Cardioprotection Effects of Sevoflurane by Regulating the Pathway of Neuroactive Ligand-Receptor Interaction in Patients Undergoing Coronary Artery Bypass Graft Surgery

This study was designed to identify attractor modules and further reveal the potential biological processes involving in sevoflurane-induced anesthesia in patients treated with coronary artery bypass graft (CABG) surgery. Microarray profile data (ID: E-GEOD-4386) on atrial samples obtained from patients receiving anesthetic gas sevoflurane prior to and following CABG procedure were downloaded from EMBL-EBI database for further analysis. Protein-protein interaction (PPI) networks of baseline and sevoflurane groups were inferred and reweighted according to Spearman correlation coefficient (SCC), followed by systematic modules inference using clique-merging approach. Subsequently, attract method was utilized to explore attractor modules. Finally, pathway enrichment analyses for genes in the attractor modules were implemented to illuminate the biological processes in sevoflurane group. Using clique-merging approach, 27 and 36 modules were obtained from the PPI networks of baseline and sevoflurane-treated samples, respectively. By comparing with the baseline condition, 5 module pairs with the same gene composition were identified. Subsequently, 1 out of 5 modules was identified as an attractor based on attract method. Additionally, pathway analysis indicated that genes in the attractor module were associated with neuroactive ligand-receptor interaction. Accordingly, sevoflurane might exert important functions in cardioprotection in patients following CABG, partially through regulating the pathway of neuroactive ligand-receptor interaction

The Preconditioning Effect of Sevoflurane on Coronary Artery Bypass Surgery Patients

Background: One of the most important issues in the field of surgery is ischemic preconditioning (IPC) of the myocardium during the coronary artery bypass grafting (CABG). The current study attempted to reevaluate the issue to find a potential approach to diminish morbidity, inotrope administration, ischemia and possibly intensive care unit stay after CABG in adult patients.Materials and Methods: Through randomized single-blind clinical trial, all elective coronary bypass surgeries in 40 to 80 years-old patients enrolled the study. Atrioventricular (AV) block (mobitz2); complete heart block; left bundle branch block (LBBB); acute heart failure (ejection fraction (EF) <30%); re-exploration due to surgical complications and MI cases in the last 7 days were excluded. In all patients, induction (sufentanil, cis-atracurium and etomidate) and maintenance phase (sufentanil, midazolam, cis-atracurium) of anesthesia were done following the same protocol. After cross-clamp of aorta in intervention group, the patients received oxygen (2Lit/min) and sevoflurane (4%) during coronary bypass surgery. After rewarming of the patients, sevoflurane was discontinued. Main outcome measures were troponin 4, 8, 24, 48 hours after surgery with charting the electrocardiogram (ECG) changes, need for inotrope agents and hemodynamic indices during and after CABG in ICU.Results: 58 CABG candidates enrolled the current study: 29 in intervention group and 29 in control group. There were no statistical differences between the groups concerning hemodynamic issues, Central Venous Pressure (CVP), hematocrit (HCT), ECG changes, demands for inotrope, or ICU stay between the groups.Conclusion: No significant relationship between application of 4% sevoflurane and IPC was found in adult CABG patients. However, the effect of Sevoflurane on IPC might be dose-related.Keywords: Ischemic preconditioning (IPC); Sevoflurane; Coronary Artery Bypass Surgery (CABG

Incremental Metabolic Benefits from Cryoablation for Paroxysmal Atrial Fibrillation: Insights from Metabolomic Profiling

Background: Cryoablation (CRYO) is a novel catheter ablation technique for atrial fibrillation (AF). However, uncertainty persists regarding the role of metabolic modifications associated with CRYO. This study was aimed at exploring whether CRYO influences the metabolic signature – a possibility not previously investigated. Methods: Paired serum samples from patients with AF (n = 10) were collected before and 24 h after CRYO. Untargeted metabolomic analysis was conducted with LC-MS. Univariate and multivariate analyses were applied to identify differential metabolites between samples. Pathway enrichment and Pearson correlation analyses were performed to reveal the perturbed metabolic pathways and potential interactions. Results: Levels of 19 metabolites showed significant changes between baseline and 24 h after CRYO. Pathway analysis revealed that the perturbed metabolites were enriched in unsaturated fatty acid biosynthesis, retrograde endocannabinoid signaling, and neuroactive ligand-receptor interactions. Pearson correlation analysis indicated strong correlations among differential metabolites, biochemical markers, and clinical indicators. Conclusions: CRYO induces systemic changes in the serum metabolome in patients with paroxysmal AF and provides potential metabolic benefits. Our findings might enable enhanced understanding of the pathophysiology and metabolic mechanisms involved in catheter ablation

Drug Discovery

Natural products are a constant source of potentially active compounds for the treatment of various disorders. The Middle East and tropical regions are believed to have the richest supplies of natural products in the world. Plant derived secondary metabolites have been used by humans to treat acute infections, health disorders and chronic illness for tens of thousands of years. Only during the last 100 years have natural products been largely replaced by synthetic drugs. Estimates of 200 000 natural products in plant species have been revised upward as mass spectrometry techniques have developed. For developing countries the identification and use of endogenous medicinal plants as cures against cancers has become attractive. Books on drug discovery will play vital role in the new era of disease treatment using natural products