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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adenosine (ADO) is an important endogenous protective metabolite of the heart which also exerts beneficial effects when exogenously supplied before or after ischemia. Previous studies established that after initial massive release of ADO, its endogenous production could be significantly reduced following myocardial ischemia. However, the mechanism and consequences of this phenomenon are not clear. We investigated whether this suppressed endogenous ADO production could be reversed by a transient supply of exogenous ADO during reperfusion. Furthermore, we studied the recovery of mechanical function, coronary flow and myocardial nucleotide levels after this intervention. Three concentrations of ADO were applied: 1 microM, which exerts maximal vasodilatation: 30 microM, optimal for adenylate resynthesis: and 1 mM which exerts a cardioplegic effect. Rat hearts perfused in the Langendorff mode were divided into five groups (n = 6-9 per group): all hearts had transient (30-s) ischemia at 20 min (TI-1) and 70 min (TI-3) of perfusion. Group 1 (control) had an additional transient (30-s) ischemia at 45 min (TI-2). Group 2 (ischemic control) had 10-min ischemia at 30 min: groups 3, 4 and 5 also had 10-min ischemia at 30 min but were reperfused for the initial 15 min with 1 microM, 30 microM or 1 mM ADO. Developed tension, coronary flow and coronary effluent purines and pyrimidines were measured throughout the 75-min experimental period. Nucleotide content was evaluated in freeze-clamped hearts at the end of the experiment. Endogenous ADO release to the coronary effluent increased immediately after TI-1 in all groups. This increase was similar after TI-1 and after TI-3 in control, while it was reduced to 30% in ischemic control group. In the 30 microM ADO group the increase in endogenous ADO release after TI-3 was restored and was similar to that after TI-1. A similar trend was observed with 1 mM ADO, while in 1 microM group recovery of endogenous ADO release after TI-3 was not observed. The highest recovery of developed tension (+ S.E.) occurred with 1 microM and 30 microM ADO (72 +/- 3% and 72 +/- 5% of pre-ischemic value, respectively) compared to 53 +/- 5% and 63 +/- 5% in ischemic control and 1 mM ADO groups, respectively (P <0.05). Coronary flow was restored 30 s after 10 min ischemia in hearts treated with 1 microM and 30 microM ADO, whereas more than 2 min were necessary in ischemic control or 1 mM ADO groups. Furthermore, hyperemic response after TI-3 was significantly enhanced in the 1 microM or 30 microM ADO groups. ATP content at the end of reperfusion was highest in the 30 microM ADO group (18.9 +/- 0.5 micromol/g dry wt.) as compared to ischemic control. 1 microM or 1 mM ADO groups (15.2 +/- O.6, 16.4 +/- 0.4, and 17.2 +/- 0.4 micromol/g dry wt. respectively). Concentrations of other nucleotide triphosphates (GTP, UTP and CTP) were similar in all hearts subjected to 10-min ischemia. In summary, depressed endogenous ADO production in the post-ischemic heart could be ameliorated by transient supply of exogenous ADO during reperfusion at 30 microM concentration. This effect was found to be related to the elevation of the adenine nucleotide pool. However, restoration of endogenous ADO production was not necessary for improvement in the recovery of mechanical function by exogenous ADO.
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PMID:Exogenous adenosine, supplied transiently during reperfusion, ameliorates depressed endogenous adenosine production in the post-ischemic rat heart. 904 48

