title: Inhibition of the pentose phosphate pathway decreases ischemia-reperfusion-induced creatine kinase release in the heart.
abstract: OBJECTIVE
  The oxidative pentose phosphate pathway (oxPPP) produces NADPH, which can be used to maintain glutathione in its reduced state (anti-oxidant; beneficial effects) or to produce radicals or nitric oxide (NO) through NADPH oxidase/NO synthase (detrimental effects). Changes in cytosolic redox status have been implicated in ischemic preconditioning (PC). This study investigates whether (1) PC affects mitochondrial redox state, (2) the oxPPP plays a protective or detrimental role in ischemia (I)-reperfusion (R) injury in the intact heart and (3) PPP is altered with PC.
  
  
  METHODS
  Isolated rat hearts were subjected to 40-min global I and 30-min R (CO, control). Ischemia was either preceded by three 5-min I/R periods (PC) and/or oxPPP inhibition by 6-aminonicotinamide (6AN) or NADPH oxidase/NO synthase inhibition by diphenyleneiodonium (DPI). NADH videofluorometry was used to determine mitochondrial redox state. PPP intermediates were determined in CO and PC hearts using tandem mass spectrometry.
  
  
  RESULTS
  PC reduced ischemic damage (creatine kinase, CK, release from 337+/-64 to 147+/-41 U/R/gdw) and contracture (from 59+/-5 to 31+/-3 mm Hg) and increased recovery of contractility (from 48+/-10% to 88+/-8%), as compared to CO. PC was without effect on NADH fluorometry. Inhibition of the oxPPP reduced injury (CK release: 91+/-24 U/R/gdw) to similar levels as PC, without improving contractility. Inhibition of NADPH oxidase/NO synthase mimicked the effects of oxPPP inhibition on injury (CK release: 140+/-22 U/R/gdw). Although levels of ribose-5P and (ribulose-5P+xylulose-5P) rose several fold during ischemia with minor changes in sedoheptulose-7P, demonstrating an active PPP in the heart, PC did not affect these levels.
  
  
  CONCLUSIONS
  (1) PC can attenuate cardiac reperfusion injury without alterations in mitochondrial redox state; (2) inhibition of the oxPPP protects the heart against I/R-induced CK release; and (3) PC does not result in altered activity of the PPP.
authors.affiliation: Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. c.j.zuurbier@amc.uva.nl
authors.forename: C J
authors.initials: CJ
authors.lastname: Zuurbier
authors.forename: O
authors.initials: O
authors.lastname: Eerbeek
authors.forename: P T
authors.initials: PT
authors.lastname: Goedhart
authors.forename: E A
authors.initials: EA
authors.lastname: Struys
authors.forename: N M
authors.initials: NM
authors.lastname: Verhoeven
authors.forename: C
authors.initials: C
authors.lastname: Jakobs
authors.forename: C
authors.initials: C
authors.lastname: Ince
mesh_terms: D000818:Animals; D003402:Creatine Kinase / Q000378:metabolism*; D003864:Depression, Chemical; D008297:Male; D017202:Myocardial Ischemia / Q000378:metabolism / Q000473:pathology; D015428:Myocardial Reperfusion Injury / Q000378:metabolism* / Q000473:pathology; D009206:Myocardium / Q000201:enzymology* / Q000473:pathology; D009336:Necrosis; D010084:Oxidation-Reduction; D010427:Pentose Phosphate Pathway / Q000187:drug effects*; D010477:Perfusion; D051381:Rats; D013997:Time Factors
chemical_list: D003402:Creatine Kinase