Antagonism of selectin function attenuates microvascular platelet deposition and platelet-mediated myocardial injury after transient ischemia.
OBJECTIVE
The goal of this study was to assess whether selectin blockade reduces myocardial platelet deposition and platelet-mediated injury after transient ischemia.


BACKGROUND
Selectins participate in platelet adhesion to reperfused endothelium.


METHODS
Thiopental-anesthetized, open-chest pigs were subjected to mechanical injury of the left anterior descending coronary artery followed by a 48-min occlusion and 2 (n = 20) or 4 (n = 16) h of reperfusion. Fifteen minutes before occlusion, animals were blindly allocated to receive a continuous intravenous infusion of the selectin blocker fucoidan (30 microg/kg/min, plus a 1-mg/kg bolus in the latter group) or saline. In isolated rat hearts infused with thrombin-activated platelets, the effects of fucoidan (30 microg/ml) administered during reperfusion after 40 min of global ischemia were also analyzed.


RESULTS
Fucoidan did not prevent the development of cyclic reductions in coronary flow, but reduced the content of (99m)Tc-labeled platelets in reperfused myocardium after 2 h of reperfusion (23.4 +/- 3.3 vs. 42.1 +/- 8.3 x 10(6) platelets/g in treated and untreated animals, p = 0.03) and attenuated the impairment in the coronary flow reserve and reduced infarct size after 4 h (53 +/- 2% vs. 73 +/- 5% of the ischemic region, respectively, p = 0.003). Treated animals showed a trend toward less neutrophil infiltration early after reperfusion, but not after 4 h. In isolated hearts, fucoidan improved functional recovery and reduced coronary resistance and lactate dehydrogenase release, lacking any beneficial effects if given in the absence of platelets.


CONCLUSIONS
The results suggest that selectin-dependent adhesion is a prominent mechanism of platelet deposition in reperfused cardiac microvessels and highlight its potential as a therapeutic target in patients with acute myocardial infarction.
Barrabés
José A
JA
Department of Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Garcia-Dorado
David
D
Mirabet
Maribel
M
Inserte
Javier
J
Agulló
Luis
L
Soriano
Bernat
B
Massaguer
Anna
A
Padilla
Ferran
F
Lidón
Rosa-Maria
RM
Soler-Soler
Jordi
J
D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology; D018929:Cell Culture Techniques; D005260:Female; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D017202:Myocardial Ischemia; D015425:Myocardial Reperfusion; D010973:Platelet Adhesiveness / Q000502:physiology*; D010976:Platelet Count; D011134:Polysaccharides / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D019087:Selectins / Q000187:drug effects / Q000502:physiology*; D013552:Swine
D000925:Anticoagulants; D011134:Polysaccharides; D019087:Selectins; C007789:fucoidan