Abstract
The beneficial effects of pyruvate in organ reperfusion injury have been documented, however the therapeutic use of pyruvate has been hindered by the lack of an appropriate delivery method. Pyruvic acid is unstable and high rates of sodium pyruvate infusion are toxic. Dipyruvyl-acetyl-glycerol (DPAG) ester was developed as a novel method for intravenous pyruvate delivery at a high rate without sodium overload. We tested the ability of DPAG to reduce myocardial infarct size when administered after severe myocardial ischemia in an anesthetized open-chest pig model of ischemia-reperfusion injury. Ischemia was induced by total occlusion of the distal 2/3 of the left anterior descending coronary artery for one hour, followed by two hours of reperfusion. Animals were either untreated (n = 7), or treated with intravenous DPAG (8.0 mg/kg−1 · min−1, n = 8) during the two hours of reperfusion. Infarct size was measured on blinded samples using tetrazolium staining. The DPAG treated group had elevated pyruvate levels (0.82 ± 0.07 mM) and reduced infarct size (20.1 ± 4.2% of the volume at risk, compared to 30.8 ± 4.6% in the untreated animals (p < 0.05)), with no difference in blood pressure or heart rate between groups. In conclusion, an intravenous infusion of DPAG safely increases arterial pyruvate concentration and reduces myocardial infarct size following myocardial ischemia.
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Liedtke AJ, Nellis SH, Neely JR, Hughes HC. Effects of treatment with pyruvate and Tris in experimental myocardial ischemia. Cir Res 1976;39:378-387.
Liedtke AJ, Nellis SH. Effects of buffered pyruvate on regional cardiac function in moderate, short-term ischemia in swine heart. Circ Res 1978;43:189-199.
Bünger R, Swindall B, Brodie D, Zdunek D, Stiegler H, Walter G. Pyruvate attenuation of hypoxia damage in isolated working guinea-pig heart. J Molec Cell Cardiol 1986;18:423-438.
Bünger R, Mallet RT, Hartman DA. Pyruvate-enhanced phosphorylation potential and inotropism in normoxic and postischemic isolated working heart. Near-complete prevention of reperfusion contractile failure. Eur J Biochem 1989;180:221-233.
Mallet RT. Pyruvate: Metabolic protector of cardiac performance. Experimental Biol Med 2000;223:136-148.
Mentzer RM Jr, Van Wylen DG, Sodhi J, et al. Effect of pyruvate on regional ventricular function in normal and stunned myocardium. Annals of Surgery 1989;209:629-633.
Zhou Z, Lasley RD, Hegge JO, Bünger R, Mentzer RM Jr. Myocardial stunning: A therapeutic conundrum. J Thorac Cardiovasc Surg 1995;110:1391-1400.
Regitz V, Azumi T, Stephan H, Naujocks S, Schaper W. Biochemical mechanism of infarct size reduction by pyruvate. Cardiovas Res 1981;15:652-658.
Gutterman DD, Chilian WH, Eastham CL, Inou T, White CW, Marcus ML. Failure of pyruvate to salvage myocardium after prolonged ischemia. Am J Physiol 1986;250:H114-H120.
Mongan PD, Fontana JL, Chen R, Bünger R. Intravenous pyruvate prolongs survival during hemorrhagic shock in swine. Am J Physiol 1999;277:H2253-H2263.
Mongan PD, Capacchione J, Fontana JL, West S, Bünger R. Pyruvate improves cerebral metabolism during hemorrhagic shock. Am J Physiol (Heart Circ) 2001;281:H854-H864.
Martin BJ, Lasley RD, Mentzer RM. Infarct size reduction with the nucleoside transport inhibitor R-75231 in swine. Am J Physiol (Heart Circ) 1997;272:H1857-H1865.
Mallet RT, Sun J. Mitochondrial metabolism of pyruvate is required for its enhancement of cardiac function and energetics. Cardiovasc Res 1999;42:149-161.
Panchal AR, Comte B, Huang H, et al. Partitioning of pyruvate between oxidation and anaplerosis in swine heart. Am J Physiol (Heart Circ) 2000;279:H2390-H2398.
Panchal AR, Comte B, Huang H, et al. Acute hibernation decreases myocardial pyruvate carboxylation and citrate release. Am J Physiol (Heart Circ) 2001;281:H1613-H1620.
Suemune H, Mizuhara Y, Akita H, Sakai K. Enzymatic synthesis of 2,3-O-isopropylidene-sn-glycerol, a chiral building block for platelet-activating factor. Chem Pharm Bull 1986;34:3440-3444.
Ottenheijm HCJ, De Man JHM. Synthesis of ?-keto acid chlorides. Synthesis 1975:163-164.
Hall JL, Stanley WC, Lopaschuk GD, et al. Impaired pyruvate oxidation but normal glucose uptake in diabetic swine myocardium during dobutamine-induced work. Am J Physiol (Heart Circ) 1996;271:H2320-H2329.
