Reperfusion injury is a complex pathological event involving processes that can lead to further disruption of the cell membrane and function following an ischemic event. Return of blood flow allows for the needed reperfusion; however, for a period of time before remaining viable cells stabilize, reperfusion results in additional cellular injury. In cardiomyocytes, loss of membrane integrity allows abnormal influx of extracellular calcium, leading to hyper-contracture and cell death. Methods to improve the membrane integrity of cardiomyocytes overwhelmed by pathological disruptions, such as reperfusion injury, are needed to prevent cell death, because of the myocardium's limited ability to regenerate. Research has shown administration of the copolymer P(oloxamer) 188 before ischemia/reperfusion can protect cardiomyocytes through membrane stabilization. This study sought to determine whether the administration of P188 at the beginning of the clinically more relevant time of reperfusion after ischemia will attenuate any additional damage to cardiomyocytes by stabilizing membrane integrity to allow the cells to maintain function. Using an in-vitro cardiomyocyte model subjected to hypoxia/reoxygenation to simulate ischemia/reperfusion injury, we show that reoxygenation significantly potentiates the injury caused by hypoxia itself. P188, with its unique combination of hydrophobic and hydrophilic chemical properties, and only delivered at the beginning of reoxygenation, dose-dependently protected cardiomyocytes from injury due to reoxygenation by repairing cell membranes, decreasing calcium influx, and maintaining cellular morphology. Our study also shows the hydrophobic portion of P188 is necessary for the stabilization of cell membrane integrity in providing protection to cardiomyocytes against reoxygenation injury.
Bibliographical noteFunding Information:
This work was supported by a Merit Review Award [Grant I01 BX003482] from the US Department of Veterans Affairs Biomedical Laboratory R&D Service; a National Institutes of Health National Heart, Lung, and Blood Institute [Grant R01 HL123227]; and departmental funds awarded to Matthias L. Riess, MD, PhD, FASA. The authors thank Joey V. Barnett, PhD (Vanderbilt University), Jerod S. Denton, PhD (Vanderbilt University Medical Center), Janis T. Eells, PhD (University of Wisconsin‐Milwaukee), as well as Frank S. Bates, PhD, and Benjamin J. Hackel, PhD (University of Minnesota‐Minneapolis) for their advice on this project.
© 2020 The Authors. Pharmacology Research & Perspectives published by British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics and John Wiley & Sons Ltd. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
- cell membrane stabilizer
- polyethylene glycol
- reperfusion injury
- tri-block copolymer