伴随着左心室功能的改善。
在小鼠中,zVAD.fmk和Q-VD-OPh均未减小梗死面积。然而,在大鼠中,zVAD.fmk使缺血(25分钟)和再灌注(7天)后的梗死面积减少了约53%。然而,这伴随着左心室舒张末期压力的增加。
本研究提供了进一步的证据,即通过抑制半胱天冬酶消除细胞凋亡可能不足以有效限制MI/R后的梗死面积。