The mode of protection against cardiac
reperfusion injury by mild
hypothermia and
TRO40303 was investigated in various experimental models and compared to
MitoQ in vitro. In isolated cardiomyocytes subjected to
hypoxia/reoxygenation,
TRO40303,
MitoQ and mild
hypothermia delayed
mPTP opening, inhibited generation of mitochondrial
superoxide anions at reoxygenation and improved cell survival. Mild
hypothermia, but not
MitoQ and
TRO40303, provided protection in a metabolic
starvation model in H9c2 cells and preserved respiratory function in isolated rat heart mitochondria submitted to
anoxia/reoxygenation. In the Langendorff-perfused rat heart, only mild
hypothermia provided protection of hemodynamic function and reduced
infarct size following
ischemia/reperfusion. In biopsies from the left ventricle of pigs subjected to in vivo occlusion/reperfusion,
TRO40303 specifically preserved respiratory functions in the peri-
infarct zone whereas mild
hypothermia preserved both the ischemic core area and the peri-
infarct zones. Additionally in this pig model, only
hypothermia reduced
infarct size. We conclude that mild
hypothermia provided protection in all models by reducing the detrimental effects of
ischemia, and when initiated before occlusion, reduced subsequent
reperfusion damage leading to a smaller
infarct. By contrast, although
TRO40303 provided similar protection to
MitoQ in vitro and offered specific protection against some aspects of
reperfusion injury in vivo, this was insufficient to reduce
infarct size.