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Clarithromycin attenuates myocardial ischemia-reperfusion injury

Takuya Nakajima1, Keiichi Hishikari, Masahito Ogawa

  • 1Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Japan.

Expert Opinion on Therapeutic Targets
|July 29, 2010
PubMed
Abstract

Insights

Clarithromycin treatment significantly reduces heart damage after ischemia-reperfusion injury by suppressing matrix metalloproteinases (MMPs). This macrolide antibiotic protects cardiac function and limits fibrosis in a rat model.

Area of Science:

  • Cardiology
  • Pharmacology
  • Biochemistry

Background:

  • Matrix metalloproteinase (MMP) activity increases in the heart post-myocardial ischemia-reperfusion, contributing to left ventricular (LV) dysfunction.
  • Clarithromycin, a macrolide antibiotic, is known to regulate MMPs, but its role in myocardial reperfusion injury via MMPs is not well understood.

Purpose of the Study:

  • To investigate the role of MMPs regulated by clarithromycin in myocardial reperfusion injury.
  • To clarify the therapeutic potential of clarithromycin in mitigating cardiac damage following ischemia-reperfusion.

Main Methods:

  • Rats with ischemia-reperfusion injury received clarithromycin twice daily for 7 days pre-reperfusion and 14 days post-reperfusion.
  • Infarction size, left ventricular function (fractional shortening), and cardiac fibrosis were assessed.
  • Immunohistochemistry was used to identify the cellular source of MMPs and quantify macrophage infiltration.

Main Results:

  • Clarithromycin significantly reduced the infarct area to area-at-risk ratio and preserved fractional shortening.
  • Macrophages were identified as a major source of MMPs in the injured heart.
  • Clarithromycin treatment led to fewer macrophages in the ischemic area and reduced LV fibrosis and MMP activity.

Conclusions:

  • Clarithromycin effectively attenuates myocardial ischemia-reperfusion injury.
  • The cardioprotective effects of clarithromycin are mediated through the suppression of MMPs, particularly those associated with macrophage activity.

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