Rohilla Ankur et al. IRJP 2011, 2 (10), INTERNATIONAL RESEARCH JOURNAL OF PHARMACY ISSN Available online

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1 Rohill Ankur et l. IRJP 211, 2 (1), INTERNATIONAL RESEARCH JOURNAL OF PHARMACY ISSN Aville online Reserch Article AMELIORATION OF MYOCARDIAL ISCHEMIA REPERFUSION INJURY BY SIMVASTATIN IN RATS Rohill Ankur 1 *, Singh Gurfteh 1, Khn M.U. 2, Khnm Rzi 3 1 Deprtment of Phrmcy, NIMS University, Shoh Ngr, Jipur , Rjsthn, Indi 2 Sri Si College of Phrmcy, Bdhni, Pthnkot-145 1, Punj, Indi 3 Fcutly of Phrmcy, Jmi Hmdrd University, Delhi-1162, Indi *E-mil: nkurrohill1984@rediffmil.com Article Received on: 11/8/11 Revised on: 16/9/11 Approved for puliction: 2/1/11 ABSTRACT The present study hs een designed to investigte the effect of Simvsttin, 3-hydroxymethyl-glutryl coenzyme A (HMG-CoA) reductse inhiitor, on ischemi-reperfusion (I/R)-induced myocrdil injury. The isolted Lngendorff-perfused rt herts were sujected to glol ischemi for 3 min followed y reperfusion for 12 min. Myocrdil injury ws ssessed y mesuring myocrdil infrct size longwith relese of lctte dehydrogense (LDH) nd cretine kinse (CK) in the coronry effluent. Additionlly, the oxidtive stress prmeters were nlyzed in the hert which ws ssessed y mesuring lipid peroxidtion, superoxide nion genertion nd reduced glutthione. I/R ws noted to produce myocrdil injury, s ssessed in terms of increse in myocrdil infrct size, LDH nd CK in coronry effluent. Moreover, oxidtive stress ws noted to e incresed due to I/R injury s ssessed in terms of decresed TBARS (thiorituric cid-rective sustnce) nd superoxide nion genertion levels longwith increse in reduced glutthione levels in the hert. Tretment with Simvtstin t different concentertions (3 µmol, 1 µmol nd 3 µmol) fforded crdioprotection ginst I/R-induced myocrdil injury in rt herts s ssessed in terms of reductions in myocrdil infrct size, LDH nd CK levels in coronry effluent. Moreover, the high degree of oxidtive stress produced s result of I/R injury ws noted to e reduced y Simvsttin tretment. It my e concluded tht reductions in myocrdil infrct size nd oxidtive stress my e responsile for the oserved crdioprotective potentil of Simvsttin ginst I/R-induced myocrdil injury. KEY WORDS: Simvsttin, HMG-CA, Ischemi-reperfusion injury, Oxidtive stress INTRODUCTION The reperfusion to previously ischemic myocrdium induces detrimentl chnges in the myocrdium resulting in inflmmtion, oxidtive dmge nd crdic dysfunction known s ischemireperfusion (I/R)-injury 1,2. Oxidtive stress, intrcellulr clcium overlod, neutrophil nd leukocyte ctivtion, excessive intrcellulr osmotic lod, poptotic nd necrotic myocytes deth hve een implicted in the pthogenesis of I/R-induced myocrdil injury 2,3. It hs een widely ccepted tht oxidtive stress plys n importnt role in producing lethl injury ssocited with myocrdil I/R 4. Surprisingly, rective oxygen species (ROS) produced t the onset of reperfusion hs een noted to enhnce the oxidtive stress in hert which is known to cuse the detrimentl chnges in hert 5. The HMG-CoA reductse inhiitors commonly known s sttins, possess mnifold fvorle effects ove nd eyond tht of cholesterol lowering in ffording crdioprotection 6. Simvsttin, potent HMG- CoA reductse inhiitor, hs een well reported to e potent crdioprotective gent due to its ntioxidnt properties 7. Simvsttin hs een noted to prevent the leukocytic nd ortic productions of rective oxygen