title: Zinc chloride-mediated reduction of apoptosis as an adjunct immunosuppressive modality in cardiac transplantation.
abstract: BACKGROUND
  Zinc (Zn) blocks caspase-3 activation in cardiac allografts and therefore may synergistically decrease apoptosis along with cyclosporine (CsA), which inhibits mitochondrial release of cytochrome c. Simultaneous treatment of rat recipients of heterotopic heart transplants with zinc chloride (ZnCl(2)) thus may allow lower doses of CsA for immunosuppression.
  
  
  METHODS
  PVG (RT1(c)) rat hearts were transplanted heterotopically into the abdomen of ACI (RT1(a)) rats. Group 1 (n = 15) rats received no treatment. Group 2 rats (n = 8) received 2 mg/kg/day CsA (sub-therapeutic dose) by oral gavage. Group 3 rats (n = 9) received 2 mg/kg/day oral CsA in addition to 1 mg/kg/day sub-cutaneous ZnCl(2) delivered by osmotic pump. All rats were imaged using Annexin V-bound (99m)Technetium ((99m)Tc-Annexin V) on post-operative Day 4 and subsequently killed. Annexin V avidly binds apoptotic cells in vivo. Region of interest per whole body (WB) data were calculated using the images. The allograft survival study was conducted with n = 11, 6, and 5 in control, CsA, and CsA+Zn groups, respectively. Finally, percentages of allografts that reached tolerance were measured in both CsA-only and CsA+Zn groups (n = 8 each).
  
  
  RESULTS
  Zinc chloride had an additive effect with CsA on apoptotic blockade and graft survival. The regions of interest per WB uptake of (99m)Tc-Annexin V were 2.43% +/- 0.37%, 2.08% +/- 0.52%, and 1.49% +/- 0.29%*, and acute survivals were 6.4 +/- 1.7, 7.2 +/- 2.1, and 11.2 +/- 2.5* days for control, CsA, and CsA+Zn groups, respectively (*p < 0.001 vs controls). In addition, 87.5% of allografts became tolerant and survived for 90 days in the CsA+Zn group compared with only 37.5% in the CsA-only group (p = 0.049).
  
  
  CONCLUSIONS
  Zinc-mediated reduction of apoptosis served as an effective adjunct immunosuppressive therapy to CsA in a rat model of cardiac transplantation.
authors.affiliation: Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California 94305-5247, USA.
authors.forename: Murray H
authors.initials: MH
authors.lastname: Kown
authors.forename: T J
authors.initials: TJ
authors.lastname: van der Steenhoven
authors.forename: Christina L
authors.initials: CL
authors.lastname: Jahncke
authors.forename: Carina
authors.initials: C
authors.lastname: Mari
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Lijkwan
authors.forename: Mark L
authors.initials: ML
authors.lastname: Koransky
authors.forename: Francis G
authors.initials: FG
authors.lastname: Blankenberg
authors.forename: H William
authors.initials: HW
authors.lastname: Strauss
authors.forename: Robert C
authors.initials: RC
authors.lastname: Robbins
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D002712:Chlorides / Q000494:pharmacology*; D016572:Cyclosporine / Q000494:pharmacology; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006321:Heart / Q000000981:diagnostic imaging; D016027:Heart Transplantation / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D011877:Radionuclide Imaging; D051381:Rats; D011912:Rats, Inbred ACI; D017967:Zinc Compounds / Q000494:pharmacology*
chemical_list: D002712:Chlorides; D007166:Immunosuppressive Agents; D017967:Zinc Compounds; D016572:Cyclosporine; C016837:zinc chloride