Original Article. Introduction

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1 [Downloe free from on Mony, Septemer 11, 17, IP: ] Originl Artile Effet of Angiotensin onverting Enzyme Inhiitor on Cri Firosis n Oxitive Stress Sttus in Lipopolyshrie inue Inflmmtion Moel in Rts Astrt Bkgroun: Renin ngiotensin (Ang) losterone system not only plys key role in the regultion of irultory homeostsis, ut lso it ts s powerful pro inflmmtory meitor. The im of this stuy ws to evlute the effet of ptopril (Cp), known Ang onverting enzyme inhiitor, on inflmmtion inue ri firosis, n hert oxitive stress sttus in lipopolyshrie () inue inflmmtion in mle rts. Methos: Fifty mle rts were rnomly ivie into five groups ontrol, (1 mg/kg/y), + Cp 1 mg/kg, + Cp mg/kg n + Cp 1 mg/kg. After weeks, loo smples were tken, n herts were hrveste for evlution of tumor nerosis ftor lph (TNF α), interleukin (IL ) n nitri oxie metolite in serum n tissue hemogente, histopthology (hemtoxylin n eosin n Msson s trihrome) n oxitive stress sttus. Results: Serum IL n TNF α onentrtion were higher in group ompre to ontrol n Cp reue them, signifintly. Hert TNF α n IL ontents in group were signifintly higher thn ontrol (P <.). The ministrtion of Cp signifintly erese inflmmtory mrkers level to ontrol (P <.). The higher levels of mlonilehye n lower ntioxitive mrkers (totl thiol, superoxie ismutse, n tlse) in the hert were oserve in group n tretment y Cp improve them, ose epenently. Histopthologil stuy revele ri firosis n more ollgen ontent in group whih signifintly improve y Cp tretment. Conlusions: Tretment y Cp reue ri firosis possily through improving oxitive stress sttus, n it n e onsiere to inrese ri ompline in this onition. Keywors: Angiotensin, ri, firosis, inflmmtion Introution Renin ngiotensin (Ang) losterone system hs key role in the regultion of irultory homeostsis, oy flui volume, ontrol of loo pressure n soium lne, n lso ffet riovsulr system. Stuies inite tht over tivity of this system les to riovsulr iseses, myoril infrtion, hert filure, hypertension, n theroslerosis. [1,] It is lso inite tht inrese Ang II proution n enhne Ang onverting enzyme (ACE) tivity re ssoite with roti theroslerosis. [3] Furthermore, in ptients with the ute oronry synrome, ACE tivity in vsulr tissue ws inrese. [] Besie the role of Ang II in the regultion of irultory homeostsis, it ts s powerful pro inflmmtory meitor. [] In the ourse of inflmmtion, Ang II hs severl effets inluing inrese vsulr permeility through inresing prostglnins n vsulr enothelil growth ftor, up regultion of hesion moleules n expression of monoyte hemottrtnt protein n inflmmtory mrkers. [,] Therefore, it seems tht ACE inhiition results in reution of inflmmtion inue riovsulr iseses. Inflmmtion plys key role in initition n evelopment of mny riovsulr iseses suh s theroslerosis. [] Lipopolyshrie () reeptor or Toll like reeptors (TLRs) is expresse in riomyoytes n plys key role in riovsulr iseses suh s myoril ysfuntion. [7] TLR n TLR knokout mie showe etter ri funtion fter inution of sepsis ompre to wil type. [7] The tivtion of Azm Areshi, Ftemeh Norouzi 1, Fereshteh Asghrzeh, Frimh Beheshti, Mhmou Hosseini, Mehi Frzni 3, Mji Khzei Deprtment of Physiology, Shool of Meiine, Mshh University of Meil Sienes, Mshh, Irn, 1 Deprtment