Effects of inosine on reperfusion injury after heart transplantation

Gábor Szabó, Nicole Stumpf, Tamás Radovits, Karin Sonnenberg, Domokos Gerö, Siegfried Hagl, Csaba Szabó, Susanne Bährle

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30 Scopus citations


Objective: Inosine, a break-down product of adenosine, has been recently shown to exert inodilatory and anti-inflammatory properties. We investigated the effects of inosine on ischemia/reperfusion injury in a rat heart transplantation model. Methods: Intraabdominal heterotopic transplantation was performed in Lewis rats. After 1 h of ischemic preservation, reperfusion was started after application of either saline vehicle (control, n = 12) or inosine (100 mg/kg, n = 12). Coronary blood flow, left ventricular function, endothelium-dependent vasodilatation to acetylcholine and endothelium-independent vasodilatation to sodium nitroprusside, and high energy phosphate content were measured after 1 and 24 h of reperfusion. In addition, the activation of the poly(ADP-ribose) polymerase was detected by immunhistology. Results: After 1 h, coronary blood flow (4.1 ± 0.3 ml/(min g) vs 2.9 ± 0.3 ml/(min g), p < 0.05), left ventricular systolic pressure (102 ± 9 mmHg vs 83 ± 4 mmHg, p < 0.05) and dP/dt (2765 ± 609 mmHg/s vs 1740 ± 116 mmHg/s, p < 0.05) were significantly higher in the inosine group in comparison to control. Vasodilatatory response to sodium nitroprusside was similar in both groups. Acetylcholine resulted in a significantly higher increase in coronary blood flow in the inosine group (76 ± 5% vs 48 ± 9%, p < 0.05). Energy charge potential was significantly higher in the inosine group (1.69 ± 0.10 μmol/g vs 0.74 ± 0.27 μmol/g, p < 0.05). After 24 h, there was no difference between the groups in basal coronary blood flow, left ventricular systolic pressure, dP/dt, and the response to sodium nitroprusside. However, acetylcholine led to a still significantly higher response in the inosine group (112 ± 13% vs 88 ± 7%, p < 0.05). Immunhistologic stainings revealed activation of poly(ADP-ribose) polymerase in control animals which was abolished by inosine. Conclusions: Thus, inosine improves myocardial and endothelial function during early reperfusion after heart transplantation with a persisting beneficial effect against reperfusion induced graft coronary endothelial dysfunction. The effects of inosine are mediated at least partly by modulation of the peroxynitrite-poly(ADP-ribose) polymerase pathway.

Original languageEnglish (US)
Pages (from-to)96-102
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number1
StatePublished - Jul 2006
Externally publishedYes


  • Endothelial function
  • Inosine
  • Rat
  • Reperfusion injury
  • Transplantation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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