Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Institute for Molecular Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
Pharmacology. 2021;106(3-4):225-232. doi: 10.1159/000511279. Epub 2020 Nov 20.
Targeting inflammation in patients with coronary artery disease and/or acute myocardial infarction (AMI) is a matter of debate. Methotrexate (MTX) is one of the most widely used immunosuppressants. Cardiovascular Inflammation Reduction Trial (CIRT) recently failed to demonstrate reduced cardiovascular events in MTX-treated patients. However, it is not known if long-term MTX treatment improves cardiac outcome in AMI. Therefore, in this study, we investigated the postischemic phase in MTX-treated mice undergoing AMI.
Wild-type mice received MTX medication intraperitoneally for 2 weeks. Afterward, AMI was induced by transient left anterior ascending artery ligation. Postischemic cardiac damage after 24 h was assessed.
MTX treatment did not affect infarct size as compared to control (IS/AAR: Con 76.20% ± 12.37%/AAR vs. MTX 73.51 ± 11.72%/AAR, p = 0.64). Moreover, systolic function and structural parameters did not differ between groups (24hejection fraction: Con 36.49 ± 3.23% vs. MTX 32.77 ± 2.29%, p = 0.41; 24hLVID; d: Con 3.57 ± 0.17 mm vs. MTX 3.19 ± 0.13 mm, p = 0.14). Platelets were increased by MTX (Con 1,442 ± 69.20 × 103/mm3 vs. MTX 1,920 ± 68.68 × 103/mm3, p < 0.0001). White blood cell and RBC as well as rate of monocytes, granulocytes, lymphocytes, and serum amyloid P levels were equal.
MTX medication did not improve postischemic cardiac damage in a murine model of AMI. Future trials are needed to identify and investigate other anti-inflammatory targets to improve cardiovascular outcome.
针对患有冠状动脉疾病和/或急性心肌梗死(AMI)的患者的炎症反应是一个有争议的问题。甲氨蝶呤(MTX)是最广泛使用的免疫抑制剂之一。心血管炎症减少试验(CIRT)最近未能证明 MTX 治疗患者的心血管事件减少。然而,目前尚不清楚长期 MTX 治疗是否能改善 AMI 患者的心脏预后。因此,在这项研究中,我们研究了接受 AMI 的 MTX 治疗小鼠的缺血后阶段。
野生型小鼠接受 MTX 腹腔内治疗 2 周。此后,通过短暂性左前升动脉结扎诱导 AMI。24 小时后评估缺血后心脏损伤。
与对照组相比,MTX 治疗并未影响梗死面积(IS/AAR:Con 76.20%±12.37%/AAR 与 MTX 73.51%±11.72%/AAR,p=0.64)。此外,两组之间的收缩功能和结构参数没有差异(24 小时射血分数:Con 36.49%±3.23%与 MTX 32.77%±2.29%,p=0.41;24 小时 LVID;d:Con 3.57±0.17mm 与 MTX 3.19±0.13mm,p=0.14)。MTX 增加了血小板(Con 1,442±69.20×103/mm3 与 MTX 1,920±68.68×103/mm3,p<0.0001)。白细胞和红细胞以及单核细胞、粒细胞、淋巴细胞的比例和血清淀粉样蛋白 P 水平相等。
MTX 治疗并未改善 AMI 小鼠模型的缺血后心脏损伤。需要进一步的临床试验来确定和研究其他抗炎靶点,以改善心血管结局。