of Physiology, Shool of Meiine, Esfryen Fulty of Meil Sienes, Esfryen, Irn, Neuroognitive Reserh Center, Shool of Meiine, Mshh University of Meil Sienes, Mshh, Irn, 3 Deprtment of Pthology, Shool of Meiine, Mshh University of Meil Sienes, Mshh, Irn, Neurogeni Inflmmtion Reserh Center, Shool of Meiine, Mshh University of Meil Sienes, Mshh, Irn Aress for orresponene: Prof. Mji Khzei, Deprtment of Physiology, Fulty of Meiine, Mshh University of Meil Sienes, Mshh, Irn. E mil: khzeim@mums..ir Aess this rtile online Wesite: DOI: 1.13/ijpvm.IJPVM_3_1 Quik Response Coe: This is n open ess rtile istriute uner the terms of the Cretive Commons Attriution NonCommeril ShreAlike 3. Liense, whih llows others to remix, twek, n uil upon the work non ommerilly, s long s the uthor is reite n the new retions re liense uner the ientil terms. For reprints ontt: reprints@meknow.om How to ite this rtile: Areshi A, Norouzi F, Asghrzeh F, Beheshti F, Hosseini M, Frzni M, et l. Effet of ngiotensin onverting enzyme inhiitor on ri firosis n oxitive stress sttus in lipopolyshrie inue inflmmtion moel in rts. Int J Prev Me 17;8:9. 17 Interntionl Journl of Preventive Meiine Pulishe y Wolters Kluwer - Meknow 1

2 [Downloe free from on Mony, Septemer 11, 17, IP: ] TLRs les to the nuler trnslotion of nuler ftor κb (NF κb), whih inrese ytokines proution n the expression of hesion moleules. [8] These ply key role uring riomyopthy. In the present stuy, we use for inution of systemi inflmmtion. is omponent of the outer memrne of Grm negtive teri n is wiely use for inution of inflmmtion. [9] It tivtes innte immunity n inues systemi inflmmtion through TLRs. TLRs re foun in ells with or without immune funtion inluing enothelil ells n riomyoytes. [1] TLRs my initite pro inflmmtory response in these ells n les to inue the relese of inflmmtory mrkers n expression of hesion moleules. [11] inue tivtion of TLRs on riomyoytes is thought to inue ri stress n poptosis in riomyoytes [1] y stimulting ngiotensinogen n hene Ang II. [13] Thus, the tivtion of renin Ang losterone system my le to ri firosis. [1] In this stuy, we evlute the effet of ptopril (Cp), known ACE inhiitor, on serum n hert inflmmtory mrkers, inflmmtion inue ri firosis n hert oxitive stress sttus in experimentlly inue inflmmtion in mle rts. Methos Animls n experimentl groups Fifty mle Wistr rts, 8 weeks ol n weighing g, were otine from the Institute of Experimentl Animls (Mshh University of Meil Sienes, Mshh, Irn). They were house in the niml house with stnr temperture ( C) n 1 h light/rk yle n llowe free ess to rinking wter n stnr roent how. The Lol Institutionl Animl Cre n use Committee pprove the stuy. The nimls were rnomly ivie into five groups (n = 1 in eh group): (1), (), (3) + Cp 1 mg/kg, () + Cp mg/kg, n () + Cp 1 mg/kg. Lipopolyshrie ministrtion n phrmologil intervention trete groups reeive 1 mg/kg/y from Esherihi oli serotype (:B; Sigm Alrih Chemil Co.) for 1 ys, intrperitonelly. [1] The ontrol group reeive.9% norml sline inste of. Cp (Sigm Alrih Chemil Co.) ws ministere 1 y efore strting ministrtion of y three oses (Cp 1,, n 1 mg/kg/y), intrperitonelly. At the en of the experiment, ll nimls were nesthetize; loo smples were tken from the hert n entrifuge. The serum smples were store t 7 C for further