{"id":{"repo_id":"lund","oai_identifier":"oai:lup.lub.lu.se:95e86895-bd85-4558-9b39-811c8ea29242"},"canonical_url":"https://search.dev.ndltd.org/etd/lund/oai:lup.lub.lu.se:95e86895-bd85-4558-9b39-811c8ea29242","repository":{"repo_id":"lund","name":"University of Lund","base_url":"https://lup.lub.lu.se/oai"},"display":{"title":"Cardioprotective treatment strategies","abstract":"In myocardial ischemia-reperfusion (I/R) injury, complement activation, tissue plasminogen activator (t-PA) and extracellular adenosine triphosphate (ATP) release contribute to myocardial injury. ATP is degraded into adenosine by the enzyme apyrase, and adenosine possesses cardioprotective properties. ADC-1004 is an antagonist of the receptor to the activated complement factor C5a. Hypothermia has been shown to suppress the development of I/R injury. In this thesis, the cardioprotective effects of ADC-1004 (paper I), apyrase (paper II) and hy- pothermia (paper III) were investigated. The effects of hypothermia on coronary t-PA release (paper IV), and on systemic t-PA release in cardiogenic shock (paper V) were also studied. An experimental porcine ischemia/reperfusion model was used. Infarct size (IS), microvascular obstruction and area at risk (AAR) were measured with ex-vivo MRI and SPECT. ADC-1004 treatment (paper I) was found to reduce infarct size (ADC-1004: 58.3±3.4 vs control: 74.1±2.9 %AAR, p=0.007) but not microvascular obstruction (ADC-1004: 2.2±1.2 vs control: 5.3±2.5 %AAR, p=NS). Treatment with apyrase (paper II) did not reduce infarct size (apyrase: 75.7±4.2 vs saline: 69.4±5.0 %AAR, p=NS) nor microvascular obstruction (apyrase: 10.7±4.8 vs saline: 11.4±4.8 %IS, p=NS). Hypothermia (paper III) reduced both infarct size (hypothermia: 60.8±4.9 vs normothermia: 73.8±4.0 %AAR, p<0.05) and microvascular obstruction (hypothermia: 0.5±0.5 vs normothermia: 21.5±5.2 %IS, p<0.001). Hypothermia also inhibited an increase in coronary net t-PA release during reperfusion (paper IV; hypothermia: 0.79±0.45 ng/ml vs normothermia: 9.44±4.34 ng/ml, p<0.05); and an increase in systemic net t-PA release in cardiogenic shock (paper V; hypothermia: 0.60 ± 0.12 ng/ml vs normothermia: 2.16 ± 1.09 ng/ml, p<0.05). In conclusion, complement inhibition by ADC-1004 and therapeutic hypothermia reduces myocardial ischemia-reperfusion injury, and represents clinically applicable treatment strategies. Mechanistically, therapeutic hypothermia acts to reduce t-PA release in myocardial ischemia and cardiogenic shock. Treatment with apyrase does not protect the heart from ischemia/reperfusion injury.","abstract_html":"In myocardial ischemia-reperfusion (I/R) injury, complement activation, tissue plasminogen activator (t-PA) and extracellular adenosine triphosphate (ATP) release contribute to myocardial injury. ATP is degraded into adenosine by the enzyme apyrase, and adenosine possesses cardioprotective properties. ADC-1004 is an antagonist of the receptor to the activated complement factor C5a. Hypothermia has been shown to suppress the development of I/R injury. In this thesis, the cardioprotective effects of ADC-1004 (paper I), apyrase (paper II) and hy- pothermia (paper III) were investigated. The effects of hypothermia on coronary t-PA release (paper IV), and on systemic t-PA release in cardiogenic shock (paper V) were also studied. An experimental porcine ischemia/reperfusion model was used. Infarct size (IS), microvascular obstruction and area at risk (AAR) were measured with ex-vivo MRI and SPECT. ADC-1004 treatment (paper I) was found to reduce infarct size (ADC-1004: 58.3±3.4 vs control: 74.1±2.9 %AAR, p=0.007) but not microvascular obstruction (ADC-1004: 2.2±1.2 vs control: 5.3±2.5 %AAR, p=NS). Treatment with apyrase (paper II) did not reduce infarct size (apyrase: 75.7±4.2 vs saline: 69.4±5.0 %AAR, p=NS) nor microvascular obstruction (apyrase: 10.7±4.8 vs saline: 11.4±4.8 %IS, p=NS). Hypothermia (paper