Clinical manifestations and basic mechanisms of myocardial ischemia/reperfusion injury

• Published in: Ci ji yi xue za zhi Vol. 30; no. 4; pp. 209 - 215
• Main Author: Yang, Chiu-Fen
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.10.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Edition: 2
• Subjects: Active oxygen; Acute myocardial infarction; Ischemia/reperfusion injury; Protein phosphorylation; Proteins; Review; Review Article; United States; Acute myocardial infarction; Protein phosphorylation; Ischemia/reperfusion injury
• ISSN: 1016-3190; 2223-8956; 2223-8956
• DOI: 10.4103/tcmj.tcmj_33_18

Acute myocardial ischemia/reperfusion (I/R) injury is a significant, unsolved clinical puzzle. In the disease context of acute myocardial infarction, reperfusion remains the only effective strategy to salvage ischemic myocardium, but it also causes additional damage. Myocardial I/R injury is composed of four types of damage, and these events attenuate the benefits of reperfusion therapy. Thus, inventing new strategies to conquer I/R injury is an unmet clinical need. A variety of pathological processes and mediators, including changes in the pH, generation of reactive oxygen radicals, and intracellular calcium overload, are proposed to be crucial in I/R-related cell injury. Among the intracellular events that occur during I/R, we stress the importance of protein phosphorylation signaling and elaborate its regulation. A variety of protein kinase pathways could be activated in I/R, including reperfusion injury salvage kinase and survivor-activating factor enhancement pathways, which are critical to cardiomyocyte survival. In addition to serine/threonine phosphorylation signaling, protein tyrosine phosphorylation is also critical in multiple cell functions and survival. However, the roles of protein kinases and phosphatases in I/R have not been extensively studied yet. By better understanding the mechanisms of I/R injury, we may have a better chance to develop new strategies for I/R injury and apply them in the clinical patient care.