species (ROS) longwith inhiition of protein nd lipid oxidtion products such s thiorituric cid rective oxygen species (TBARS) confirming its ntioxidnt potentil 7,8. In ddition, experimentl studies hve shown tht tretment with simvsttin ttenuted the oxidtive stress nd produced crdioprotection y decresing mlondildehyde (MDA) levels nd incresing the superoxide dysmutse (SOD) nd nitric oxide (NO) levels 9,1. Further, tretment with simvsttin reduced oxidtive stress nd infrction volume therey meliorting ischemic dmge in rts tht confirmed the crdioprotective potentil of the drug. Moreover, experimentl studies in rts hve shown tht the tretment with simvsttin decresed oxidtive stress in dietichypercholesterolemic rts further confirming its ntioxidnt potentil 11. In ddition, Simvsttin hs een well reported to llevite myocrdil contrctile dysfunction nd lethl ischemic injury in isolted Lngendorff-perfused rt hert model Therefore, the present study ws undertken to investigte the crdioprotective effect of Atorvsttin ginst I/R-induced myocrdil injury in rt herts. MATERIALS AND METHODS Experimentl Animls The experimentl protocol used in the present study ws pproved y the Institutionl Animl Ethicl Committee. Wistr lino rts of either sex weighing g were used. They were housed in Institutionl niml housing nd were mintined on rt feed (Kisn Feeds Ltd., Chndigrh, Indi) nd tp wter d liitum. Isolted Rt Hert Preprtion Rts were heprinized (5 IU i.p.) nd scrificed y stunning. The hert ws rpidly excised nd immeditely mounted on Lngendorff pprtus 16. The hert ws enclosed in doule wlled jcket, the temperture of which ws mintined t 37 C y circulting hot wter. The preprtion ws perfused with Kres- Henseleit (K-H) solution (NCl 118 mm; KCl 4.7 mm; CCl mm; MgSO 4.7H 2 O 1.2 mm; NHCO 3 25 mm; KH 2 PO mm; C 6 H 12 O 6 1 mm) ph 7.4, mintined t 37 C nd uled with 95% O 2 nd 5% CO 2. The coronry flow rte ws mintined t round 7 ml/min, nd the perfusion pressure ws kept t 8 mmhg. Glol ischemi ws produced for 3 min y locking the inflow of physiologicl solution nd it ws followed y perfusion for 12 min. Lortory Assys Myocrdil infrct size ws mesured mcroscopiclly using triphenyl tetrzolium chloride (TTC) stining employing volume method 17. The myocrdil injury ws ssessed y mesuring the relese of lctte dehydrogense (LDH) nd cretine kinse-mb (CK-MB) in the coronry effluent using the commercilly ville enzymtic kits (Vitl Dignostics, Thne, Mhrshtr, Indi). The level of thiorituric cid rective sustnces (TBARS), n index of lipid peroxidtion in the hert ws estimted ccording to the method of Ohkw et l. 18. The superoxide nion genertion ws ssessed y estimting the reduced nitro lue tetrzolium (NBT) using the method of Wng et l. 19. Moreover, the reduced glutthione content in ech hert ws estimted using the method of Beutler et l. 2. Experimentl Protocol Five groups of 8-1 nimls ech were employed in the present study. In ll groups, ech isolted perfused hert ws llowed to stilize for 1 min y perfusing with K-H solution. INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 2(1), 211

