Document Detail


Immediate mineralocorticoid receptor blockade improves myocardial infarct healing by modulation of the inflammatory response.
MedLine Citation:
PMID:  18299485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mineralocorticoid receptor (MR) blockade reduces morbidity and mortality after acute myocardial infarction; however, the underlying mechanisms are still under investigation. This study examined whether MR antagonism promotes healing of the infarcted myocardium. Starting immediately after coronary ligation, male Wistar rats were treated with the selective MR antagonist eplerenone (100 mg/kg per day by gavage) or placebo for 2 to 7 days. At 7 days, eplerenone therapy versus placebo significantly reduced thinning and dilatation of the infarcted wall, improved left ventricular function, and enhanced neovessel formation in the injured myocardium. At 2 days, eplerenone-treated rats displayed lower plasma corticosterone levels, higher circulating blood monocytes, and more macrophages infiltrating the infarcted myocardium. MR blockade led to a transient upregulation (at days 2 and 3 but not at day 7) of monocyte chemoattractant protein-1, tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, interleukin-10, and interleukin-4 and an increase in factor XIIIa protein expression in the healing myocardium. Prevention of macrophage accumulation into the infarct zone by treatment with liposome-encapsulated clodronate almost abrogated the protein expression of factor XIIIa and the beneficial effects of eplerenone on infarct expansion. In conclusion, selective MR blockade immediately after myocardial infarction accelerated macrophage infiltration and transiently increased the expression of healing promoting cytokines and factor XIIIa in the injured myocardium resulting in enhanced infarct neovascularization and reduced early LV dilation and dysfunction.
Authors:
Daniela Fraccarollo; Paolo Galuppo; Susanne Schraut; Susanne Kneitz; Nico van Rooijen; Georg Ertl; Johann Bauersachs
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-25
Journal Detail:
Title:  Hypertension     Volume:  51     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  905-14     Citation Subset:  IM    
Affiliation:
Medizinische Klinik und Poliklinik I, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood
Aldosterone Antagonists / pharmacology
Animals
Clodronic Acid / pharmacology*
Collagen / metabolism
Cytokines / metabolism
Factor XIIIa / genetics
Heart Failure / drug therapy,  immunology,  pathology
Humans
Male
Monocytes / drug effects,  immunology,  metabolism
Myocardial Infarction / drug therapy*,  immunology*,  pathology
Myocarditis / drug therapy,  pathology
Myocardium / metabolism,  pathology
Neovascularization, Physiologic / drug effects
RNA, Messenger / metabolism
Rats
Rats, Wistar
Receptors, Mineralocorticoid / antagonists & inhibitors*
Spironolactone / analogs & derivatives,  pharmacology
Ventricular Function, Left / drug effects
Wound Healing / drug effects*
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Cytokines; 0/RNA, Messenger; 0/Receptors, Mineralocorticoid; 0/eplerenone; 10596-23-3/Clodronic Acid; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 9007-34-5/Collagen; EC 2.3.2.13/Factor XIIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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