Sulodexide protected the heart against ischemia/reperfusion injury by reducing oxidative stress, inflammation, and apoptosis in the isolated rat heart

Abstract

Introduction: This study aimed to investigate the antioxidant effects of suledoxide (SDX) on myocardial tissue in ischemia-reperfusion (IR) injury using the Langendorff heart system. Methods: Rat hearts were studied with the Langendorff technique and subjected to 30 min perfusion in the presence or absence of SDX (1.5 mg/L) and followed by 60 min reperfusion again in the presence or absence of SDX (1.5 mg/L). The hearts were homogenized for biochemical and western blot analysis. Results: Total antioxidant status of heart tissue was significantly higher in both Pre-sulodexide- administrated group (PreSDX) (p < 0.05) and Pre-Post sulodexide administrated group (PrePostSDX) (p < 0.01) groups compared to the IR group. Levels of total oxidant status were significantly lower in both PreSDX (p < 0.01) and PrePostSDX (p < 0.001) groups compared to the IR group and the Oxidative Stress Index (OSI) levels were significantly lower in PreSDX (p < 0.001), Post sulodexide administrated group (PostSDX) (p < 0.01) and PrePostSDX (p < 0.001) groups than the IR group. The levels of caspase 3, Bcl-2 homologues antagonist/killer (Bak) and Cytochrome-c (Cyt-c) were significantly lower in all three SDX groups (p’s < 0.001) compared to the IR group and the levels of B-cell lymphoma 2 (Bcl-2) were significantly higher in all three groups of SDX (p’s < 0.001) compared to the IR group. Levels of Bax were significantly lower in PreSDX (p < 0.001), PostSDX (p < 0.01) and PrePostSDX (p < 0.001) groups than the IR group. The Bcl-2–associated X protein (Bax)//Bcl-2 ratio was also significantly higher in IR group than all three SDX treated groups (p’s < 0.001). Conclusions: It was concluded that SDX has anti-apoptotic, anti-inflammatory and antioxidant effects in both pre-ischemia and pre- and post-ischemia treatment and might be added to cardioplegia solutions in clinical practice.