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1 Department of Internal Medicine, Keio University School of Medicine, Tokyo 160 - 8582, Japan; and 2 Division of Cardiology, University of Louisville and Jewish Hospital Heart and Lung Institute, Louisville, Kentucky 40202
Opioids confer biphasic (early
and late) cardioprotection against myocardial infarction by opening
mitochondrial ATP-sensitive K+ channels. It is unknown
whether cyclooxygenase-2 (COX-2), which mediates
ischemia-induced late preconditioning, also mediates opioid-induced cardioprotection. Isolated perfused rat hearts were
subjected to 20 min of global ischemia followed by 20 min of
reperfusion. BW-373U86 (BW), a
-opioid receptor agonist, was administered 1, 12, or 24 h before death. Recovery of left
ventricular developed pressure (LVDP) after ischemia-reperfusion
improved when BW was administered 1 or 24 h before
ischemia (control: 57 ± 8, BW 1 h: 75 ± 5, BW
24 h: 85 ± 6%) but not when it was administered 12 h
before (60 ± 5%). Levels of 6-keto-PGF1
(a stable
metabolite of PGI2) in coronary effluent after 20 min of
reperfusion were higher with 24-h BW pretreatment than in controls
(1,053 ± 92 vs. 724 ± 81 pg/ml), whereas
6-keto-PGF1
levels at baseline did not differ.
Administration of a selective COX-2 inhibitor, NS-398, abolished the
late phase of cardioprotection (recovery of LVDP, 53 ± 8%) and
attenuated the increase in PGI2 (706 ± 138 pg/ml) but
did not block the early phase of cardioprotection. The selective COX-1
inhibitor SC-560 did not affect either phase of protection. Western
immunoblotting revealed upregulation of PGI2 synthase
protein 24 h after BW administration without changes in COX-1 and
COX-2 protein levels. In conclusion, the late (but not the early) phase
of
-opioid receptor-induced preconditioning is mediated by COX-2. A
functional coupling between COX-2 and upregulated PGI2
synthase appears to underlie this cardioprotective phenomenon in the rat.
myocardial ischemia; opioid; prostaglandin; reperfusion injury
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