An article published in Experimental Biology and Medicine (Volume 242, Issue 9, May, 2017) describes a new treatment for minimizing injury to the heart during cardiac procedures. The study, led by Dr. Paul Iaizzo from the Department of Surgery and Institute for Engineering in Medicine at the University of Minnesota in Minneapolis, reports that administration of Deltorphin D, a delta-opioid agonist, during reperfusion improves heart function in a porcine ex vivo model system.
Patients undergoing cardiac procedures such as coronary artery stenting, bypass surgery, and cardiac transplantation often experience decreased blood flow and lack of oxygen, a process called ischemia, which damages the heart. Paradoxically, additional injury to the heart can occur upon reperfusion and restoration of blood flow. One option for reducing reperfusion injury is post-conditioning, which involves treatment with adjuvant therapies at the onset of reperfusion. Although numerous agents have shown promise in preclinical trials, results from clinical trials for reperfusion injury have been disappointing. Thus, improving clinical outcomes for cardiac patients requires new insights regarding the pathophysiology and pharmacology of reperfusion injury.
Several studies suggest that opioids are cardioprotective in humans and animal models when administered prior to ischemia (pre-conditioning) and at the onset of reperfusion (post-conditioning). In this study, Dr. Iaizzo and colleagues investigated the ability of Deltorphin D, a delta specific opioid agonist, to reduce reperfusion injury when administered as a supplement to the reperfusion buffer in an ex vivo reanimated swine heart; that underwent an ischemic downtime. Post-ischemic hemodynamic performance, arrhythmia burden, relative tissue perfusion, and development of necrosis were improved over the 2-hour reperfusion period, suggesting improved microvascular function.
Dr. Daniel Sigg, a co-author on the study, said, "Delta opioid receptors, alone or in conjunction with other drug targets, represent a promising strategy to minimize reperfusion related cardiac injury."
Dr. Iaizzo added that "the opportunity to utilize post-conditioning pharmacological agents to improve cardiac function will have significant applications in both cardiac surgery and transplantation."
Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicine, said, "Iaizzo and colleagues have demonstrated that delta specific opioid agonists, such as Deltorphin D, may play an important therapeutic role in decreasing reperfusion injury during cardiac procedures."
About Experimental Biology and Medicine
Experimental Biology and Medicine is a journal dedicated to the publication of multidisciplinary and interdisciplinary research in the biomedical sciences. The journal was first established in 1903. Experimental Biology and Medicine is the journal of the Society of Experimental Biology and Medicine. To learn about the benefits of society membership visit www.sebm.org. If you are interested in publishing in the journal, please visit http://ebm.sagepub.com/.
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