The Therapeutic Potential of Ethyl Pyruvate for the Management of Ischemia/Reperfusion Syndromes, Sepsis and Sepsis‐Related Organ Dysfunction, and Other Conditions Associated With Excessive Inflammation

Abstract

SUMMARYPyruvate, the final product of glycolysis and the starting substrate for the tricarboxylic acid cycle, plays a central role in intermediary metabolism. It is also an effective scavenger of reactive oxygen species. In order to take advantage of the beneficial effects of pyruvate while circumventing the problem of its poor stability in solution, our laboratory formulated the ester derived from pyruvic acid and ethanol, namely ethyl pyruvate, in a Ringer's‐type calcium‐ and potassium‐containing balanced salt solution. Ringer's ethyl pyruvate solution (REPS) has been evaluated in preclinical studies using animal models of mesenteric ischemia/reperfusion injury, hemorrhagic shock, acute endotoxemia, sepsis, and severe acute alcoholic hepatitis. Treatment with REPS, when compared with treatment with Ringer's lactate solution, has been shown to be able to improve survival and decrease expression of proinflammatory mediators. REPS warrants further evaluation for the resuscitation of patients with hemorrhagic shock and a variety of acute inflammatory conditions.