Early Administration of Glutamine Protects Cardiomyocytes from Post-Cardiac Arrest Acidosis

Abstract

Postcardiac arrest acidosis can decrease survival. Effective medications without adverse side effects are still not well characterized. We aimed to analyze whether early administration of glutamine could improve survival and protect cardiomyocytes from postcardiac arrest acidosis using animal and cell models. Forty Wistar rats with postcardiac arrest acidosis (blood pH < 7.2) were included. They were divided into study (500 mg/kg L-alanyl-L-glutamine, n = 20) and control (normal saline, n = 20) groups. Each of the rats received resuscitation. The outcomes were compared between the two groups. In addition, cardiomyocytes derived from human induced pluripotent stem cells were exposed to HBSS with different pH levels (7.3 or 6.5) or to culture medium (control). Apoptosis-related markers and beating function were analyzed. We found that the duration of survival was significantly longer in the study group (p < 0.05). In addition, in pH 6.5 or pH 7.3 HBSS buffer, the expression levels of cell stress (p53) and apoptosis (caspase-3, Bcl-xL) markers were significantly lower in cardiomyocytes treated with 50 mM L-glutamine than those without L-glutamine (RT-PCR). L-glutamine also increased the beating function of cardiomyocytes, especially at the lower pH level (6.5). More importantly, glutamine decreased cardiomyocyte apoptosis and increased these cells' beating function at a low pH level.

Glutamine ameliorates Bungarus multicinctus venom-induced lung and heart injury through HSP70: NF-κB p65 and P53/PUMA signaling pathways involved

“…Studies have shown that in many lung and heart diseases, the interference of Gln can repair cardiopulmonary function [ 16 , 17 , 33 ]. In the lung, it had been reported that Gln improve the vascular function and ameliorate inflammation and damage of lung tissues [ 19 , 34 ].…”

“…In heart disease research, early administration of glutamine protects cardiomyocytes from Post-Cardiac Arrest Acidosis [ 51 ]. In a CLP rat model, treatment with Gln reduced sepsis-induced cardiac myocyte injury [ 52 ].…”

Efeitos e segurança do uso pré-operatório de glutamina ou Whey Protein: Uma revisão sistemática

“…A circulação extracorpórea também é uma forma de lesão cardíaca por isquemia e reperfusão, provavelmente por este motivo estes dois últimos autores encontraram desfechos clínicos mais significativos. 26,27 Debates recentes mostram que minimizar o tempo de jejum pré-operatório é uma estratégia segura e eficaz para diminuir inflamação, resposta ao estresse e resistência insulínica. Há diversos trabalhos encorajando o uso de CHO 12,5% nas 2 horas que antecedem a cirurgia, e enriquecer esta bebida com whey protein e/ou glutamina é um tópico com crescente interesse de estudo e promissor para otimizar ainda mais a recuperação operatória.…”

Reduced Glutamatergic Neurotransmission as Possible Indicator of Unfavorable Prognosis

“…[48; 49] Currently, in contrast to previous studies, H. Buter et al [50] have shown an association between plasma Gln levels and severity of clinical condition calculated on the APACHE-IV scale. According to Y. Lin et al, [51 Gln reduces apoptosis of cardiomyocytes and increases their functional activity at low pH. Under experimental conditions, Gln increased the lifespan of rats after asystole.…”