nlysis. The left ventriles were hrveste n put in formlin 1% for lter histologil evlution. The right ventriles were use for mesurement of inflmmtory mrkers n oxitive stress sttus in tissue homogentes. Determintion of serum n hert nitrite n inflmmtory mrker levels Nitrite ws mesure in serum n hert hemogente y Griess regent metho using stnr enzyme linke immunosorent ssy (ELISA) kit (Promeg Corp., USA, Ct#G93). In rief, 1 µl of serums or tissue homogentes were e to 9 well flt ottome miroplte. Then, sulfnilmie solution n N 1 nphtylethyleneimine ihyrohlorie uner ii onitions were e to ll ollete smples, respetively. The sorne ws etete y miroplte reer (Biotek, USA) in nm wvelengths. The limit etetion ws. µm nitrite. [1,17] Serum n hert tumor nerosis ftor lph (TNF α) n interleukin (IL ) were quntifie y ville ELISA kits (ebiosiene Co., Sn Diego, CA, USA) oring to mnufturers instrution. The sorne ws mesure using miroplte reer (Biotek, USA) n onentrtion of eh ftor ws lulte y omprison urve estlishe in the sme mesurement. Eh ytokine ssy ws performe in uplite eh time. Cri mlonilehye Mlonilehye (MDA) level whih is n inex of lipi peroxition ws mesure s previously esrie. [18] In rief, MDA rets with thiorituri i (TBA) n proues re olore omplex. First, the TBA trihloroeti i HCL regent ws e to tissue homogente. Then, the solution ws hete in wter th for min. Next, it ws entrifuge n the sorne mesure t 3 nm. The MDA onentrtion ws lulte s follows: C (m) = Asorne/(1. 1). Cri totl thiol onentrtion Cri totl thiol groups were mesure using, ithiois ( nitroenzoi i) (DTNB) s the regent. In rief, 1 ml of Tris ethyleneiminetetreti i (EDTA) uffer (ph = 8.) ws e to µl hert homogente. Then, the sorne ws re t 1 nm ginst Tris EDTA uffer lone (A1). Next, µl DTNB regents were e to the mixture n the smple sorne ws re gin (A). The sorne of DTNB regent ws re s lnk (B). Totl thiol onentrtion (mm) ws mesure s previously esrie using the following eqution: Totl thiol onentrtion (mm) = (A A1 B) 1.7/. 13. Cri superoxie ismutse n tlse Superoxie ismutse (SOD) ws mesure oring to metho of Mesh n Blsurmnin. [19] One unit of SOD ws efine s the mount of enzyme require to inhiit the rte of 3 (, imethythizol yl), iphenyl tetrzolium romie reution y %. The results were shown s unit per milligrm protein. Ctlse tivity ws mesure s previously esrie. [] One unit of tlse Interntionl Journl of Preventive Meiine 17, 8: 9

3 [Downloe free from on Mony, Septemer 11, 17, IP: ] tivity is etermine s the miromoles of the hyrogen peroxie onsume per milligrm of protein smple. Histologil exmintion The left ventriles were emee in formlin 1% n slie t 1 µm, eprffinize, stine with hemtoxylin n eosin (H n E) n exmine uner light mirosopy. An verge numer of 1 rnomly selete fiels in eh slie in six nimls per group were nlyze y investigtors who were unwre of the niml groups. For evlution of ri firosis, the setions were stine with Msson s trihrome. A lue stin inite positive stining for ollgen. The firoti hnges were ssesse y pthologist in 1 rnomly selete high power fiels ( ) for eh tissue slie n reporte s ollgen ontent. The frtionl re of firosis ws quntifie using NIH imge softwre (Imge J). [1] Sttistil nlysis All t re presente s the men ± stnr error. The nlysis ws performe using the SPSS softwre version (SPSS, In., Chigo, IL, USA). The omprisons were evlute using one wy ANOVA, followe y LSD post ho test. P <. ws onsiere sttistilly signifint. Results Serum n tissue inflmmtory mrkers As we expete, serum IL in group ws signifintly higher thn tht of ontrol group (P <.1). Aministrtion of Cp y ll oses (1,, n 1 mg/kg) erese serum levels of IL ompre to group whih ws sttistilly signifint t higher oses (Cp n 1 mg/kg) (P <.) [Figure 1]. There were no signifint ifferenes in serum IL etween + Cp n 1 mg/kg n ontrol group (P >.). Hert IL levels in group were higher thn ontrol n Cp reue it signifintly [Figure 1]. Tretment y Cp mg/kg lowere hert IL ontent to lower thn ontrol level (P <.) [Figure 1]. Although group h higher serum TNF α level ompre to ontrol, it ws not sttistilly signifint. Tretment y Cp i not hnge serum TNF α [Figure 1]. However, the evlution of hert TNF α levels showe tht TNF α ontent in group ws signifintly higher thn ontrol rts (P <.). Aministrtion of Cp signifintly reverse hert TNF α ontent to ontrol level ( + Cp 1 n 1 mg/kg; P <.) n even lower thn ontrol levels ( + Cp mg/kg; P <.1) [Figure 1]. Serum n hert nitri oxie metolite A signifint reution in serum n hert nitrite levels were oserve in group ompre to ontrol group (P <.1) [Figure ]. Cp y ose of 1 mg/kg i not lter serum n hert nitrite levels, however, ministrtion of n 1 mg/kg Cp inrese nitri oxie (NO) metolite levels in serum n hert (P <.1 n P <. ompre to n + Cp 1 mg/kg, respetively). Serum IL- (pg/ml) # Hert IL- (pg/ml) mg/kg mg/kg 1 mg/kg 1mg/kg mg/kg 1 mg/kg Serum TNF-α(pg/ml) 1 8 1mg/kg mg/kg 1 mg/kg Hert TNF-α(pg/ml) mg/kg # mg/kg 1 mg/kg Figure 1: Serum interleukin levels in experimentl groups ( n ). # P <. ompre to ontrol; P <. ompre to ontrol n lipopolyshrie; P <.1 ompre to ontrol. ( n ) Hert tumor nerosis ftor lph levels. # P <.1 ompre to lipopolyshrie; P <. ompre to other groups. n = eh group Interntionl Journl of Preventive Meiine 17, 8: 9 3

4 [Downloe free from on Mony, Septemer 11, 17, IP: ] Cri mlonilehye n totl thiol onentrtion The nimls of group h higher MDA onentrtion [Figure 3] n lower thiol ontents [Figure 3] in hert tissues ompre to ontrol nimls (oth P <.1). Aministrtion of Cp in trete group y lowest ose (1 mg/kg) slightly erese MDA n inrese thiol onentrtion whih were not sttistilly signifint, however, in the nimls who trete y higher oses of Cp, these hnges were signifint ompre to group (P <.). Cri superoxie ismutse n tlse tivity ministrtion erese hert SOD ompre to ontrol nimls (P <.1) whih ws signifintly inrese y 1 mg/kg Cp ministrtion (P <.1). Aministrtion of 1 n mg/kg Cp oul not improve hert SOD ompre to group [Figure 3]. The evlution of tissue tlse inite tht tlse in the hert tissue ws reue fter ministrtion (P <.1). Tretment y 1 mg/kg Cp in groups inrese it in the hert tissue, signifintly (P <. ompre to group), however, Cp y ose of 1 n mg/kg i not lter tissue tlse [Figure 3]. Histopthologil finings As illustrte in Figure n, the ri musle fiers in ontrol group revele no pthologil hnges Serum nitrite (μmol/lit) Nitrite/gr tissue mg/kg 1 mg/kg mg/kg mg/kg 1 mg/kg 1 mg/kg Figure : Serum n hert nitrite onentrtions in experimentl groups. P <. ompre lipopolyshrie n lipopolyshrie + ptopril 1 mg/kg; P <.1 ompre to lipopolyshrie n lipopolyshrie + ptopril 1 mg/kg. n = eh