BBB seminar: Anne K. Jonassen
The cardioprotective role of insulin: Identification and validation of novel therapeutic targets regulated by insulin therapy at myocardial reperfusion
Anne K. Jonassen
Heart and Circulatory Research Group, Department of Biomedicine, University of Bergen
Cardiovascular disease remains a leading cause of death worldwide. Impaired coronary circulation in the heart following a myocardial ischemic episode will lead to compromised hemodynamic function and ultimately cell death. Coronary reperfusion is the only means of limiting infarct size, provided that it occurs early after coronary occlusion, but may paradoxically directly result in tissue injury (lethal reperfusion injury). The management of patients with acute myocardial infarction (AMI) has improved dramatically with the widespread use of thrombolytic and antiplatelet therapy as well as mechanical disruption of the occlusive coronary thrombus or plaque. Even so, attention has turned to adjunctive pharmacologic treatments to enhance myocardial tolerance to ischemia/reperfusion induced stress. This strategy is being pursued in an attempt to further reduce mortality in patients undergoing reperfusion therapy.
In studies conducted during the last few years, we have demonstrated that insulin therapy during reperfusion can activate cell survival programs, leading to reduced infarct size following ischemia and reperfusion, and thereby representing a potential adjunct to post-ischemic therapy. Currently, a translational approach is being pursued for further development of new therapeutic protocols for the identification and validation of novel therapeutic targets in the treatment of AMI and reperfusion injury.