Integrative Physiology |
From the Department of Molecular and Cellular Physiology (M.R.H., S.P.J., B.S., M.B.G., F.S.L., D.J.L.), LSU Health Sciences Center, Shreveport, La; Department of Anatomy & Physiology, College of Veterinary Medicine (C.R.R.), Kansas State University, Manhattan, Kans; and Department of Physiology (T.J.S., R.S.), Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pa.
Correspondence to David J. Lefer, PhD, Department of Molecular and Cellular Physiology, LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130. E-mail dlefer{at}lsuhsc.edu\\ © 2000 American Heart Association, Inc.
| Abstract |
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Key Words: murine infarct oxygen free radicals neutrophils echocardiography
| Introduction |
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Previous efforts have focused on the role of reactive oxygen species in myocardial reperfusion injury. A burst of reactive oxygen metabolites after reestablishing blood flow to a previously ischemic zone has been observed by several investigators in various models of MI/R.21 22 23 24 The extreme reactivity of these oxidants results in irreversible damage to vital cell components, such as membrane phospholipids, membrane ion transport proteins, and other enzymatic proteins.25 Experiments involving oxygen free radical scavengers have demonstrated reductions in infarct size and emphasized the role of reactive oxygen species in reperfusion injury.26 27 28
Recently, a transgenic mouse was generated containing a mutation in the gene coding for the p47phox subunit of NADPH oxidase, rendering the enzyme nonfunctional in homozygous mutants.29 This mouse model grants unique opportunities to investigate the pathophysiology of reactive oxygen species formed by NADPH oxidase. Because of the highly reactive nature of toxic oxidant species, we hypothesized that oxidants such as the superoxide anion are a major contributor to MI/R injury and contractile dysfunction. To test this hypothesis, mice lacking NADPH oxidase and their littermate heterozygous controls were subjected to acute coronary artery occlusion and reperfusion. Additional experiments to examine the role of this enzyme in the recruitment of leukocytes to the inflamed mesentery were also performed using intravital microscopy.
| Materials and Methods |
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Superoxide Assay
Superoxide production rates were determined as
previously
described,30 with
minor modifications. Briefly, 106
extravasated neutrophils were incubated in the presence of 2 µg/mL
phorbol myristate acetate (PMA), 1 mg/mL cytochrome c,
30 µg/mL catalase, ±100 µg/mL superoxide dismutase in
D-glucose phosphate-buffered saline (D-PBS).
The cells were incubated for 30 minutes at 37°C. The cells were then
removed, and the absorbance of reduced cytochrome c was measured at 550
nm. The rate of superoxide production was calculated as follows:
O2(nmol·min1·106
cells1)=(47.7x[A-SOD-A+SOD])/30
minutes.
Hematology of Peripheral Blood
Total leukocyte, neutrophil, and platelet counts were
performed on fresh, whole blood samples from NADPH
oxidase/ mice (n=4) and heterozygous
control mice (n=4) by the clinical hematology laboratory at Louisiana
State University Health Sciences Center.
Neutrophil Transmigration Assay
Heterozygous control mice (n=7) and NADPH
oxidasedeficient mice (n=6) were injected with 25 mg of oyster
glycogen suspended in 0.5 mL PBS 6 hours before peritoneal lavage with
5 mL PBS containing 10 mmol/L D-PBS. Extravasated leukocytes were
pelleted, resuspended in 1 mL D-PBS, and quantitated using a Coulter
counter.
MI/R Protocol
Heterozygous control (n=23) mice and NADPH
oxidasedeficient mice (n=24) were used for the in vivo MI/R
experiments. The surgical protocol and infarct size determination were
performed similar to methods described
previously,31 with
several modifications because of the longer period of reperfusion in
the present study. Briefly, the mice were orally intubated with
polyethylene-90 (PE-90) tubing and connected to a rodent ventilator
(model 683, Harvard Apparatus). Body temperature was maintained at
37°C using a rectal thermometer and infrared heating lamp. The left
anterior descending coronary artery (LAD) was visualized and ligated
with 7-0 silk suture. Ischemia was confirmed by the appearance of
myocardial hypokinesis and pallor. After 30 minutes of LAD occlusion,
the ligature was removed and reperfusion was visually confirmed. The
chest wall was closed and the mice were given butorphanol tartrate (0.1
mg/kg IP) for analgesia and allowed to recover in a
temperature-controlled area.