group in H n E stine setions. group showe fol inflmmtory ell infiltrtion n isrrngement of musle fiers n ministrtion of Cp reue the severity of the pthologil hnges [Figure e]. To investigte whether the inue ri firosis, the mount of ollgen ontent ws etete. Bse on the trihrome stining, ministrtion signifintly inrese the intensity of myoril firosis in myorium n roun the vessels (in lue olor) [Figure n ]. In ition, the interstitil ollgen eposition in group ws higher thn ontrol. Figure e illustrtes tht Cp inue ose epenent erese in ri firosis n perent of ollgen ontent in groups [Figure f]. Disussion In the present stuy, we use for inution of inflmmtion in the nimls whih is known moel for inution of inflmmtion. [9] Our results showe higher inflmmtory mrkers, firosis, n more ollgen ontent in the hert in group. ins to speifi ell memrne reeptors of ifferent ells inluing enothelil ells n leukoytes n relese ifferent inflmmtory ytokines suh s TNF α, ILs, NO n oxygen free rils. All of these meitors re involve in the pthophysiology of enotoxin inue ute injury. [8,] In the present stuy, we foun higher inflmmtory ytokine levels in group ompre to ontrol, lthough, there ws no sttistilly signifint in serum TNF α ompre to ontrol. Previous stuies inite tht level of TNF α ten to e greter in septi nimls thn ontrol, however, it ws not sttistilly signifint. [3] In ition, inrese MDA level, whih n inex of lipi peroxition n reue tissue levels of totl thiol, SOD, n tlse in group inites higher retive oxygen speies (ROS) whih support the previous stuies. We lso reporte tht group h lower serum n hert NO metolite. NO hs omplex role in inflmmtion inue ri ysfuntion. [] It proue y ll types of ri ells n hs ifferent riovsulr effets in norml n pthologil onitions. NO is generte uring onversion of L rginine to L itrulline y three isoforms of NO synthse. It is inite tht inuile form of NO synthse is overproue in sepsis whih is importnt in lte stge of sepsis inue myoril ysfuntion. [] Our results showe tht ri firosis inue in group whih supporte the previous stuies. [1,7] Lew et l. inite tht exposure to sulinil levels of inues ri firosis even fter weeks. They suggeste tht this my relte to erese in ri mir 9 n n inrese in niotinmie enine inuleotie phosphte oxise expression. [] Ang II whih is potent vsoonstritor is now reognize s multifuntionl hormone importnt in the regultion of vsulr funtion, inluing ell growth, migrtion, Interntionl Journl of Preventive Meiine 17, 8: 9

5 [Downloe free from on Mony, Septemer 11, 17, IP: ] Thiol (μmol/g tissue) MDA (nmol/g tissue) mg/kg mg/kg 1 mg/kg 1 1 mg/kg mg/kg 1 mg/kg Ctlse (U/g tissue) SOD (U/g tissue) mg/kg mg/kg 1 mg/kg 1 mg/kg mg/kg 1 mg/kg Figure 3: Hert mlonilehye (), totl thiol (), superoxie ismutse () n tlse () in the hert tissue. P <. ompre to ontrol n lipopolyshrie + ptopril 1 mg/kg; n = in eh group e Figure : The light mirogrph of hert tissue stine y hemtoxylin n eosin. () group with norml rhiteture (, hemtoxylin n eosin). () lipopolyshrie group showing infiltrtion of inflmmtory ells (rrows) n isrrngement of fiers. Cptopril reue inflmmtion in the myorium ( e) inflmmtion, n firosis. Our results showe tht tretment y Cp, known ACE inhiitor, improve ri firosis n lowere ollgen ontent in hert tissue. To investigte the mehnism of Cp on ri firosis, Interntionl Journl of Preventive Meiine 17, 8: 9 we mesure serum n hert levels of inflmmtory mrkers inluing IL n TNF α. Aministrtion of Cp signifintly reue serum n tissue levels of those ytokines. Ang II hs severl effets uring inflmmtion. It

