Abstract

PurposeThe melatonin receptor (MT) agonist ramelteon has a higher affinity to MT1 than for MT2 receptors and induces cardioprotection by involvement of mitochondrial potassium channels. Activation of mitochondrial potassium channels leads to release of free radicals. We investigated whether (1) ramelteon-induced cardioprotection is MT2 receptor specific and (2) if free radicals are involved in ramelteon-induced cardioprotection.MethodsHearts of male Wistar rats were randomized, placed on a Langendorff system, and perfused with Krebs-Henseleit buffer at a constant pressure of 80 mmHg. All hearts were subjected to 33 min of global ischemia and 60 min of reperfusion. Before ischemia hearts were perfused with ramelteon (Ram) with or without the MT2 receptor inhibitor 4-phenyl-2-propionamidotetralin (4P-PDOT+Ram, 4P-PDOT). In subsequent experiments, ramelteon was administered together with the radical oxygen species (ROS) scavenger N-2-mercaptopropionylglycine (MPG+Ram). To determine whether the blockade of ramelteon-induced cardioprotection can be restored, we combined ramelteon and MPG with mitochondrial permeability transition pore (mPTP) inhibitor cyclosporine A (CsA) at different time points. Infarct size was determined by triphenyltetrazolium chloride (TTC) staining.ResultsRamelteon-induced infarct size reduction was completely blocked by 4P-PDOT and MPG. Ramelteon and MPG combined with CsA before ischemia were not cardioprotective but CsA at the onset of reperfusion could restore infarct size reduction.ConclusionsThis study shows for the first time that despite the higher affinity to MT1 receptors, (1) ramelteon-induced cardioprotection involves MT2 receptors, (2) cardioprotection requires ROS release, and (3) inhibition of the mPTP can restore infarct size reduction.

Highlights

  • Reperfusion after myocardial ischemia is essential for the survival of the patient

  • Cardioprotection can be induced by ischemic preconditioning with short cycles of ischemia and reperfusion or realized by pharmacologic preconditioning with drugs like volatile anesthetics [3], opioids [4], or noble gases [5]

  • We showed that administration of the melatonin receptor (MT) agonist ramelteon prior to ischemia is cardioprotective in a Cardiovasc Drugs Ther (2020) 34:303–310 concentration-dependent manner [6]

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Summary

Introduction

Reperfusion itself causes myocardial injury [1] being contraproductive in such situations. Cardioprotective strategies that could counteract this situation and limit myocardial injury would be of great value. Preconditioning is a strong cardioprotective intervention to reduce the infarct size after ischemia-reperfusion injury [2]. We showed that administration of the melatonin receptor (MT) agonist ramelteon prior to ischemia is cardioprotective in a Cardiovasc Drugs Ther (2020) 34:303–310 concentration-dependent manner [6]. Own previous data showed that the non-selective MT receptor antagonist luzindole completely abolished ramelteon-induced infarct size reduction [6]. Because luzindole is non-selective for a MT receptor subtype, it remains unclear whether the higher affinity to MT1 and the activation of MT1 receptors is essentially responsible for the cardioprotection by ramelteon

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