SummaryPlatelet gel improves left ventricular mechanical function in the ischemic reperfused Langendorff rabbit heart, decreases ROS production and mitochondrial depolarization in HUV-EC cells (Homo sapiens, human Umbilical Vein Endothelium) in vitro, protects catalase and superoxide dismutase when prepared using nanosecond pulsed electric fields rather than bovine thrombin and decreases the metalloproteinase MMP-2 and increases the metalloproteinase inhibitor TIMP-1 in H9c2 cells (Rattus norvegicus H9c2 cardiac myoblast cells) in vitro.
IntroductionIn patients admitted to a hospital with myocardial infarction, some of the myocardial tissue is irreversibly damaged by necrosis, but a larger part is under ischemic stress and may still be saved by appropriate intervention. It is essential to restore coronary flow to the ischemic region (reperfusion), but if no additional measures are taken, reperfusion causes the production of reactive oxygen species (ROS), which can lead to substantial tissue death (reperfusion injury) [1].Autologous Platelet-rich plasma (PRP) or platelet gel is emerging as a biological tool to reduce cardiovascular reperfusion injury in animal experiments [2]. PRP is made from an animal's own whole blood (autologous). The platelets are concentrated and the release of growth factors from the platelets is induced, typically by combining the platelet concentrate with bovine thrombin and calcium. The resulting "activated" PRP contains a super-physiological concentration of growth factors, cytokines, and other proteins [3]. Injecting it into the myocardium after infarction and prior to reperfusion significantly improves left ventricular mechanical function during reperfusion in vivo [4] in rabbit hearts and promotes angiogenesis and mitogenesis in the sheep heart when injected 3 weeks after coronary ligation and evaluated 9 weeks later [5]. In addition to the growth and healing promoting proteins, PRP provides a scaffold that traps cells such as stem cells in the region of injury giving the proteins time to help the cells differentiate into cardiac myocytes. Several problems have so far precluded the use of activated PRP in the cardiovascular system of patients: 1) injecting a PRP that contains red blood cells into the heart may lead to thrombi that can cause stroke or myocardial infarction; 2) thrombin used to prepare PRP can cause serious bleeding abnormalities in some patients who develop antibodies against certain clotting factors as well as other adverse events 3 (thrombin, itself, causes the generation of ROS and 4) lack of a mechanism explaining the mode of action of activated PRP.
AbstractBackground: The prompt restoration of blood flow (reperfusion) to the ischemic myocardium after an acute myocardial infarction is critical to the survival of non damaged heart tissue. However, reperfusion is responsible for additional myocardial damage. Our objective was to investigate the role of autologous platelet rich plasma or platelet gel prepared using nanosecond pulsed electric fields (nsPEFs) in imp...