High-Dose Polymerized Hemoglobin Fails to Alleviate Cardiac Ischemia/Reperfusion Injury due to Induction of Oxidative Damage in Coronary Artery

Oxid Med Cell Longev. 2015:2015:125106. doi: 10.1155/2015/125106. Epub 2015 Jun 16.

Abstract

Objective. Ischemia/reperfusion (I/R) injury is an unavoidable event for patients in cardiac surgery under cardiopulmonary bypass (CPB). This study was designed to investigate whether glutaraldehyde-polymerized human placenta hemoglobin (PolyPHb), a hemoglobin-based oxygen carrier (HBOC), can protect heart against CPB-induced I/R injury or not and to elucidate the underlying mechanism. Methods and Results. A standard dog CPB model with 2-hour cardiac arrest and 2-hour reperfusion was established. The results demonstrated that a low-dose PolyPHb (0.1%, w/v) provided a significant protection on the I/R heart, whereas the high-dose PolyPHb (3%, w/v) did not exhibit cardioprotective effect, as evidenced by the impaired cardiac function, decreased myocardial oxygen utilization, and elevated enzymes release and pathological changes. Further study indicated that exposure of isolated coronary arteries or human umbilical vein endothelial cells (HUVECs) to a high-dose PolyPHb caused impaired endothelium-dependent relaxation, which was companied with increased reactive oxygen species (ROS) production, reduced superoxide dismutase (SOD) activity, and elevated malonaldehyde (MDA) formation. Consistent with the increased oxidative stress, the NAD(P)H oxidase activity and subunits expression, including gp91(phox), p47(phox), p67(phox), and Nox1, were greatly upregulated. Conclusion. The high-dose PolyPHb fails to protect heart from CPB-induced I/R injury, which was due to overproduction of NAD(P)H oxidase-induced ROS and resultant endothelial dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Substitutes / chemistry
  • Blood Substitutes / pharmacology*
  • Blood Substitutes / therapeutic use
  • Cardiopulmonary Bypass
  • Coronary Vessels / drug effects
  • Coronary Vessels / metabolism*
  • Coronary Vessels / pathology
  • Creatine Kinase, MB Form / metabolism
  • Disease Models, Animal
  • Dogs
  • Female
  • Glutaral / chemistry
  • Hemoglobins / chemistry*
  • Human Umbilical Vein Endothelial Cells
  • Humans
  • Malondialdehyde / metabolism
  • Myocardial Reperfusion Injury / drug therapy
  • Myocardial Reperfusion Injury / etiology
  • Myocardium / metabolism
  • NADPH Oxidases / metabolism
  • Oxidative Stress / drug effects*
  • Placenta / metabolism
  • Pregnancy
  • Protein Subunits / metabolism
  • Reactive Oxygen Species / metabolism
  • Superoxide Dismutase / metabolism
  • Up-Regulation / drug effects

Substances

  • Blood Substitutes
  • Hemoglobins
  • Protein Subunits
  • Reactive Oxygen Species
  • Malondialdehyde
  • Superoxide Dismutase
  • NADPH Oxidases
  • Creatine Kinase, MB Form
  • Glutaral