6 [Downloe free from on Mony, Septemer 11, 17, IP: ] e 7 Collgen ontent (%) # ## 3 1 f 1 mg/kg mg/kg 1 mg/kg Figure : Msson trihrome stining of left ventriulr musles of ontrol () n lipopolyshrie () groups show more ollgen eposition in lipopolyshrie trete group. Blue olor illustrtes ollgen fiers. Blk rrows inite ollgen fiers. ( e) Cptopril reue ri firosis. Left ventriulr wll firosis shows higher ollgen ontent (%) in lipopolyshrie group ompre to ontrol whih reue ose epenently y ptopril (f). P <. ompre to ontrol; P <.1 ompre to ontrol. #P <. ompre to lipopolyshrie n lipopolyshrie + ptopril 1 mg/kg; ##P <. ompre to lipopolyshrie n lipopolyshrie + ptopril 1 mg/kg inreses vsulr permeility, ontriutes to reruitment of inflmmtory ells, n regultes some trnsriptionl ftors suh s NF κb.[1,,] the present stuy, we i not mesure loo pressure in nimls who reeive Cp, n this is the limittion of the stuy. One of the intrellulr signling pthwys involve in Ang II inue inflmmtion is the proution of ROS.[] ROS ppers to e importnt in Ang II signling in vsulr ells.[7] It is emonstrte tht exogenous oxints tivte the sme signling ses s Ang II. On the other hn, mjor trgets of ROS inlue trnsription ftors, tyrosine kinses n mitogen tivte protein kinses, ll of whih re regulte y Ang II.[8] In this stuy, we foun tht Cp improve tissue ntioxitive mrkers, ose epenently. Although the effet of Ang II on ROS proution is eoming lerer, there is still puity of knowlege to its mehnism n how these reox sensitive proesses le to vsulr inflmmtion n firosis n wht ftors t s mging stress signls to inue vsulr injury. In The linil signifine of this stuy is tht in onitions with exposure to sulinil suh s oesity or high ft iet, ietes, smoking, ri firosis ours whih n ontriute to hert filure with preserve ejetion frtion.[9] Tretment y Cp improves ri firosis n therefore, inreses ri ompline in these onitions. Aknowlegments The uthors knowlege the Vie Chnellor of Mshh University of Meil Sienes for their finnil support. Finnil support n sponsorship The uthors knowlege the Vie Chnellor of Mshh University of Meil Sienes for their finnil support. Interntionl Journl of Preventive Meiine 17, 8: 9

7 [Downloe free from on Mony, Septemer 11, 17, IP: ] Conflits of interest There re no onflits of interest. Reeive: 7 Sep 1 Aepte: 9 Apr 17 Pulishe: Sep 17 Referenes 1. Mentz RJ, Bkris GL, Weer B, MMurry JJ, Gheorghie M, Ruilope LM, et l. The pst, present n future of renin ngiotensin losterone system inhiition. Int J Criol 13;17: Ferrrio CM, Strwn WB. Role of the renin ngiotensin losterone system n proinflmmtory meitors in riovsulr isese. Am J Criol ;98: Fukuhr M, Gery RL, Diz DI, Gllgher PE, Wilson JA, Glzier SS, et l. Angiotensin onverting enzyme expression in humn roti rtery theroslerosis. Hypertension ;3 (1 Pt ): Hoshi S, Kto J, Nishino M, Egmi Y, Tke T, Kwt M, et l. Inrese ngiotensin onverting enzyme tivity in oronry rtery speimens from ptients with ute oronry synrome. Cirultion 1;13:3 3.. Purri M, Kfoury R, Thounwou PB, Neele K. The renin ngiotensin losterone system in vsulr inflmmtion n remoeling. Int J Inflm 1;1:893.. Mrhesi C, Pris P, Shiffrin EL. Role of the renin ngiotensin system in vsulr inflmmtion. Trens Phrmol Si 8;9: Blij TM, Lowry SF. Lipopolyshrie n sepsis ssoite myoril ysfuntion. Curr Opin Infet Dis 11;: Ahn J, Kim J. Mehnisms n onsequenes of inflmmtory signling in the myorium. Curr Hypertens Rep 1;1:1. 