A novel hypothesis is proposed and tested describing open-system kinetics for myocardial phosphoenergetics. The hypothesis is that during severe coronary underperfusion there is precise matching of the rates of ATP synthesis and hydrolysis, but despite the precise balance of ATP rates, there is a decrease in the concentration of ATP and an increase in the concentration of phosphocreatine (PCr) caused by the hydrolysis of AMP to adenosine. Isolated rabbit hearts were perfused using a crystalloid medium, and coronary flow was reduced by 95% from baseline for 45 min followed by reperfusion. Phosphorus nuclear magnetic resonance spectroscopy showed a rapid decrease in PCr concentration to 25% of baseline at the onset of underperfusion followed by a gradual increase in PCr to 42% of baseline, while ATP decreased continuously to 65% of baseline. The kinetics of PCr and ATP could only be described by the precise matching of the rates of ATP synthesis and ATP hydrolysis and an open adenylate system that included the decrease in cytosolic AMP concentration via the production and efflux of adenosine. To confirm the hypothesis of open-system kinetics, two independent predictions were tested in separate experiments: 1) total coronary venous purine efflux (adenosine+inosine+hypoxanthine) during underperfusion was equal to the decrease in ATP concentration, and 2) there was no increase in PCr during moderate coronary underperfusion (80% flow reduction). In conclusion, the open nature of the myocardial adenylate system causes mass action effects that exert novel control over PCr and ATP concentrations during coronary underperfusion. The open-system kinetics cause ATP to decrease and PCr to increase, even though there is precise matching of the rates of ATP synthesis and hydrolysis. Finally, the hydrolysis of AMP to adenosine may benefit tissue survival during ischemia by improving the free energy of ATP hydrolysis, thereby delaying or preventing calcium overload.
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PMID:Open-system kinetics of myocardial phosphoenergetics during coronary underperfusion. 922 32

Using an isolated ferret heart preparation (Langendorff perfusion, perfusion pressure 90 mmHg), energy metabolism has been characterized in right and left ventricles from control and hypertrophied hearts. Hypertrophy was induced by pulmonary artery clipping for 30-45 days (right ventricle wall weight/body weight ratio increased by 70%). Myocardial contents of high energy phosphate compounds, glycogen and lactate, and the activities of some enzymes were biochemically measured in perfused hearts and also after ischemic arrest (30 min global ischemia). In hypertrophied right ventricles, PCr (-46%), Cr (-34%) levels, creatine kinase activity (-18%) were significantly decreased compared with control. ATP and Pi levels were not affected by hypertrophy. The adenylate energy charges were similar (0.85-0.86) in both types of heart. The activities of hexokinase (+26%), aldolase (+212%), pyruvate kinase (+14%) and glucose 6-phosphate dehydrogenase (+107%) were increased by hypertrophy. The LDH isozyme pattern was significantly changed such that LDH3 was decreased by 11%, and LDH4 and LDH5 were increased by a factor 1.4 and 2.9 respectively in hypertrophy. After 30 min of global ischemia, PCr level was decreased by 89 and 79% in control and hypertrophied ventricles respectively. ATP level was depressed by 41 in control and only by 21% in hypertrophied muscles. Altogether, the present data suggested that, in the adult ferret heart, the capacity for the ATP synthesis could be maintained during hypertrophy by the enhancement of the glycolytic pathway. The smaller decline of ATP after ischemia in hypertrophied tissue could be explained by a lower consumption of ATP in the hypertrophied compared to the control heart during the earliest period of ischemia.
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PMID:Energy metabolism in normal and hypertrophied right ventricle of the ferret heart. 923 44