III) reduced both infarct size (hypothermia: 60.8±4.9 vs normothermia: 73.8±4.0 %AAR, p&lt;0.05) and microvascular obstruction (hypothermia: 0.5±0.5 vs normothermia: 21.5±5.2 %IS, p&lt;0.001). Hypothermia also inhibited an increase in coronary net t-PA release during reperfusion (paper IV; hypothermia: 0.79±0.45 ng/ml vs normothermia: 9.44±4.34 ng/ml, p&lt;0.05); and an increase in systemic net t-PA release in cardiogenic shock (paper V; hypothermia: 0.60 ± 0.12 ng/ml vs normothermia: 2.16 ± 1.09 ng/ml, p&lt;0.05). In conclusion, complement inhibition by ADC-1004 and therapeutic hypothermia reduces myocardial ischemia-reperfusion injury, and represents clinically applicable treatment strategies. Mechanistically, therapeutic hypothermia acts to reduce t-PA release in myocardial ischemia and cardiogenic shock. Treatment with apyrase does not protect the heart from ischemia/reperfusion injury.","abstract_has_math":false,"creators":["vanderPals, Jesper"],"institution":"Department of Cardiology, Clinical sciences, Lund University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2011,"date_issued":"2011","date_published":"2011","updated_at":"2026-07-24T02:59:36Z","subjects":["Cardiology and Cardiovascular Disease","ADC-1004","apyrase","Cardioprotection","ischemia/reperfusion","hypothermia","t-PA"],"languages":["eng"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["urn:isbn:978-91-86671-64-8"],"render_values":[{"text":"urn:isbn:978-91-86671-64-8","href":null,"code":true}]}]},"links":{"outbound_url":"https://lup.lub.lu.se/record/1785599","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["vanderPals, Jesper"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2011"]},{"key":"dc:publisher","label":"Institution","values":["Department of Cardiology, Clinical sciences, Lund University"]},{"key":"dc:type","label":"Dc Type","values":["thesis/doccomp","info:eu-repo/semantics/doctoralThesis","text"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Cardiology and Cardiovascular Disease","ADC-1004","apyrase","Cardioprotection","ischemia/reperfusion","hypothermia","t-PA"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://lup.lub.lu.se/record/1785599","urn:isbn:978-91-86671-64-8","https://portal.research.lu.se/files/3449330/1785600.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["In myocardial ischemia-reperfusion (I/R) injury, complement activation, tissue plasminogen activator (t-PA) and extracellular adenosine triphosphate (ATP) release contribute to myocardial injury. ATP is degraded into adenosine by the enzyme apyrase, and adenosine possesses cardioprotective properties. ADC-1004 is an antagonist of the receptor to the activated complement factor C5a. Hypothermia has been shown to suppress the development of I/R injury. In this thesis, the cardioprotective effects of ADC-1004 (paper I), apyrase (paper II) and hy- pothermia (paper III) were investigated. The effects of hypothermia on coronary t-PA release (paper IV), and on systemic t-PA release in cardiogenic shock (paper V) were also studied. An experimental porcine ischemia/reperfusion model was used. Infarct size (IS), microvascular obstruction and area at risk (AAR) were measured with ex-vivo MRI and SPECT. ADC-1004 treatment (paper I) was found to reduce infarct size (ADC-1004: 58.3±3.4 vs control: 74.1±2.9 %AAR, p=0.007) but not microvascular obstruction (ADC-1004: 2.2±1.2 vs control: 5.3±2.5 %AAR, p=NS). Treatment with apyrase (paper II) did not reduce infarct size (apyrase: 75.7±4.2 vs saline: 69.4±5.0 %AAR, p=NS) nor microvascular obstruction (apyrase: 10.7±4.8 vs saline: 11.4±4.8 %IS, p=NS). Hypothermia (paper III) reduced both infarct size (hypothermia: 60.8±4.9 vs normothermia: 73.8±4.0 %AAR, p<0.05) and microvascular obstruction (hypothermia: 0.5±0.5 vs normothermia: 21.5±5.2 %IS, p<0.001). Hypothermia also inhibited an increase in coronary net t-PA release during reperfusion (paper