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Anti‐inflammatory effects of pyruvate‐enriched cardioplegia in pigs undergoing cardiopulmonary bypass
Author(s) -
Mallet Robert T,
Ryou MyoungGwi,
Flaherty Devin C,
Hoxha Besim,
Sun Jie,
Bellard Monica,
Hodge Lisa M,
OlivenciaYurvati Albert H
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.991.14
Subject(s) - cardiopulmonary bypass , myeloperoxidase , inflammation , infiltration (hvac) , medicine , pharmacology , anesthesia , physics , thermodynamics
Background Reactive oxygen species produced during cardiopulmonary bypass (CPB) can elicit inflammation. Cardioplegia enriched with the intermediary metabolite pyruvate exerts antioxidant protection in myocardium of pigs subjected to CPB. Hypothesis Pyruvate‐fortified cardioplegia mitigates myocardial inflammation by increasing anti‐inflammatory cytokines, enhancing myocardial antioxidant defenses, and suppressing matrix metalloproteinase activity and neutrophil infiltration. Methods In situ swine hearts were arrested for 1 h with 4:1 blood:crystalloid cardioplegia, where the crystalloid component contained 188 mM glucose ± 24 mM pyruvate, then the hearts were reperfused and the pigs weaned from CPB. At 4 h post‐CPB, left ventricular myocardium was sampled for immunoblot analyses of the acute inflammation marker C‐reactive peptide (CRP), matrix metalloproteinase‐3 (MMP3) and tissue inhibitor of metalloproteinase‐2 (TIMP2), and to assess neutrophil infiltration by histology and myeloperoxidase activity. Results Myocardial CRP content increased over fivefold following CPB with control cardioplegia, but pyruvate cardioplegia prevented this increase. Circulating IL‐10 temporarily increased during and immediately after CPB; pyruvate cardioplegia provoked more sustained and robust enhancement of this anti‐inflammatory cytokine. CPB increased myocardial neutrophil infiltration and myeloperoxidase activity, but pyruvate‐fortified cardioplegia prevented these effects. Conclusion Pyruvate‐enriched cardioplegia suppresses CPB‐induced inflammation, an effect potentially mediated by anti‐inflammatory cytokines and TIMP‐2. Support: OHF 02‐18‐522