Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response

Background Glutathione is a water‐soluble tripeptide with a potent oxidant scavenging activity. We hypothesized that glutathione administration immediately before and after primary angioplasty (primary percutaneous coronary intervention) could be effective in modulating immune cell activation, there...

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Autores principales:	Gaetano Tanzilli, Alessio Arrivi, Attilio Placanica, Nicola Viceconte, Vittoria Cammisotto, Cristina Nocella, Francesco Barillà, Concetta Torromeo, Giacomo Pucci, Maria Cristina Acconcia, Antonino Granatelli, Stefania Basili, Marcello Dominici, Carlo Gaudio, Roberto Carnevale, Enrico Mangieri
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	immune cells inflammation left ventricular remodeling oxidative stress reperfusion injury STEMI Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/29f5c9ce6f704892bc6dbbcb309c4571
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spelling	oai:doaj.org-article:29f5c9ce6f704892bc6dbbcb309c45712021-11-23T11:36:35ZGlutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response10.1161/JAHA.120.0205602047-9980https://doaj.org/article/29f5c9ce6f704892bc6dbbcb309c45712021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.020560https://doaj.org/toc/2047-9980Background Glutathione is a water‐soluble tripeptide with a potent oxidant scavenging activity. We hypothesized that glutathione administration immediately before and after primary angioplasty (primary percutaneous coronary intervention) could be effective in modulating immune cell activation, thereby preventing infarct expansion. Methods and Results One hundred consecutive patients with ST‐segment–elevation myocardial infarction, scheduled to undergo primary percutaneous coronary intervention were randomly assigned before the intervention to receive an infusion of glutathione (2500 mg/25 mL over 10 minutes), followed by drug administration at the same doses at 24, 48, and 72 hours elapsing time or placebo. Total leukocytes, NOX2 (nicotinamide adenine dinucleotide phosphate oxidase 2) activation, NO bioavailability, cTpT (serum cardiac troponin T), hsCRP (high‐sensitivity C‐reactive protein), and TNF‐α (tumor necrosis factor α) levels were measured. Left ventricular size and function were assessed within 120 minutes, 5 days, and 6 months from percutaneous coronary intervention. Following reperfusion, a significant reduction of neutrophil to lymphocyte ratio (P<0.0001), hsCRP generation (P<0.0001), NOX2 activation (P<0.0001), TNF‐α levels (P<0.001), and cTpT release (P<0.0001) were found in the glutathione group compared with placebo. In treated patients, blunted inflammatory response was linked to better left ventricular size and function at follow‐up (r=0.78, P<0.005). Conclusions Early and prolonged glutathione infusion seems able to protect vital myocardial components and endothelial cell function against harmful pro‐oxidant and inflammatory environments, thus preventing maladaptive cardiac repair and left ventricular adverse remodeling. Registration URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2014‐004486‐25.Gaetano TanzilliAlessio ArriviAttilio PlacanicaNicola ViceconteVittoria CammisottoCristina NocellaFrancesco BarillàConcetta TorromeoGiacomo PucciMaria Cristina AcconciaAntonino GranatelliStefania BasiliMarcello DominiciCarlo GaudioRoberto CarnevaleEnrico MangieriWileyarticleimmune cellsinflammationleft ventricular remodelingoxidative stressreperfusion injurySTEMIDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	immune cells inflammation left ventricular remodeling oxidative stress reperfusion injury STEMI Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	immune cells inflammation left ventricular remodeling oxidative stress reperfusion injury STEMI Diseases of the circulatory (Cardiovascular) system RC666-701 Gaetano Tanzilli Alessio Arrivi Attilio Placanica Nicola Viceconte Vittoria Cammisotto Cristina Nocella Francesco Barillà Concetta Torromeo Giacomo Pucci Maria Cristina Acconcia Antonino Granatelli Stefania Basili Marcello Dominici Carlo Gaudio Roberto Carnevale Enrico Mangieri Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
description	Background Glutathione is a water‐soluble tripeptide with a potent oxidant scavenging activity. We hypothesized that glutathione administration immediately before and after primary angioplasty (primary percutaneous coronary intervention) could be effective in modulating immune cell activation, thereby preventing infarct expansion. Methods and Results One hundred consecutive patients with ST‐segment–elevation myocardial infarction, scheduled to undergo primary percutaneous coronary intervention were randomly assigned before the intervention to receive an infusion of glutathione (2500 mg/25 mL over 10 minutes), followed by drug administration at the same doses at 24, 48, and 72 hours elapsing time or placebo. Total leukocytes, NOX2 (nicotinamide adenine dinucleotide phosphate oxidase 2) activation, NO bioavailability, cTpT (serum cardiac troponin T), hsCRP (high‐sensitivity C‐reactive protein), and TNF‐α (tumor necrosis factor α) levels were measured. Left ventricular size and function were assessed within 120 minutes, 5 days, and 6 months from percutaneous coronary intervention. Following reperfusion, a significant reduction of neutrophil to lymphocyte ratio (P<0.0001), hsCRP generation (P<0.0001), NOX2 activation (P<0.0001), TNF‐α levels (P<0.001), and cTpT release (P<0.0001) were found in the glutathione group compared with placebo. In treated patients, blunted inflammatory response was linked to better left ventricular size and function at follow‐up (r=0.78, P<0.005). Conclusions Early and prolonged glutathione infusion seems able to protect vital myocardial components and endothelial cell function against harmful pro‐oxidant and inflammatory environments, thus preventing maladaptive cardiac repair and left ventricular adverse remodeling. Registration URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2014‐004486‐25.
format	article
author	Gaetano Tanzilli Alessio Arrivi Attilio Placanica Nicola Viceconte Vittoria Cammisotto Cristina Nocella Francesco Barillà Concetta Torromeo Giacomo Pucci Maria Cristina Acconcia Antonino Granatelli Stefania Basili Marcello Dominici Carlo Gaudio Roberto Carnevale Enrico Mangieri
author_facet	Gaetano Tanzilli Alessio Arrivi Attilio Placanica Nicola Viceconte Vittoria Cammisotto Cristina Nocella Francesco Barillà Concetta Torromeo Giacomo Pucci Maria Cristina Acconcia Antonino Granatelli Stefania Basili Marcello Dominici Carlo Gaudio Roberto Carnevale Enrico Mangieri
author_sort	Gaetano Tanzilli
title	Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
title_short	Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
title_full	Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
title_fullStr	Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
title_full_unstemmed	Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response
title_sort	glutathione infusion before and 3 days after primary angioplasty blunts ongoing nox2‐mediated inflammatory response
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/29f5c9ce6f704892bc6dbbcb309c4571
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Glutathione Infusion Before and 3 Days After Primary Angioplasty Blunts Ongoing NOX2‐Mediated Inflammatory Response

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