2. Academic Validation
  3. Sulforaphane improves post-resuscitation myocardial dysfunction by inhibiting cardiomyocytes ferroptosis via the Nrf2/IRF1/GPX4 pathway

Sulforaphane improves post-resuscitation myocardial dysfunction by inhibiting cardiomyocytes ferroptosis via the Nrf2/IRF1/GPX4 pathway

  • Biomed Pharmacother. 2024 Oct:179:117408. doi: 10.1016/j.biopha.2024.117408.
Zhongjun Zheng 1,  Jiefeng Xu 1,  Yi Mao 2,  Zhihan Mei 3,  Jinjiang Zhu 4,  Pin Lan 5,  Xianlong Wu 6,  Shanxiang Xu 7,  Mao Zhang 8
Affiliations

Affiliations

  • 1 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, China.
  • 2 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Emergency Medicine, The First People's Hospital of Wenling, Taizhou, China.
  • 3 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Emergency Medicine, Tiantai People's Hospital of Zhejiang Province, Taizhou, China.
  • 4 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Emergency Medicine, Yiwu Central Hospital, Jinhua, China.
  • 5 Department of Emergency Medicine, Lishui Central Hospital, Lishui, China.
  • 6 Department of Emergency Medicine, Taizhou First People's Hospital, Taizhou, China.
  • 7 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, China. Electronic address: 2201027@zju.edu.cn.
  • 8 Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, China. Electronic address: z2jzk@zju.edu.cn.
PMID: 39244999 DOI: 10.1016/j.biopha.2024.117408
Abstract

Background: Ferroptosis is an important type of cell death contributing to myocardial dysfunction induced by whole body ischemia reperfusion following cardiac arrest (CA) and resuscitation. Sulforaphane (SFN), known as the activator of the nuclear factor E2-related factor 2 (Nrf2), has been proven to effectively alleviate regional myocardial ischemia reperfusion injury. The present study was designed to investigate whether SFN could improve post-resuscitation myocardial dysfunction by inhibiting cardiomyocytes Ferroptosis and its potential regulatory mechanism.

Methods and results: An in vivo pig model of CA and resuscitation was established. Hypoxia/reoxygenation (H/R)-stimulated AC16 cardiomyocytes was constructed as an in vitro model to simulate the process of CA and resuscitation. In vitro experiment, SFN reduced ferroptosis-related ferrous iron, lipid Reactive Oxygen Species, and malondialdehyde, increased glutathione, and further promoted cell survival after H/R stimulation in AC16 cardiomyocytes. Mechanistically, the activation of Nrf2 with the SFN decreased interferon regulatory factor 1 (IRF1) expression, then reduced its binding to the promoter of Glutathione Peroxidase 4 (GPX4), and finally recovered the latter's transcription after H/R stimulation in AC16 cardiomyocytes. In vivo experiment, SFN reversed abnormal expression of IRF1 and GPX4, inhibited cardiac Ferroptosis, and improved myocardial dysfunction after CA and resuscitation in pigs.

Conclusions: SFN could effectively improve myocardial dysfunction after CA and resuscitation, in which the mechanism was potentially related to the inhibition of cardiomyocytes Ferroptosis through the regulation of Nrf2/IRF1/GPX4 pathway.

Keywords

Cardiac arrest; Cardiopulmonary resuscitation; Ferroptosis; Glutathione peroxidase 4; Interferon regulatory factor 1; Myocardial dysfunction; Nuclear factor E2-related factor 2; Sulforaphane.

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