At 24 hours of reperfusion, the LAD was religated, and Evans blue (1.5 mL of 1% solution) was retrogradely infused into the carotid artery to delineate the ischemic from the nonischemic zones. Ex vivo incubation in 2,3,5-triphenyltetrazolium chloride for 5 minutes at 37°C allowed differentiation between the viable and necrotic areas of the previously ischemic myocardium.
Echocardiographic Assessment of LV
Function
We performed in vivo transthoracic echocardiography
of the left ventricle (LV) using a 15-MHz linear array transducer
(15L8) interfaced with a Sequoia C256 (Acuson). Ventricular parameters
were measured according to the leading-edge
technique.32 M-mode
(frame rate=30 Hz; sweep speed=200 mm/s) echocardiograms were captured
from short-axis views of the LV at the mid-papillary level. LV end
diastolic diameters (LVEDD) and LV end systolic diameters (LVESD) were
assessed in heterozygous control mice (n=10) and NADPH
oxidase/ mice (n=8) before ischemia and
at 24 hours of reperfusion. LV fractional shortening (LVFS) was
calculated according to the following equation:
LVFS=([LVEDD-LVESD]/ LVEDD)x100.
Myocardial Histology
Routine histological staining (hematoxylin and eosin)
was performed on multiple sections of ischemic/reperfused myocardium to
determine the extent of PMN infiltration. Neutrophils were identified
by nuclear morphology in 4 fields per sample by a blinded observer and
are presented as
PMNs/mm2.
Intravital Microscopy of Mouse
Mesenteric Venules
The abdominal cavity was opened via a midline
laparotomy, as described
previously.33
Briefly, a loop of ileal mesentery was exteriorized through the midline
incision and placed in a temperature-controlled superfusion chamber. A
Microphot microscope (Nikon) was used to visualize the mesenteric
microcirculation and the mesenteric tissue, as previously
described.33 Red
blood cell velocity was determined on-line using an optical Doppler
velocimeter obtained from the Microcirculation Research Institute.
Video recordings were made before and 60 minutes after initiation of
superfusion (25 µmol/L NG-nitro-L-arginine
methyl ester) for quantification of leukocyte rolling and adherence.
The number of rolling and adhered leukocytes was determined off-line by
playback analysis of the videotape, as previously
reported.33
Statistical Analysis
All findings were analyzed with a 2-tailed unpaired
t test calculated with StatView 4.5 (Abacus Concepts).
Values are reported as mean±SE, with significance set at
P<0.05.
| Results |
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Superoxide Production
Graphic interpretation of superoxide production by
neutrophils from NADPH oxidase/ (n=6)
and heterozygous control (n=7) mice after stimulation with PMA is
displayed in
Figure 1
. NADPH oxidase/
neutrophils displayed a significant impairment
(P<0.01) in superoxide radical production (0.04±0.03
nmol
O2·min1·106
cells1) compared with heterozygous control
animals (2.20±0.08 nmol
O2·min1·106
cells1).
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Neutrophil Transmigration
Heterozygous control mice (n=7) and NADPH
oxidase/ mice (n=6) were
intraperitoneally injected with oyster glycogen to assess possible
differences in neutrophil transmigration. As shown in
Figure 2
, the number of transmigrated neutrophils
(x106/mL) was not significantly different
between the control mice (5.22±1.86) and NADPH
oxidase/ mice
(4.51±0.66).