2 Group I (Norml Control): Isolted norml rt hert ws perfused for 15 min using K-H solution fter 1 min of stiliztion. Group II (I/R): Isolted norml rt hert fter 1 min of stiliztion ws sujected to 3 min of glol ischemi followed y 12 min of reperfusion Group III (Sim Treted I/R-3 µmol): After 1 min of stiliztion, isolted norml rt hert ws infused with Simvsttin (3 μmol) for 1 min. The hert ws then sujected to 3 min of glol ischemi followed y 12 min of reperfusion. Group IV (Sim Treted I/R-1 µmol): After 1 min of stiliztion, isolted norml rt hert ws infused with Simvsttin (1 μmol) for 1 min. The hert ws then sujected to 3 min of glol ischemi followed y 12 min of reperfusion. Group V (Sim Treted I/R-3 µmol): After 1 min of stiliztion, isolted norml rt hert ws infused with Simvsttin (3 μmol) for 1 min. The hert ws then sujected to 3 min of glol ischemi followed y 12 min of reperfusion. Sttisticl Anlysis The results were expressed s men ± SD. The dt otined from vrious groups were sttisticlly nlyzed using one-wy ANOVA followed y Tukey s multiple-comprison test. A P vlue <.5 ws considered to e sttisticlly significnt. Drugs nd Chemicls The LDH nd CK enzymtic estimtion kits were purchsed from Vitl Dignostics, Thne, Mhrstr, Indi. DTNB nd NBT were otined from Lo Chem, Mumi, Indi. Simvsttin, 1,1,3,3- tetrmethoxy propne nd reduced glutthione were procured from Sigm-Aldrich, USA. All other regents used in this study were of nlyticl grde. RESULTS Effect of I/R on Myocrdil Infrct size nd Oxidtive Stress I/R ws noted to increse the infrct size in rt herts s ssessed mcroscopiclly using TTC (Fig. 1). Moreover, the glol ischemi for 3 min followed y reperfusion for 12 min significntly incresed LDH nd CK relese in the coronry effluent in rt herts. Mximum relese of LDH ws noted immeditely fter reperfusion (Fig. 3), while mximum relese of CK ws noted t 5 min of reperfusion (Fig. 2). Lipid peroxidtions, mesured in terms of TBARS, nd superoxide nion genertion, ssessed in terms of reduced NBT, were significntly incresed in rt herts sujected to I/R. Moreover, the levels of reduced GSH were found to e decresed in the rt herts sujected to I/R tht my e ttriuted to the enhnced oxidtive stress in I/R-induced myocrdil injury (Figs. 4-6). Effect of Simvsttin on I/R-Induced Infrct size nd Oxidtive Stress Tretments with Simvsttin in different concentertions (3 μmol, 1 μmol nd 3 μmol) fforded crdioprotection y significntly ttenuting I/R-induced myocrdil injury in rt herts s ssessed in terms of reductions in myocrdil infrct size nd decresed relese of LDH nd CK in coronry effluent (Fig. 1-3). However, mximum crdioprotection ws noted t concentrtion of 1 μmol. In ddition, Simvsttin tretments (3 μmol, 1 μmol nd 3 μmol) mrkedly ttenuted the I/R-induced oxidtive stress in norml rt herts, s ssessed in terms of reduction in TBARS nd superoxide nion genertion, nd the consequent increse in GSH (Fig. 4-6). However, mximum reduction of I/R-induced oxidtive stress ws noted t concentrtion of 1 μmol. DISCUSSION Ischemic hert disese (IHD) represents the leding cuse of moridity nd mortlity worldwide whose prevlence is continuously incresing worldwide 21. Myocrdil ischemi is condition in which the coronry lood flow to the hert is reduced, which results in deficient oxygen nd nutrients supply to the hert 1,2. Myocrdil reperfusion is the restortion of lood flow to n Rohill Ankur et l. IRJP 211, 2 (1), ischemic hert. Reperfusion to n ischemic myocrdium often results in lethl myocrdil injury known s I/R injury 2. The increse in infrct size nd the relese of LDH nd CK re documented to e n index of I/R-induced myocrdil injury 22,23. In the present study, 3 min of ischemi followed y 12 min of reperfusion ws noted to produce myocrdil injury, s ssessed in terms of incresed infrct size in the hert nd elevted relese of LDH