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Research Proposal on Myocardial ischaemia-reperfusion injury in AIDS and potential therapeutic treatment target AIDS




            Accordingly, the presence of ischaemia reperfusion injury occurs in diseases like for instance, myocardial infarction and during surgical procedures that involve the application of tourniquet as the mechanism of leucocytes adhesion to endothelium involves expression of adhesion molecules on surface of leucocytes and of the endothelium. Aside, the sternness of several complications in acquired immune deficiency syndrome (AIDS) in some of the affected patients can be associated with acute ischaemia reperfusion injury (Cited from, Redmond et al., 2000, Van Tol and Hendricks, 2001). Generally, certain literature studies suggests that such moderate ethanol consumption have certain myocardial protective effects but, it can be not known if chronic ethanol consumption benefits acute myocardial ischaemia reperfusion injury in AIDS. There can be that, the survival from myocardial infarction was reduced in murine AIDS even though the early stage of murine AIDS hearts did survive in acute myocardial infarction, the infarct size has been considerably better.




            Moreover, certain chronic ethanol consumption then, improved the survival of murine AIDS mice from an acute myocardial infarction. As the disseminated cytomegalovirus (CMV) infection occurs frequently in HIV infected patients within CMV antigen and CMV mediated early gene expression were found in myocytes from HIV-infected patients (Cited from, Wu et al., 1992). Thus, Acierno et al. (Cited from, 1989) suggested that myocardial damage is related to uncontrolled hyper-gamma-globulinaemia. In addition, some viral genes may alter the cell surface of the muscle fibre. Some of these cell surface proteins become immunogenic and elicit such progressive autoimmune reaction. However, there has been some series of experiments has revealed the presence of circulating cardiac autoantibodies to heavy chain myosin in AIDS patients having cardiovascular complications. Amicably, chronic ethanol consumption did not reduce infarct size in AIDS. There can be indications that multiple deleterious effects may enhance acute ischaemia reperfusion injury in AIDS. The beneficial effects of chronic ethanol consumption in myocardial ischaemia reperfusion injury may be due to modulation of neutrophil adhesion molecule expression and cytokine secretion. However, it is unknown if chronic ethanol consumption can attenuate myocardial ischaemia reperfusion injury in AIDS (Cited from, Redmond et al., 2000, Van Tol and Hendricks, 2001).




            Furthermore, one potential mechanism by which regular drinking may improve survival after myocardial infarction is to reduce ischaemia reperfusion injury, analogous to experimental ischaemic preconditioning (Cited from, Klatsky et al., 1990; Kawano et al., 1992; Hu and Nattel, 1995). Amicably, ischaemic preconditioning occurs when brief periods of ischaemia and reperfusion protect hearts against injury from subsequent prolonged ischaemia reperfusion. Aside, some researchers have found the presence of HIV-1 in the myocardium of AIDS patients (Cited from, Calabrese et al., 1987; Lipshultz et al., 1990). Therefore, increased cytokines may contribute to the initiation and perpetuation of activated blood cells, causing heart dysfunction. Ideally, during the ischaemia reperfusion, hypersensitive neutrophils may become more activated as there can be more cytokines released in response to ischaemia reperfusion injury. Therefore, in its overall process the activated neutrophils release reactive oxygen species and the proteolytic enzymes that directly destroy heart tissue and the overly produced cytokines and over-expressed ways will have to amplify the local pathological inflammatory reaction and perturb myocardial function. It can be possible that such chronic ethanol consumption has improved survival cases of the injury state but did not completely reverse certain deleterious effects on hearts due to some actions of retroviral infection.



Acierno, L. J. (1989) Cardiac complications in acquired immunodeficiency syndrome (AIDS): a review. Journal of the American College of Cardiology 13, 1144–1154


Calabrese, L. H., Proffitt, M. R., Yen-Lieberman, B., Hobbs, R. E. and Ratliff, N. B. (1987) Congestive cardiomyopathy and illness related to the acquired immunodeficiency syndrome (AIDS) associated with isolation of retrovirus from myocardium. Annals of Internal Medicine 107, 691–692


Hu, K. and Nattel, S. (1995) Mechanisms of ischemic preconditioning in rat hearts. Involvement of 1B-adrenoceptors, pertussis toxin-sensitive G proteins, and protein kinase C. Circulation 92, 2259–2265


Kawano, Y., Abe, H., Kojima, S., Ashida, T., Yoshida, K., Imanishi, M., Yoshimi, H., Kimura, G., Kuramochi, M. and Omae, T. (1992) Acute depressor effect of alcohol in patients with essential hypertension. Hypertension 20, 219–226.


Klatsky, A. L., Armstrong, M. A. and Friedman, G. D. (1990) Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. American Journal of Cardiology 66, 1237–1242


Lipshultz, S. E., Fox, C. H., Perez-Atayde, A. R., Sanders, S. P., Colan, S. D., McIntosh, K. and Winter, H. S. (1990) Identification of human immunodeficiency virus-1 RNA and DNA in the heart of a child with cardiovascular abnormalities and congenital acquired immune deficiency syndrome. American Journal of Cardiology 66, 46–50.


Redmond, E. M., Sitzmann, J. V. and Cahill, P. A. (2000) Potential mechanisms for cardiovascular protective effect of ethanol. Acta Pharmacologica Sinica 21, 385–390


van Tol, A. and Hendriks, H. F. (2001) Moderate alcohol consumption: effects on lipids and cardiovascular disease risk. Current Opinion in Lipidology 12, 19–23


Wu, T. C., Pizzorno, M. C., Hayward, G. S., Willoughby, S., Neumann, D. A., Rose, N. R., Ansari, A. A., Beshorner, W. E., Boughman, K. L. and Herskowitz, A. (1992) In situ detection of human cytomegalovirus immediate–early gene transcripts within cardiac myocytes of patients with HIV-associated cardiomyopathy. AIDS 6, 777–785





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