How the Heart Copes with Oxidant Stress

In common with many other tissues, the heart possesses a diverse array of cellular defences that act in concert to 

The heart has a relatively low catalase activity, which, together with the superoxide dismutase (SOD) system, acts to remove hydrogen peroxide and superoxide radicals. In addition, in man, dietary vitamin C plays an important role in the reduction of vitamin E, an intrinsic antioxidant component of biological membranes (Chen and Thacker, 1986 Niki, 1987). Both vitamins C and E can also react directly with hydroxyl and superoxide radicals (HalliwcU and Gutteridge, 1989 Meister, 1992). 

During ischaemia, the activity of cellular antioxidant systems may be reduced (Ferrari et al. 1985 GaUnanes etal. 1992). In addition, a number of cellular pathways that produce free radicals are primed during ischaemia such as the xanthine/xanthine oxidase system (McCord, 1987), catecholamine auto-oxidation (Jackson et al., 1986) and the arachadonic acid pathway (Halliwell and Gutteridge, 1989). Thus, during early reperfusion there is a burst of free radical production (see Fig. 4.1) that may overwhelm the antioxidant systems of the cells. 

While many biological molecules may be targets for oxidant stress and free radicals, it is clear that the cell membrane and its associated proteins may be particularly vulnerable. The ability of the cell to control its intracellular ionic environment as well as its ability to maintain a polarized membrane potential and electrical excitability depends on the activity of ion-translocating proteins such as channels, pumps and exchangers. Either direct or indirect disturbances of the activity of these ion translocators must ultimately underlie reperfiision and oxidant stress-induced arrhythmias in the heart. A number of studies have therefore investigated the effects of free radicals and oxidant stress on cellular electrophysiology and the activity of key membrane-bound ion translocating proteins. 

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