nd CK in the coronry effluent. The mximl relese of LDH ws noted immeditely fter reperfusion, wheres pek relese of CK ws oserved fter 5 min of reperfusion - oth findings in ccordnce with our erlier studies 24,25. Increses in lipid peroxidtion nd superoxide nion genertion hve een suggested s indictors of oxidtive stress 26,27. The lipid peroxidtions, mesured in terms of TBARS, nd superoxide nion genertion, ssessed in terms of reduced NBT, were noted to e incresed s result of I/R. In ddition, the GSH level ws decresed in rt herts sujected to I/R. These indictors suggest the development of I/R-induced oxidtive stress, which my e responsile for the noted I/R-induced myocrdil injury in the present study. When oxygen is reintroduced during reperfusion, conversion of excess hypoxnthine to xnthine y xnthine oxidse results in the formtion of ROS, including superoxide nions (O 2 ), hydroxyl rdicls (OH ), hydrogen peroxide (H 2 O 2 ) nd peroxinitrite (ONOO ) 2,3,5. Thus, the oserved mrked increse in myocrdil injury in the rt hert my e due to the high degree of oxidtive stress s result of I/R. Sttins, commonly known s HMG-CoA reductse inhiitors, hve een widely ccepted to possess vrious pleiotropic effects in wy to fford crdioprotection 6. Simvsttin, memer of the sttins, is synthetic derivte of fermenttion product of Aspergillus terreus, initilly mrketed y Merck nd Compny under the trde nme Zocor, tht hs een well reported to inhiit HMG-CoA reductse enzyme found in liver nd show crdioprotection 7. In ddition, numerous studies hve demonstrted Simvsttin to possess crdioprotective effects due to its potent ntioxidnt properties 7. Simvsttin reduced the ctivity of NADPH-CoQ reductse, n enzyme required in genertion of free rdicls tht evidenced its potent role s n ntioxidnt 28. Moreover, tretment with Simvsttin prevented the leukocytic nd ortic productions of ROS longwith inhiition of lipid oxidtion products such s TBARS confirming its ntioxidnt potenti l8. Experimentl studies hve shown tht tretment with simvsttin ttenuted the oxidtive stress nd produced crdioprotection y decresing MDA levels nd incresing the SOD ctivity 9,1. Moreover, experimentl studies in rts hve shown tht the tretment with simvsttin decresed oxidtive stress in dietic-hypercholesterolemic rts further confirming its ntioxidnt potentil 11. This contention is supported y the results otined in the present study tht tretment with Simvsttin in different concentertions (3 μmol, 1 μmol nd 3 μmol), hs mrkedly reduced the oxidtive stress in rt herts sujected to I/R, s ssessed in terms of reductions in TBARS nd superoxide nion genertion, nd consequent increse in reduced glutthione levels, with mximum reductions t concentrtion of 1 μmol. In ddition, numer of studies hve demonstrted Simvsttin to reduce myocrdil injury prmeters in order to mimic crdioprotection. Tretment with simvsttin hs een noted to significntly improve the endothelil function in mice 29. Further, tretment with simvsttin reduced the infrction volume therey meliorting ischemic dmge in rts tht confirmed the crdioprotective potentil of the drug. In ddition, Simvsttin hs een well reported to llevite myocrdil contrctile dysfunction nd lethl ischemic injury in isolted Lngendorff-perfused rt hert model 12,13,14,15. The present study investigted the crdioprotective potentil of Simvsttin ginst I/R injury in rt herts when dministered t the onset of reperfusion. The dt demonstrtes tht INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 2(1), 211

