Sulforaphane pretreatment prevents systemic inflammation and renal injury in response to cardiopulmonary bypass  Bao Nguyen, MRCS, Le Luong, PhD, Hatam.

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Sulforaphane pretreatment prevents systemic inflammation and renal injury in response to cardiopulmonary bypass  Bao Nguyen, MRCS, Le Luong, PhD, Hatam Naase, MRCS, Marc Vives, PhD, Gentjan Jakaj, MRCS, Jonathan Finch, MRCS, Joseph Boyle, PhD, FRCPath, John W. Mulholland, BSc, Jong-hwan Kwak, PhD, Suhkneung Pyo, PhD, Amalia de Luca, MSc, Thanos Athanasiou, PhD, FRCS, Gianni Angelini, FMedSci, FRCS, Jon Anderson, FRCS, Dorian O. Haskard, DM, FRCP, Paul C. Evans, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 148, Issue 2, Pages 690-697.e3 (August 2014) DOI: 10.1016/j.jtcvs.2013.12.048 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 p38 and NF-κB activation in leukocytes in response to CPB was suppressed by pretreatment with sulforaphane. Animals were treated with sulforaphane or vehicle alone as a control and then subjected to CPB for 2 hours. Peripheral blood samples were collected before sulforaphane or vehicle injection (baseline), immediately before CPB (cannulation), and at varying times after CPB initiation. Leukocytes were fixed and permeabilized before intracellular staining using Alexafluor568-conjugated antibodies that recognize (A) Thr180/Tyr182 phosphorylated p38 or (B) Ser529 phosphorylated RelA or with isotype-matched irrelevant antibodies as a control. After lysis of red blood cells, fluorescence of granulocytes or mononuclear cells was quantified by flow cytometry (after gating of cells by size and granularity). Mean fluorescence levels were calculated after subtracting values from isotype-control antibodies. Mean values pooled from 5 animals per group are shown with standard deviations. *P < .05, **P < .01, ***P < .001. NF-κB, Nuclear factor-κB; ns, not significant. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Inflammatory cytokine induction in response to CPB was reduced by pretreatment with sulforaphane. Animals were treated with sulforaphane or vehicle alone as a control and then subjected to CPB for 2 hours. Peripheral blood samples were collected before sulforaphane or vehicle injection (baseline), immediately before CPB (cannulation), and at varying times after CPB initiation. TNFα (A), IL-8 (B), and IL-6 (C) transcript levels were quantified by RT-PCR. Mean values pooled from 5 animals per group are shown with standard deviations. *P < .05, **P < .01, ***P < .001. IL, Interleukin; TNFα, tumor necrosis factor-α; mRNA, messenger RNA. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Plasma sulforaphane levels in experimental groups. Animals were treated with sulforaphane or vehicle alone as a control and then subjected to CPB for 2 hours. Plasma samples were collected before sulforaphane or vehicle injection (baseline), immediately before CPB (cannulation), and at varying times after CPB initiation. Sulforaphane levels were determined by liquid chromatography mass spectrometry (not detected). Data were pooled from 5 animals, and mean levels ± standard deviations are shown. ND, Not detected. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Sulforaphane pretreatment reduces acute renal injury in response to CPB. Animals were treated with sulforaphane (animals 6-10) or vehicle alone as a control (animals 1-5) and then subjected to CPB for 2 hours. Renal tissues were harvested. A, Tissue sections were stained with hematoxylin–eosin before histologic assessment by an experienced pathologist who was blinded to the experimental design. Representative images are shown. Open arrows indicate abnormal tubular flattening and debris within the tubular lumina. B, Renal tissue lysates were tested by Western blotting using antibodies that recognize Thr180/Tyr182 phosphorylated p38, total p38, Ser536 phosphorylated RelA, or total RelA, and by using anti-α-tubulin antibodies to assess total protein levels. Lysates from phorbol myristyl acetate–stimulated porcine aortic endothelial cells (known to contain phosphorylated p38 and RelA) were tested in parallel and served as a positive control for antibody binding. C, IL-6, IL-8, and TNFα transcript levels were quantified by RT-PCR. Data were pooled from 5 animals, and mean values ± standard deviations are shown. CPB, Cardiopulmonary bypass; IL, interleukin; ns, not significant; PAEC, porcine aortic endothelial cell; PMA, phorbol myristyl acetate; TNFα, tumor necrosis factor-α; mRNA, messenger RNA. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Animals were treated with sulforaphane or vehicle alone as a control and then subjected to CPB for 2 hours. Myocardial and lung tissues were harvested. Tissue sections were stained with hematoxylin–eosin before histologic assessment by an experienced pathologist who was blinded to the experimental design. Representative images are shown. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Animals were treated with sulforaphane (animals 6-10) or vehicle alone as a control (animals 1-5) and then subjected to CPB for 2 hours. Myocardial and lung tissues were harvested. Tissue lysates were tested by Western blotting using antibodies that recognize Thr180/Tyr182 phosphorylated p38, total p38, Ser536 phosphorylated RelA, or total RelA, and by using anti-α-tubulin antibodies to assess total protein levels. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Animals were treated with sulforaphane or vehicle alone as a control and then subjected to CPB for 2 hours. Myocardial and lung tissues were harvested. IL-6, IL-8, and TNFα transcript levels were quantified by RT-PCR. Data were pooled from multiple animals, and mean values ± standard deviations are shown. IL, Interleukin; TNFα, tumor necrosis factor-α; mRNA, messenger RNA; ns, not significant. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 690-697.e3DOI: (10.1016/j.jtcvs.2013.12.048) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions