Carbon Monoxide-Saturated Hemoglobin-Based Oxygen Carriers Attenuate High-Altitude-Induced Cardiac Injury by Amelioration of the Inflammation Response and Mitochondrial Oxidative Damage

Cardiology. 2017;136(3):180-191. doi: 10.1159/000448652. Epub 2016 Oct 12.

Abstract

Objective: To investigate the therapeutic effect of carbon monoxide (CO) on high-altitude hypoxia-induced cardiac damage.

Methods: Forty male C57BL/6 mice were randomly divided into 4 groups. The mice were exposed to normoxia or simulated 5,500-meter high-altitude hypoxia in a hypobaric chamber for 7 days. During the first 3 days, the mice were pretreated with CO-saturated hemoglobin (Hb)-based oxygen carrier (CO-HBOC), oxygen-saturated hemoglobin-based oxygen carrier (O2-HBOC) at a dose of 0.3 g Hb/kg/day or an equivalent volume of saline. The in vivo left ventricle function, cardiac enzyme release, histopathological changes, apoptosis and inflammation were also measured.

Results: High-altitude hypoxia induced significant cardiac damage, as demonstrated by impaired cardiac function and increased proapoptotic, proinflammatory and pro-oxidant markers. Pretreatment with CO-HBOC significantly improved cardiac performance, reduced cardiac enzyme release and limited myocardial apoptosis. The increased inflammatory response was also suppressed. In addition to the preserved mitochondrial structure, hypobaric hypoxia-induced mitochondrial oxidative damage was remarkably attenuated. Moreover, these antiapoptotic and antioxidative effects were accompanied by an upregulated phosphorylation of Akt, ERK and STAT3.

Conclusion: This study demonstrated that CO-HBOC provides a promising protective effect on high-altitude hypoxia-induced myocardial injury, which is mediated by the inhibition of inflammation and mitochondrial oxidative damage.

MeSH terms

  • Altitude*
  • Animals
  • Apoptosis
  • Carbon Monoxide / pharmacology*
  • Heart Ventricles / pathology
  • Hemoglobins
  • Hypoxia / physiopathology*
  • Inflammation / prevention & control*
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mitochondria, Heart / drug effects*
  • Necrosis
  • Oxidative Stress / drug effects*
  • Oxygen / pharmacology*
  • Random Allocation
  • Ventricular Function, Left / drug effects

Substances

  • Hemoglobins
  • Carbon Monoxide
  • Oxygen