3 dministrtion of Simvsttin t the onset of reperfusion results in significnt, dose-dependent crdioprotection, with optiml concentrtion rnges of 3 μmol, 1 μmol nd 3 μmol with mximl protection t 3 μmol, which is in ccordnce with the erlier reports 14,15. Moreover, tretments with Simvsttin fforded crdioprotection y significntly ttenuting I/R-induced myocrdil injury in rt herts s ssessed in terms of reductions in myocrdil infrct size nd decresed relese of LDH nd CK in coronry effluent, with mximum crdioprotection t concentrtion of 1 μmol. On the sis of the ove discussion, it my e concluded tht I/Rinjury my formulte the hert susceptile to incresed infrct size nd enhnced oxidtive stress. Simvsttin, due to its potent ntioxidnt effects, showed crdioprotection in rt herts. Further studies re under wy in our lortory to elucidte the mechnisms involved in the ttenution of myocrdil injury y sttins. REFERENCES 1. Collrd CD, Gelmn S. Pthophysiology, clinicl mnifesttions, nd prevention of ischemi reperfusion injury. Anesthesiology 21;94: Blkumr P, Rohill A, Singh M. Preconditioning nd postconditioning to limit ischemi reperfusion-induced myocrdil injury: wht could e the next footstep? Phrmcol Res 28;57: Yellon DM, Housenloy DJ. Myocrdil reperfusion injury. N Engl J Med 27;357: Khn NA, Chttopthyy P, Kumr D, Kishore K, Whi AK. Ischemic reperfusion injury lters the rt hert ctivity. Arch Appl Sci Res 29;1: Bertugli S, Giusti A, Del Soldto P. Antioxidnt ctivity of nitro derivtive of spirin ginst ischemi reperfusion in hmster cheek pouch microcircultion. Am J Physiol Gstrointest Liver Physiol 24;286:G Lnder JS, Copln NL. Sttin therpy in the periopertive period. Rev Crdiovsc Med 211;12: Rohill A, Rohill S, Singh G, Kumr A, Khn M.U. Crdioprotection with Simvsttin: An Apprisl. Int Res J Phrm 211;2: Delosc S, Cristol JP, Descomps B, Mimrn A, Jover B. Simvsttin prevents ngiotensin II-induced crdic ltertion nd oxidtive stress. Hypertension 22;4: Byorh MA, Gnf AA, Etmn D, Wlton M, Feuerstein GZ. Simvsttin nd losrtn enhnce nitric oxide nd reduce oxidtive stress in slt-induced hypertension. Am J Hypertens 25;18: Yin D, Liu M, Yng G, Hung J, Gui M. Effects of simvsttin on erly oxidtive stress nd endothelil function in polipoprotein E-deficient mice. J Nnjing Med Uni 27;21: Kuzelová M, Admeová A, Sumlová Z, Pulíková I, Hrcárová A, Svec P, Kuchrská J. The effect of simvsttin on coenzyme Q nd ntioxidnt/oxidnt lnce in dietic-hypercholesterolemic rts. Gen Physiol Biophys 28;27: Rohill Ankur et l. IRJP 211, 2 (1), Admeová A, Kuželová1 M, Fáerová V, Svec P. Protective effect of simvsttin nd VULM 1457 in ischemic-reperfused myocrdium of the dietichypercholesterolemic rts. Phrmzie 26;61: Admeová A, Hrčárová1 A, Mtejíková J, Pncz D, Kuželová1 M, Crnická S, et l. Simvsttin Allevites Myocrdil Contrctile Dysfunction nd Lethl Ischemic Injury in Rt Hert Independent of Cholesterol-Lowering Effects. Physiol Res 29;58: Zheng X, Hu SJ. Effects of simvsttin on crdiohemodynmic responses to ischemi reperfusion in isolted rt herts. Hert Vessels 26;21: Szárszoi O, Mlý J, Ošťádl P, Netuk I, Bešík J, Kolář F, et l. Effect of Acute nd Chronic Simvsttin Tretment on Post-Ischemic Contrctile Dysfunction in Isolted Rt Hert. Physiol Res 28;57: Lngendorff O. Untersuchungen m uerleenden Sugethierherzen. Archiv fur die gesmmte Physiologie des Menschen und der Thiere Bonn 1895,61: Prikh V, Singh