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Myocardial Area at Risk and Infarct
Size
Both heterozygous control mice (n=23) and NADPH
oxidasedeficient mice (n=24) displayed similar-sized areas at risk
and infarction after MI/R
(Figure 3
). The area at risk (AAR)/LV in heterozygous control
mice was 55±3% and in NADPH oxidase/
mice was 61±4%. Infarct/AAR (Inf/ARR) was similar in heterozygous
control mice (42±4%) and NADPH
oxidase/ animals (34±5%). The area of
infarct/LV (Inf/LV) was also similar between the 2
groups.
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Myocardial PMN Accumulation
Infiltration of PMNs into the ischemic/reperfused
myocardium of mice exposed to 30 minutes of LAD occlusion and 24 hours
of reperfusion is presented in
Figure 4
. NADPH oxidase/
hearts (n=4) contained significantly more (P<0.05)
infiltrated PMNs than heterozygous littermate control hearts (n=4)
(62±3 versus 51±1
PMNs/mm2).
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Echocardiographic Assessment of LV
Function
Table 2
displays LVFS in NADPH
oxidase/ and heterozygous control mice
at baseline and at the end of the reperfusion period. A significant
difference in LVFS was not observed in the NADPH
oxidase/ hearts compared with
heterozygous control hearts. A significant decrease
(P<0.01) in LVFS at the postreperfusion time point
was observed in both the heterozygous control and NADPH
oxidase/ mice compared with baseline
values. LVEDD and LVESD diameters for the experimental groups are also
shown in
Table 2
. Both NADPH oxidase/
littermates and heterozygous littermates exhibited similar LVEDD and
LVESD at baseline and after MI/R. LVESD was significantly increased
(P<0.05) at 24 hours of reperfusion in both the
heterozygous littermate and the NADPH
oxidase/ groups.
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Intravital Microscopy of Perimesenteric
Venules
As demonstrated in
Table 3
, baseline leukocyte rolling and adhesion were
similar in the NADPH oxidase/ group and
heterozygous control group. In addition, superfusion of 25 µmol/L
NG-nitro-L-arginine methyl ester induced
equivalent levels of rolling and adherence in the microcirculation of
both groups of mice.
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| Discussion |
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The potential role of neutrophil involvement in MI/R injury has been extensively investigated by several laboratories. PMN depletion has been shown to result in reduced myocardial necrosis after coronary artery occlusion and reperfusion.34 In sharp contrast, other studies have shown that neutrophil depletion does not alter mechanical function, arrhythmias, and vascular abnormalities.18 Additionally, other studies have demonstrated that antileukocyte agents fail to reduce myocardial infarct size.17 19 20 Although many differences may be cited among the positive and negative studies, the role of neutrophils in mediating MI/R injury presently remains unresolved.
As bactericidal cells, neutrophils produce large quantities of destructive substances, including proteolytic enzymes and oxygen free radicals.1 Many studies using oxygen free radical scavengers, such as superoxide dismutase, have demonstrated that these toxic oxidants play a central role in infarct development after reperfusion.26 27 28 With the implication of both neutrophils and reactive oxygen species in MI/R injury, recent emphasis has been placed on PMN-derived oxidants as mediators of cell necrosis. A known major source of superoxide radicals is neutrophilic NADPH oxidase.35
In this study, we sought to investigate a correlation between superoxide radicals produced via NADPH oxidase and the development of myocardial necrosis after ischemia and reperfusion. By using a mouse model of chronic granulomatous disease resulting from a defect in the p47phox subunit of NADPH oxidase,29 we isolated the pathophysiological effects of this enzyme in the postischemic myocardium. Similar to this previous report,29 we found that NADPH oxidase/ mice have impaired formation of a respiratory burst (superoxide production) on stimulation. In agreement with our present findings, the same study29 also found no difference in fertility, weight, and circulating leukocyte counts. It is important to note that Jackson et al29 found no difference between the wild-type (+/+) and heterozygous (+/-) mice in any of their experiments. As a result of these findings, we used heterozygotes as control mice in the present study.