9. Doi K, Leelhvnihkul A, Yuen PS, Str RA. Animl moels of sepsis n sepsis inue kiney injury. J Clin Invest 9;119: Asghrzeh F, Rouzhni R, Khzei M. Chroni low gre inflmmtion: Etiology n its effets. J Isfhn Me Sh 1;3: Chgnon F, Metz CN, Bul R, Lesur O. Enotoxin inue myoril ysfuntion: Effets of mrophge migrtion inhiitory ftor neutrliztion. Cir Res ;9: Ysu S, Lew WY. Lipopolyshrie epresses ri ontrtility n et renergi ontrtile response y eresing myofilment response to C+ in ri myoytes. Cir Res 1997;81: Suzuki J, Byn E, Li HL, Molle ED, Lew WY. Lipopolyshrie tivtes lineurin in ventriulr myoytes. J Am Coll Criol 7;9: Meht PK, Grienling KK. Angiotensin II ell signling: Physiologil n pthologil effets in the riovsulr system. Am J Physiol Cell Physiol 7;9:C Norouzi F, Areshi A, Asghrzeh F, Beheshti F, Hosseini M, Frzni M, et l. The effet of Nigell stiv on inflmmtion inue myoril firosis in mle rts. Res Phrm Si 17;1: Nemtollhi S, Nemtkhsh M, Hghjooyjvnmr S, Khzei M, Slehi M. Inuile nitri oxie synthse moultes ngiogenesis in ishemi hinlim of rt. Biome Pp Me F Univ Plky Olomou Czeh Repu 9;13: Khzei M, Nemtkhsh M. The effet of hypertension on serum nitri oxie n vsulr enothelil growth ftor onentrtions. A stuy in DOCA-Slt hypertensive ovrietomize rts. Regul Pept. ;13: Mehri S, Anous K, Khooei A, Mousvi SH, Shrity VM, Hosseinzeh H. Croin reue rylmie inue neurotoxiity in Wistr rt through inhiition of oxitive stress. Irn J Bsi Me Si 1;18: Mesh M, Blsurmnin KA. Mirotiter plte ssy for superoxie ismutse using MTT reution y superoxie. Inin J Biohem Biophys 1998;3: Aei H. Ctlse in vitro. Methos Enzymol 198;1: Lew WY, Byn E, Molle ED, Dlton ND, Li NC, Bhrgv V, et l. Reurrent exposure to sulinil lipopolyshrie inreses mortlity n inues ri firosis in mie. PLoS One 13;8:e17.. Hohensinner PJ, Niessner A, Huer K, Weyn CM, Wojt J. Inflmmtion n ri outome. Curr Opin Infet Dis 11;:9. 3. MDonough KH, Virg JI. Sepsis inue myoril ysfuntion n myoril protetion from ishemi/reperfusion injury. Front Biosi ;11:3 3.. Znotti Cvzzoni SL, Hollenerg SM. Cri ysfuntion in severe sepsis n septi shok. Curr Opin Crit Cre 9;1: Lew WY, Byn E, Dlle Molle E, Contu R, Conorelli G, Tng T. Myoril firosis inue y exposure to sulinil lipopolyshrie is ssoite with erese mir 9 n enhne NOX expression in mie. PLoS One 1;9:e17.. Suzuki Y, Ruiz Orteg M, Lorenzo O, Ruperez M, Esten V, Egio J. Inflmmtion n ngiotensin II. Int J Biohem Cell Biol 3;3: Elmi S, Sllm NA, Rhmn MM, Teng X, Hunter AL, Moien- Afshri F, et l. Sulfphenzole tretment restores enotheliumepenent vsoiltion in ieti mie. Vsul Phrmol 8;8: Touyz RM. Retive oxygen speies n ngiotensin II signling in vsulr ells Implitions in riovsulr isese. Brz J Me Biol Res ;37: Westermnn D, Ksner M, Steenijk P, Spillmnn F, Ri A, Weitmnn K, et l. Role of left ventriulr stiffness in hert filure with norml ejetion frtion. Cirultion 8;117:1. Interntionl Journl of Preventive Meiine 17, 8: 9 7