Antioxidant therapy reduces oxidative and inflammatory tissue damage in patients subjected to cardiac surgery with extracorporeal circulation.
Ischaemia reperfusion injury is a pathophysiological event that occurs after cardiac surgery with extracorporeal circulation. This clinical event has been associated with the induction of oxidative and inflammatory damage in atrial tissue. Here, we tested whether combined omega 3 polyunsaturated fatty acids (n-3 PUFA)-antioxidant vitamin protocol therapy reduces oxidative and inflammatory cardiac tissue damage. This trial assigned 95 either-sex patients to supplementation with n-3 PUFA (2 g/day), or matching placebo groups, 7 days before on-pump surgery. Antioxidant vitamins C (1 g/day) and E (400 IU/day) or placebo were added from 2 days before surgery until discharge. Blood and atrial tissue samples were obtained during the intervention. Reduced/oxidized glutathione (GSH/GSSG) ratio, malondialdehyde (MDA) and protein carbonylation were determined in atrial tissue. Leucocyte count and high-sensitivity C-reactive protein (hs-CRP) in blood plus nuclear factor (NF)-κappaB activation in atrial tissue served for inflammation assessment. Lipid peroxidation and protein carbonylation were 27.5 and 24% lower in supplemented patients (p < 0.01). GSH/GSSG ratio was 38.1% higher in supplemented patients compared with placebo (p < 0.01). Leucocyte count and serum hs-CRP levels were markedly lower throughout the protocol in supplemented patients (p < 0.01). Atrial tissue NF-κB DNA activation in supplemented patients was 22.5% lower than that in placebo patients (p < 0.05). The combined n-3 PUFA-antioxidant vitamin protocol therapy here proposed reduced the oxidative stress and inflammation biomarkers, in patients undergoing on-pump cardiac surgery.
Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile.
Rodrigo
R
Castillo
Ramón
R
Rodrigo
Felipe
F
Perez
Mauricio
M
Cereceda
René
R
Asenjo
Jaime
J
Zamorano
Roberto
R
Navarrete
Eli
E
Villalabeitia
Juan
J
Sanz
Cristián
C
Baeza
Rubén
R
Aguayo
D000368:Aged; D000704:Analysis of Variance; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D002097:C-Reactive Protein / Q000032:analysis; D019587:Dietary Supplements; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005112:Extracorporeal Circulation / Q000379:methods*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D019803:Glutathione Disulfide / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D015227:Lipid Peroxidation; D016015:Logistic Models; D008297:Male; D008315:Malondialdehyde / Q000032:analysis; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D018384:Oxidative Stress; D050050:Protein Carbonylation; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014810:Vitamin E / Q000008:administration & dosage
D000975:Antioxidants; D015525:Fatty Acids, Omega-3; D016328:NF-kappa B; D014810:Vitamin E; D008315:Malondialdehyde; D002097:C-Reactive Protein; D001205:Ascorbic Acid; D019803:Glutathione Disulfide