Functional and metabolic responses to ischemia-reperfusion and hypoxia-reoxygenation were studied in Langendorff perfused hearts from mature (2-4 months) and aged (18-24 months) Wistar rats. Hearts were subjected to 20 min global ischemia or hypoxia followed by 30 min reperfusion or reoxygenation. Cellular metabolism was assessed by 31P-NMR spectroscopy. Normoxic function, phosphate metabolite levels, and cytosolic free energy state (delta GATP) were comparable in both age groups, although free [5'-AMP] and purine efflux were elevated in aged hearts. There were no aging-related differences in phosphate metabolite levels, pH or delta GATP during ischemia or hypoxia. Nevertheless, ischemic and hypoxic contracture tended to be higher in aged hearts. After reperfusion, heart rate x left-ventricular pressure recovered to 55% of pre-ischemia in mature hearts, and only 25% in aged hearts. After reoxygenation, function recovered to 75% in mature hearts and 55% in aged hearts. Recoveries of cellular [ATP], [phosphocreatine], [inorganic phosphate] and [Mg2+] were impaired, and delta GATP was consistently depressed in aged v mature hearts, Impaired recovery of delta GATP was associated with enhanced purine efflux in aged hearts. Post-ischemic Na+ and Ca2+ accumulation was also increased by 30-40% in aged hearts. Tissue damage assessed by post-ischemic creatine kinase efflux was modest in mature hearts (< 2% total tissue activity) and was 2.5-fold higher in aged hearts. The data show that: (i) aging reduces contractile recovery from ischemia/hypoxia; (ii) this is unrelated to the metabolic insult during ischemia/hypoxia, but parallels reduced recovery of delta GATP [inorganic phosphate], [Mg2+]i [Na+] and [Ca2+]; and (iii) increased purine catabolism may contribute to poor metabolic recovery in aged hearts.
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PMID:Aging impairs functional, metabolic and ionic recovery from ischemia-reperfusion and hypoxia-reoxygenation. 971 Aug 9

1. Myocardial tolerance against infarction is substantially increased by exposing myocytes to 3-10 min transient ischaemia. In this phenomenon, termed 'preconditioning', the adenosine receptor is one of the redundant triggers and the best characterized factor in the cardioprotective mechanism. 2. An increase in interstitial adenosine during preconditioning is thought to be derived primarily from hydrolysis of 5'-AMP in the myocyte by cytosolic 5'-nucleotidase, although a contribution of ectosolic 5'-nucleotidase remains controversial. Adenosine production during ischaemia is substantially suppressed in the preconditioned myocardium, probably due to a decrease in ATP utilization. 3. The adenosine receptor needs to be activated not only at the time of preconditioning ischemia, but also during ischaemic insult for the preconditioning to be cardioprotective. However, the extent of cardioprotection afforded by preconditioning is primarily determined by the interstitial adenosine level achieved during preconditioning ischaemia, not by the level during sustained ischaemia. These data suggest that a post-receptor mechanism downstream of the adenosine receptor may be up-regulated after preconditioning. 4. Studies in vitro suggest that the subtypes of adenosine receptor relevant to preconditioning against infarction are A1 and A3, the activation of which appears to provide additive protection. The functional interrelationship between these subtypes in vivo remains unknown. 5. An important step downstream of adenosine receptor activation is protein kinase C (PKC), which facilitates opening of ATP-sensitive potassium (KATP) channels, probably leading to enhancement of myocardial tolerance. However, activation of other protein kinases, such as tyrosine kinase, may also be important in preconditioning, depending on the animal species and preconditioning protocols. The PKC isoform and location of KATP channels (i.e. sarcolemmal vs mitochondrial KATP) that induce anti-infarct tolerance in myocytes remain to be identified.
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PMID:Adenosine and preconditioning revisited. 1006 27