IV; hypothermia: 0.79±0.45 ng/ml vs normothermia: 9.44±4.34 ng/ml, p<0.05); and an increase in systemic net t-PA release in cardiogenic shock (paper V; hypothermia: 0.60 ± 0.12 ng/ml vs normothermia: 2.16 ± 1.09 ng/ml, p<0.05). In conclusion, complement inhibition by ADC-1004 and therapeutic hypothermia reduces myocardial ischemia-reperfusion injury, and represents clinically applicable treatment strategies. Mechanistically, therapeutic hypothermia acts to reduce t-PA release in myocardial ischemia and cardiogenic shock. Treatment with apyrase does not protect the heart from ischemia/reperfusion injury."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:source","label":"Dc Source","values":["Lund University Faculty of Medicine Doctoral Dissertation Series; 2011:15 (2011)","ISSN: 1652-8220"]},{"key":"dc:title","label":"Title","values":["Cardioprotective treatment strategies"]}]}],"canonical_facts":{"dc:creator":["vanderPals, Jesper"],"dc:date":["2011"],"dc:description":["In myocardial ischemia-reperfusion (I/R) injury, complement activation, tissue plasminogen activator (t-PA) and extracellular adenosine triphosphate (ATP) release contribute to myocardial injury. ATP is degraded into adenosine by the enzyme apyrase, and adenosine possesses cardioprotective properties. ADC-1004 is an antagonist of the receptor to the activated complement factor C5a. Hypothermia has been shown to suppress the development of I/R injury. In this thesis, the cardioprotective effects of ADC-1004 (paper I), apyrase (paper II) and hy- pothermia (paper III) were investigated. The effects of hypothermia on coronary t-PA release (paper IV), and on systemic t-PA release in cardiogenic shock (paper V) were also studied. An experimental porcine ischemia/reperfusion model was used. Infarct size (IS), microvascular obstruction and area at risk (AAR) were measured with ex-vivo MRI and SPECT. ADC-1004 treatment (paper I) was found to reduce infarct size (ADC-1004: 58.3±3.4 vs control: 74.1±2.9 %AAR, p=0.007) but not microvascular obstruction (ADC-1004: 2.2±1.2 vs control: 5.3±2.5 %AAR, p=NS). Treatment with apyrase (paper II) did not reduce infarct size (apyrase: 75.7±4.2 vs saline: 69.4±5.0 %AAR, p=NS) nor microvascular obstruction (apyrase: 10.7±4.8 vs saline: 11.4±4.8 %IS, p=NS). Hypothermia (paper III) reduced both infarct size (hypothermia: 60.8±4.9 vs normothermia: 73.8±4.0 %AAR, p<0.05) and microvascular obstruction (hypothermia: 0.5±0.5 vs normothermia: 21.5±5.2 %IS, p<0.001). Hypothermia also inhibited an increase in coronary net t-PA release during reperfusion (paper IV; hypothermia: 0.79±0.45 ng/ml vs normothermia: 9.44±4.34 ng/ml, p<0.05); and an increase in systemic net t-PA release in cardiogenic shock (paper V; hypothermia: 0.60 ± 0.12 ng/ml vs normothermia: 2.16 ± 1.09 ng/ml, p<0.05). In conclusion, complement inhibition by ADC-1004 and therapeutic hypothermia reduces myocardial ischemia-reperfusion injury, and represents clinically applicable treatment strategies. Mechanistically, therapeutic hypothermia acts to reduce t-PA release in myocardial ischemia and cardiogenic shock. Treatment with apyrase does not protect the heart from ischemia/reperfusion injury."],"dc:format":["application/pdf"],"dc:identifier":["https://lup.lub.lu.se/record/1785599","urn:isbn:978-91-86671-64-8","https://portal.research.lu.se/files/3449330/1785600.pdf"],"dc:language":["eng"],"dc:publisher":["Department of Cardiology, Clinical sciences, Lund University"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Lund University Faculty of Medicine Doctoral Dissertation Series; 2011:15 (2011)","ISSN: 1652-8220"],"dc:subject":["Cardiology and Cardiovascular Disease","ADC-1004","apyrase","Cardioprotection","ischemia/reperfusion","hypothermia","t-PA"],"dc:title":["Cardioprotective treatment strategies"],"dc:type":["thesis/doccomp","info:eu-repo/semantics/doctoralThesis","text"]},"updated_at":"2026-07-24T02:59:36Z"}