Stanley WC, Hernandez LA, Spires DA, Bringas J, Wallace S, McCormack JG. Pyruvate dehydrogenase activity and malonyl-CoA levels in normal and ischemic swine myocardium: Effects of dichloroacetate. J Mol Cell Cardiol 1996;29:905-914.
Hermann HP, Peike B, Schwarzuller E, Jeul J, Just H, Hasenfuss G. Haemodynamic effects of intracoronary pyruvate in patients with congestive heart failure:Anopen study. Lancet 1999;353:1321-1323.
Tejero-Taldo MI, Caffrey JL, Sun J, Mallet RT. Antioxidant properties of pyruvate mediate its potentiation of ?-adrenergic inotropism in stunned myocardium. J Mol Cell Cardiol 1999;31:1863-1872.
Bassenge EB, Sommer O, Schwemmer M, Bünger R. Antioxidant pyruvate inhibits cardiac formation of reactive oxygen species through changes in redox state. AmJ Physiol (Heart Circ) 2000;279:H2431-H2438.
Clough D, Bünger R. Protection by pyruvate against inhibition of Na+-K+-ATPase by a free radical generating system containing t-butylhydroperoxide. Life Sci 1995;57:931-943.
Ramakrishnan N, Chen R, McClain DE, Bünger R. Pyruvate prevents hydrogen peroxide-induced apoptosis. Free Radical Res 1998;29:283-2895.
Bolli R. Causative role of oxyradicals in myocardial stunning: A proven hypothesis. A brief review of the evidence demonstrating a major role of reactive oxygen species in several forms of postischemic dysfunction. Basic Res Cardiol 1998;93:156-162.
Bolli R. Oxygen-derived free radicals and myocardial reperfusion injury: An overview. Cardiovasc Drugs Therapy 1991;5(Suppl 2):249-268.
Jeroudi MO, Hartley CJ, Bolli R. Myocardial reperfusion injury: Role of oxygen radicals and potential therapy with antioxidants. Amer J Cardiol 1994;73:2B-7B.
Ochiai K, Zhang J, Gong G, et al. Effects of augmented delivery of pyruvate on myocardial high-energy phosphate metabolism at a high workstate. Am J Physiol (Heart Circ) 2001;281:H1823-H1832.
Park J-W, Chun Y-S, Kim M-S, Park Y-C, Kwak SJ, Park SC. Metabolic modulation of cellular redox potential can improve cardiac recovery from ischemia-reperfusion injury. Int J Cardiol 1998;65:139-147.
Martin BJ, McClanahan TB, Van Wylen DG, Gallagher KP. Effects of ischemia, preconditioning, and adenosine deaminase inhibition on interstitial adenosine levels and infarct size. Ann Thorac Surg 2000;69:84-89.
Bianchi C, Wakiyama H, Faro R, et al. Anovel peroxynitrite decomposer catalyst (FP-15) reduces myocardial infarct size in an in vivo peroxynitrite decomposer and acute ischemiareperfusion in pigs. Ann Thorac Surg 2002;74:1201-1207.
Duncker DJ, Klassen CL, Ishibashi Y, Herrlinger SH, Pavek TJ, Bache RJ. Effect of temperature on myocardial infarction in swine. Am J Physiol 1996;270:H1189-H1199.
Meng H, McVey M, Perrone M, Clark KL. Intravenous AMP 579, a novel adenosine A(1)/A(2a) receptor agonist, induces a delayed protection against myocardial infarction in minipig. Eur J Pharmacol 2000;387:101-105.
Hohlfeld T, Meyer-Kirchrath J, Vogel YC, Schror K. Reduction of infarct size by selective stimulation of prostaglandin EP(3)receptors in the reperfused ischemic pig heart. J Mol Cell Cardiol 1998;32:1787-1786.
Padilla F, Garcia-Dorado D, Agullo L, et al. Intravenous administration of the natriuretic peptide urodilatin at low doses during coronary reperfusion limits infarct size in anesthetized pigs. Cardiovasc Res 2001;51:592-600.
Schwarz ER, Fleischhauer J, Montino H, et al. Infarct size reduction by ischemic preconditioning is a monophasic, short-lived phenomenon in anesthetized pigs. J Cardiovasc Pharmacol Ther 1998;3:63-70.
Sjaastad I, Grund F, Ilebekk A. Effects on infarct size and on arrhythmias by controlling reflow after myocardial ischaemia in pigs. J Invasive Cardiol 2002;14:160-166.
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Stanley, W.C., Kivilo, K.M., Panchal, A.R. et al. Post-Ischemic Treatment with Dipyruvyl-Acetyl-Glycerol Decreases Myocardial Infarct Size in the Pig. Cardiovasc Drugs Ther 17, 209–216 (2003). https://doi.org/10.1023/A:1026163921643
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DOI: https://doi.org/10.1023/A:1026163921643