We examined the effect of tyramine on the production of adenosine in rat heart. A flexibly mounted microdialysis setup was used to measure the concentration of interstitial adenosine and to assess the activity of ecto-5'-nucleotidase in in vivo rat hearts. The microdialysis probe was implanted in the left ventricular myocardium of anesthetized rats and perfused with Tyrode solution containing adenosine 5'-monophosphate (AMP) at a rate of 1.0 microl/min. The concentration of adenosine in the effluent (dialysate) was measured by high-performance liquid chromatography (HPLC). Dialysate adenosine obtained during perfusion with the AMP-containing solution through the probe originated from the hydrolysis of AMP by endogenous ecto-5'-nucleotidase, and the level of adenosine reflected the activity of ecto-5'-nucleotidase in the tissue. Tyramine (0-4 mM) increased the adenosine concentration measured during the perfusion of AMP (100 microM) in a concentration-dependent manner. Alpha,beta-methyleneadenosine 5'-diphosphate (alpha,beta-meADP, 100 microM), an inhibitor of ecto-5'-nucleotidase, abolished the AMP-induced increase in dialysate adenosine. Tyramine (1 mM) increased the adenosine concentration measured in the presence of 100 microM AMP (i.e., the activity of ecto-5'-nucleotidase) by 65.8 +/- 19.9% (n = 6, P < 0.05), an increase which was inhibited by an antagonist of the alpha1-adrenoceptor (prazosin, 50 microM) or of protein kinase C (chelerythrine, 10 microM). These data provide the first evidence that alpha1-adrenoceptor stimulation and the subsequent activation of protein kinase C can increase adenosine concentrations in the interstitial space of ventricular muscle in vivo, through activation of endogenous ecto-5'-nucleotidase. To examine the effect of tyramine on the production of adenosine by ischemia-reperfusion of the rat myocardium, the heart was subjected to myocardial ischemia for 15 min by occlusion of the left anterior descending coronary artery. When the heart was reperfused, elevation of the level of adenosine in the ischemic zone was observed, but this change was not significant. However, when corresponding experiments were performed with a subsequent systemic administration of tyramine (1 mM), a marked elevation in the level of adenosine was observed. The results suggest that tyramine elevates adenosine via stimulation of alpha1-adrenoceptors and protein kinase C-mediated activation of ecto-5'-nucleotidase in rat heart.
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PMID:Tyramine produces interstitial adenosine-mediated activation of ecto-5'-nucleotidase in rat heart in vivo. 1042 37

Myocardial glucose utilization increases in response to the energetic stress imposed on the heart by exercise, pressure overload, and myocardial ischemia. Recruitment of glucose transport proteins is the cellular mechanism by which the heart increases glucose transport for subsequent metabolism. Moderate regional ischemia leads to the translocation of both glucose transporters, GLUT4 and GLUT1, to the sarcolemma in vivo. Myocardial ischemia also stimulates 5'-adenosine monophosphate-activated protein kinase, which may be a fuel gauge in the heart and other tissues signaling the need to turn on energy-generating metabolic pathways. Pharmacologic stimulation of this kinase increases cardiac glucose uptake and transporter translocation, suggesting that it may play an important role in augmenting glucose entry in the setting of ischemic or energetic stress. Thus, recent work has provided insight into the cellular and molecular mechanisms responsible for glucose uptake during energetic stress, which may lead to new approaches to the treatment of patients with coronary artery disease.
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PMID:Regulation of myocardial glucose uptake and transport during ischemia and energetic stress. 1075 May 83

It has been suggested that nitric oxide (NO) may contribute to ischemia-induced cell injury. However, the mechanisms underlying NO toxicity have not yet been fully elucidated. In the present study, we investigated the effect of NO on the level of endoplasmic reticulum (ER) calcium stores, on ER Ca2+ pump activity, on protein synthesis, on concentrations of high-energy phosphates, and on gadd153 mRNA levels. Primary neuronal cells were exposed to the NO-donor (+/-)-S-Nitroso-N-acetylpenicillamine (SNAP) for 1 h, 2 h, 6 h or 24 h. The level of ER calcium stores was evaluated by measuring the increase in cytoplasmic calcium activity induced by exposing cells to thapsigargin, an irreversible inhibitor of ER Ca(2+)-ATPase; the activity of ER Ca(2+)-ATPase was determined by measuring a phosphorylated intermediate; SNAP-induced changes in gadd153 expression were evaluated by quantitative PCR; SNAP-induced changes in protein synthesis were investigated by measuring the incorporation of L-[4,5-3H]leucine into proteins, and changes in the levels of ATP, ADP, AMP were measured by HPLC. Exposing cells to SNAP for 1 h to 2 h induced a marked depletion of ER calcium stores through an inhibition of ER Ca(2+)-ATPase (to 58% of control), and a concentration-dependent suppression of protein synthesis which was reversed in the presence of hemoglobin, suggesting NO-related effects. ATP levels and adenylate energy charge were significantly decreased only when cells were exposed to the highest SNAP concentration for 6 h or 24 h, excluding significant effects of NO on the energy state of cells in the acute state, i.e. when ER calcium stores were already completely depleted and protein synthesis severely suppressed. In light of the regulatory role of ER calcium homeostasis in the control of protein synthesis, the results imply that the suppression of protein synthesis resulted from NO-induced inhibition of ER Ca(2+)-ATPase and depletion of ER calcium stores, and that NO-induced disturbances of energy metabolism are secondary to the effect of NO on ER calcium homeostasis. It is, therefore, concluded that ER calcium stores are a primary target of NO-toxicity.
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PMID:Effect of nitric oxide on endoplasmic reticulum calcium homeostasis, protein synthesis and energy metabolism. 1075 77