The present study failed to demonstrate a connection between NADPH oxidase activity and myocardial necrosis, contractile dysfunction, or leukocyte-endothelial cell interactions. Both heterozygous control mice and NADPH oxidasedeficient mice suffered similar-sized areas of necrosis after MI/R. Our data concerning leukocyte trafficking demonstrate no difference in the ability of leukocytes to roll, adhere, and transmigrate despite the deficiency of functional NADPH oxidase. This is important for two reasons. First, this clearly demonstrates that NADPH oxidase is not involved in leukocyte-endothelial interactions. Second, the results we present are a function of impaired superoxide production and not related to impaired leukocyte trafficking.
Previous studies have supported the involvement of NADPH oxidase in the development of ischemia and reperfusion injury. Using transgenic mice with an X-linked form of chronic granulomatous disease, Walder et al35 found that cerebral infarct size volume was diminished in deficient mice when compared with wild-type littermates. Other investigators36 reported attenuated microvascular dysfunction after ischemia and reperfusion in the rat mesentery treated with a nonspecific pharmacological inhibitor (PR-39 peptide) of NADPH oxidase. However, our findings do not implicate NADPH oxidase in the development of microvascular dysfunction, MI/R-induced necrosis, or contractile dysfunction after MI/R.
In conclusion, we have not demonstrated an improvement in myocardial necrosis, contractile function, or leukocyte-endothelial interactions in mice lacking functional NADPH oxidase. These results suggest that reactive oxygen species produced via the NADPH oxidase system do not contribute to the development of myocardial infarction and dysfunction after coronary artery occlusion and reperfusion in mice. Furthermore, NADPH oxidase does not seem to be involved in leukocyte rolling, adherence, or transmigration. The results of the present study provide additional evidence against the role of leukocyte-derived oxidant formation in MI/R injury. In addition, the present study is not in accordance with previous work in our laboratory demonstrating a strong correlation between neutrophil recruitment and infarct size. Additional studies are required to additionally examine the potential role of neutrophils in myocardial reperfusion injury.
| Acknowledgments |
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This research was supported by grants from the National Institutes of Health (R01 HL 60849 and P01 DK 43785 to D.J.L.) and American Heart Association (9951428Z to C.R.R. and 0050816U to R.S.). The authors acknowledge Willis-Knighton Medical Center (Shreveport, La), DeRoyal Surgical (Powell, Tenn), and Ethicon Surgical (Somerville, NJ) for their generous donation of surgical equipment.
Received April 24, 2000; revision received August 31, 2000; accepted August 31, 2000.
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J. Bao, K. Sato, M. Li, Y. Gao, R. Abid, W. Aird, M. Simons, and M. J. Post PR-39 and PR-11 peptides inhibit ischemia-reperfusion injury by blocking proteasome-mediated Ikappa Balpha degradation Am J Physiol Heart Circ Physiol, December 1, 2001; 281(6): H2612 - H2618. [Abstract] [Full Text] [PDF] |
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S. P. Jones, S. D. Trocha, and D. J. Lefer Cardioprotective actions of endogenous IL-10 are independent of iNOS Am J Physiol Heart Circ Physiol, July 1, 2001; 281(1): H48 - H52. [Abstract] [Full Text] [PDF] |
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R. Scalia, M. E. Gooszen, S. P. Jones, M. Hoffmeyer, D. M. Rimmer III, S. D. Trocha, P. L. Huang, M. B. Smith, A. M. Lefer, and D. J. Lefer Simvastatin Exerts Both Anti-inflammatory and Cardioprotective Effects in Apolipoprotein E-Deficient Mice Circulation, May 29, 2001; 103(21): 2598 - 2603. [Abstract] [Full Text] [PDF] |
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B. R. Sharp, S. P. Jones, D. M. Rimmer, and D. J. Lefer Differential response to myocardial reperfusion injury in eNOS-deficient mice Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2422 - H2426. [Abstract] [Full Text] [PDF] |
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