Clarithromycin attenuates myocardial ischemia–reperfusion injury

Abstract

Background: MMP activity is upregulated in the heart after myocardial ischemia reperfusion, and its activation contributes to the changes in left ventricular (LV) dysfunction. A major macrolide antibiotic, clarithromycin has many biological functions including MMP regulation. However, little is known about the effect of clarithromycin in myocardial reperfusion injury via MMPs. Our objective was to clarify the role of MMPs regulated by clarithromycin in the progression of myocardial reperfusion injury.

Methods: We administered clarithromycin to rats with ischemia–reperfusion injury twice a day for 7 days before and 14 days after reperfusion.

Results: Clarithromycin resulted in a significant reduction of the infarction area:area at risk ratio and preserved fractional shortening ratio after 14 days of reperfusion. Immunohistochemical analysis revealed that macrophages were the primary cellular source of MMPs. Fewer macrophages were detected in the ischemic area of the hearts following ischemia reperfusion in the clarithromycin-treated group compared with the vehicle-treated group. Although ischemia–reperfusion injury resulted in LV fibrosis with increasing MMP activities, clarithromycin significantly reduced these changes.

Conclusion: Clarithromycin is effective for attenuating myocardial ischemia–reperfusion injury by suppressing MMPs.

Keywords::

• antibiotics
• inflammation
• ischemia
• metalloproteinase
• remodeling
• reperfusion injury

Acknowledgments

This study was supported by grants from the Yokohama Research Foundation. The authors thank N Tamura and Y Matsuda for their excellent assistance. T Nakajima and K Hishikari contributed equally.

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