We examined whether histidine can increase the production of interstitial adenosine via noradrenaline (NA) release-mediated activation of ecto-5'-nucleotidase in the ventricular myocardium, with use of microdialysis techniques in in situ rat hearts. The microdialysis probe was implanted in the left ventricular myocardium of anesthetized rat hearts and the tissue was perfused with Tyrode's solution containing adenosine 5'-monophosphate (AMP) through the dialysis probe at a rate of 1.0 microl/min. Adenosine in the dialysate collected during perfusion with Tyrode's solution containing 100 microM AMP (through the probe) originated from the hydrolysis of AMP catalyzed by endogenous ecto-5'-nucleotidase, so that the level of adenosine reflected the activity of ecto-5'-nucleotidase in this tissue. In the presence of NA (10 microM), histidine, a scavenger of highly active singlet oxygen (1O2), significantly increased concentration of adenosine. Histidine (5-50 mM) increased the level of AMP-primed dialysate adenosine in a concentration-dependent manner. When histidine (25 mM) was infused to rat myocardium, small increase in the levels of adenosine were observed. However, when corresponding experiments were performed with NA (10 microM)-pretreated animals, a marked elevation of the level of adenosine in rat heart dialysate was obtained. To confirm the possible mechanism of interaction between 1O2 and NA, we examined the effect of histidine in ischemic-reperfused rat hearts. In the presence of histidine (25 mM), a marked elevation of NA and adenosine was observed. However, when corresponding experiments were performed with reserpinized rat hearts, the elevation of both NA and adenosine was not observed in ischemia-reperfused rat hearts. These results indicate that histidine increases interstitial adenosine concentration via NA release-mediated activation of ecto-5'-nucleotidase.
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PMID:An increase of the native interstitial adenosine concentration during histidine application. 1083 7

We evaluated the possibility that ischemic preconditioning could modify hepatic energy metabolism during ischemia. Accordingly, high-energy nucleotides and their degradation products, glycogen and glycolytic intermediates and regulatory metabolites, were compared between preconditioned and nonpreconditioned livers. Preconditioning preserved to a greater extent ATP, adenine nucleotide pool, and adenylate energy charge; the accumulation of adenine nucleosides and bases was much lower in preconditioned livers, thus reflecting slower adenine nucleotide degradation. These effects were associated with a decrease in glycogen depletion and reduced accumulation of hexose 6-phosphates and lactate. 6-Phosphofructo-2-kinase decreased in both groups, reducing the availability of fructose-2, 6-bisphosphate. Preconditioning sustained metabolite concentration at higher levels although this was not correlated with an increased glycolytic rate, suggesting that adenine nucleotides and cAMP may play the main role in the modulation of glycolytic pathway. Preconditioning attenuated the rise in cAMP and limited the accumulation of hexose 6-phosphates and lactate, probably by reducing glycogen depletion. Our results suggest the induction of metabolic arrest and/or associated metabolic downregulation as energetic cost-saving mechanisms that could be induced by preconditioning.
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PMID:Hepatic preconditioning preserves energy metabolism during sustained ischemia. 1089 59


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