M. Possile role of drenergic component nd crdic mst cell degrnultion in preconditioning-induced crdioprotection. Phrmcol Res 1999;4: Ohkw H, Ohishi N, Ygi K. Assy for lipid peroxides in niml tissues y thiorituric cid rection. Anl Biochem 1979;95: Wng HD, Pgno PJ, Du Y, Cytte AJ, Quinn MT, Brecher P, et l. Superoxide nion from the dventiti of the rt thorcic ort inctivtes nitric oxide. Circ Res 1998;82: Beutler E, Duron O, Kefly BM. Improved method for the determintion of lood glutthione. J L Clin Med 1963;61: Pepine CJ, Nichols WW. The pthophysiology of chronic ischemic hert disese. Clin Crdiol 27;3:I Kur H, Prikh V, Shrm A, Singh M. Effect of miloride N+/H+ exchnge inhiitor on crdioprotective effect of ischemic preconditioning: Possile involvement of resident crdic mst cells. Phrmcol Res 1997;36: Shrm A, Singh M. Possile mechnism of crdioprotective effect of ischemic preconditioning in isolted rt hert. Phrmcol Res 2;41: Blkumr P, Rohill A, Singh G, Singh K, Singh M. Modultion of Crdioprotective Effect of Ischemic Pre- nd Postconditioning in the Hyperhomocysteinemic Rt Hert. Meth Find Exp Clin Phrmcol 29;31: Singh G, Rohill A, Singh M, Blkumr P. Possile Role of JAK-2 in Attenuted Crdioprotective Effect of Ischemic Preconditioning in Hyperhomocysteinemic Rt Herts. Ykugku Zsshi 29;129: Ungvri Z, Csiszr A, Edwrds JG. Incresed superoxide production in coronry rteries in hyperhomocysteinemi: Role of tumor necrosis fctor-α, NAD(P)H oxidse, nd inducile nitric oxide synthse. Arterioscler Throm Vsc Biol 23;23: Devi S, Kennedy RH, Joseph L, Shekhwt NS, Melchert RB, Joseph J. Effect of long-term hyperhomocysteinemi on myocrdil structure nd function in hypertensive rts. Crdiovsc Pthol 26;15: Kettwn A, Tkhshi T, Kongkchuichi R, Chroenkitkul S, Kishi T, Okmoto T. Protective effects of coenzyme q(1) on decresed oxidtive stress resistnce induced y simvsttin. J Clin Biochem Nutr 27;4: Tong XK, Nicolkkis N, Fernndes P, Ongli B, Brouillette J, Quirion R, et l. Simvsttin improves cererovsculr function nd counters solule myloidet, inflmmtion nd oxidtive stress in ged APP mice. Neuroiol Dis 29;35: % Infrct Size I Figure 1. Effect of Simvsttin on increses in infrct size induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 2(1), 211

4 Rohill Ankur et l. IRJP 211, 2 (1), Cretine Kinse (U/L) Bsl Figure 2. Effect of Simvsttin on increses in cretine kinse (CK) levels induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. 5 min I 35 3 Lctte dehydrogense (U/L) Bsl Imm Reperfusion I Figure 3. Effect of Simvsttin on increses in lctte dehydrogense (LDH) levels induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. 9 8 TBARS (nm/gm wet tissue weight) I Figure 4. Effect of Simvsttin on increses in thiorituric cid rective sustnce (TBARS) levels induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. 8 Reduced NBT (pm/min/mg wet tissue weight) I Figure 5. Effect of Simvsttin on increses in superoxide nion levels induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 2(1), 211

5 Rohill Ankur et l. IRJP 211, 2 (1), GSH (um/mg wet tissue weight) I Figure 6. Effect of Simvsttin on decreses in reduced glutthione (GSH) levels induced y ischemi reperfusion (I/R). Vlues re expressed s men ± SD. = P <.5 vs. norml control; = P <.5 vs. I/R control. Sim Treted I/R-I= 3 µmol; = 1 µmol; I= 3 µmol. Source of support: Nil, Conflict of interest: None Declred INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 2(1), 211