Effect of dimethyl fumarate on mitochondrial metabolism in a pediatric porcine model of asphyxia-induced in-hospital cardiac arrest.
Sarah PielMeagan J McManusKristina N HeyeForrest BeaulieuHossein FazeliniaJoanna I JanowskaBryce MacTurkJonathan StarrHunter GaudioNisha PatelMarco M HeftiMartin E SmalleyJordan N HookNeha V KohliJames BrutonThomas HallowellNile DelsoAnna RobertsYuxi LinJohannes K EhingerMichael KarlssonRobert A BergRyan W MorganTodd J KilbaughPublished in: Scientific reports (2024)
Neurological and cardiac injuries are significant contributors to morbidity and mortality following pediatric in-hospital cardiac arrest (IHCA). Preservation of mitochondrial function may be critical for reducing these injuries. Dimethyl fumarate (DMF) has shown potential to enhance mitochondrial content and reduce oxidative damage. To investigate the efficacy of DMF in mitigating mitochondrial injury in a pediatric porcine model of IHCA, toddler-aged piglets were subjected to asphyxia-induced CA, followed by ventricular fibrillation, high-quality cardiopulmonary resuscitation, and random assignment to receive either DMF (30 mg/kg) or placebo for four days. Sham animals underwent similar anesthesia protocols without CA. After four days, tissues were analyzed for mitochondrial markers. In the brain, untreated CA animals exhibited a reduced expression of proteins of the oxidative phosphorylation system (CI, CIV, CV) and decreased mitochondrial respiration (p < 0.001). Despite alterations in mitochondrial content and morphology in the myocardium, as assessed per transmission electron microscopy, mitochondrial function was unchanged. DMF treatment counteracted 25% of the proteomic changes induced by CA in the brain, and preserved mitochondrial structure in the myocardium. DMF demonstrates a potential therapeutic benefit in preserving mitochondrial integrity following asphyxia-induced IHCA. Further investigation is warranted to fully elucidate DMF's protective mechanisms and optimize its therapeutic application in post-arrest care.
Keyphrases
- cardiac arrest
- oxidative stress
- cardiopulmonary resuscitation
- diabetic rats
- healthcare
- randomized controlled trial
- left ventricular
- high glucose
- gene expression
- heart failure
- palliative care
- clinical trial
- protein kinase
- white matter
- poor prognosis
- resting state
- functional connectivity
- young adults
- chronic pain
- pain management
- quality improvement
- climate change
- double blind
- cell cycle
- cerebral ischemia
- electron microscopy