Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Cardiovascular Research, Development, and Translational Research, Kyushu University, Fukuoka, Japan.
Cardiovasc Res. 2019 Jun 1;115(7):1244-1255. doi: 10.1093/cvr/cvz066.
Myocardial ischaemia-reperfusion (IR) injury hampers the therapeutic effect of revascularization in patients with acute myocardial infarction (AMI). Innate immunity for damage-associated protein patterns promotes the process of IR injury; however, the blockade of Toll-like receptor 4 (TLR4) in myocardial IR injury has not been translated into clinical practice. Therefore, we aimed to examine whether the nanoparticle-mediated administration of TAK-242, a chemical inhibitor of TLR4, attenuates myocardial IR injury in a clinically feasible protocol in a mouse model.
We have prepared poly-(lactic-co-glycolic acid) nanoparticles containing TAK-242 (TAK-242-NP). TAK-242-NP significantly enhanced the drug delivery to monocytes/macrophages in the spleen, blood, and the heart in mice. Intravenous administration of TAK-242-NP (containing 1.0 or 3.0 mg/kg TAK-242) at the time of reperfusion decreased the infarct size, but the TAK-242 solution did not even when administered at a dosage of 10.0 mg/kg. TAK-242-NP inhibited the recruitment of Ly-6Chigh monocytes to the heart, which was accompanied by decreased circulating HMGB1, and NF-κB activation and cytokine expressions in the heart. TAK-242-NP did not decrease the infarct size further in TLR4-deficient mice, confirming the TLR4-specific mechanism in the effects of TAK-242-NP. Furthermore, TAK-242-NP did not decrease the infarct size further in CCR2-deficient mice, suggesting that monocyte/macrophage-mediated inflammation is the primary therapeutic target of TAK-242-NP.
The nanoparticle-mediated delivery of TAK-242-NP represent a novel and clinical feasible strategy in patients undergone coronary revascularization for AMI by regulating TLR4-dependent monocytes/macrophages-mediated inflammation.
心肌缺血再灌注(IR)损伤会影响急性心肌梗死(AMI)患者血运重建的治疗效果。天然免疫识别损伤相关模式分子可促进 IR 损伤过程;然而,TLR4 阻断在心肌 IR 损伤中的作用尚未转化为临床实践。因此,我们旨在研究在 AMI 患者接受冠状动脉血运重建治疗的临床可行方案中,载 TAK-242 的纳米颗粒(一种 TLR4 的化学抑制剂)给药是否能减轻心肌 IR 损伤。
我们制备了载 TAK-242 的聚(乳酸-共-乙醇酸)纳米颗粒(TAK-242-NP)。TAK-242-NP 能显著增强药物在小鼠脾脏、血液和心脏中向单核细胞/巨噬细胞的递呈。在再灌注时静脉给予 TAK-242-NP(含 1.0 或 3.0mg/kg TAK-242)可减小梗死面积,但 TAK-242 溶液即使以 10.0mg/kg 的剂量给药也没有效果。TAK-242-NP 抑制 Ly-6Chigh 单核细胞向心脏募集,同时减少循环 HMGB1 和 NF-κB 激活以及心脏细胞因子表达。在 TLR4 缺陷型小鼠中,TAK-242-NP 进一步减小梗死面积,证实了 TAK-242-NP 作用的 TLR4 特异性机制。此外,在 CCR2 缺陷型小鼠中,TAK-242-NP 进一步减小梗死面积,表明单核细胞/巨噬细胞介导的炎症是 TAK-242-NP 的主要治疗靶点。
载 TAK-242 的纳米颗粒递呈代表了一种新的、具有临床可行性的策略,可通过调节 TLR4 依赖性单核细胞/巨噬细胞介导的炎症,改善 AMI 患者接受冠状动脉血运重建治疗的效果。