APOPTOSIS IN MYOCARDIAL INFARCTION

In 1972 Kerr Wyllie and Currie described for the first time the term of  “Apoptosis“(1).  They called “Apoptosis“ the programed nature of the observed cell death.  The term is derived from Greek: an  described the described the “dropping-  off “  or   “falling off “  of  leaves  from trees, or petals from flowers.   And  is  practically  the “suicides“  of  the  cells  in  an  altruistic  form  vs. the  necrotic  cells  that are dying from gross physical or chemical insults.
Apoptosis  have  been  described  in  neurodegenerative disordes like  Alzheimer disease(2); in anemic syndromes  with   low  eritropeyetin(3),  in  ulcer  peptic  disease  from  helicobacter  pylori(4), and in other patologies.   Also  in  experimental  myocardial infarction the apoptosis fenomena have bee recently described(5).  We  use  the  Caspasa inhibidor: Acey1-DEVD-aldehido labaell with Tecnisium –99-me-taestable for the “in vivo“ visualization of  the  apoptosis in  humans  with myocardial infarction: and the present report is the experience we make in this field.

MATERIAL AND METHODS:

We labell  the following compound whit Tecnesium-99-metastabale: Ac-Asp-Glu-Val-CHO-Tc-99m.
The  compound  is:  Acetyl-DEVD-Aldehyd   and   is   an   inhibitor  of  the  interleucin  convertidor  enzyme (ICE inhibitor)(6).  The method of labelling is whit Cloramin-T (7).  Whit this new radiopharmaco  we   take myocardial scan in-six healthy volunteers to know the normal image of apoptosis in heart and compared with six myocardial infarction (acute) in an  homologous  poblation.  Both patients and healthy  volunteers, were observed during six  months of  follow-up to determined the  possible reactions  that  the  new  radiopharmaco could do.

RESULTS:

Fig. No. 1 represents the common image of the apoptosis in myocardial infarction take inmediatly post endovenous inyection with ICE inhibitor radiolobell whit Tecnesium 99 metaestabel (Tc-99 m): with a SPECT  camera.   Contrarly to this image, the normal myocard, don´t  present apoptosis captation (“negative image”) vs. the “positive image” of apoptosis captation in myocardial infarction.
Nobody   of    the   patient   or   normal  volunteers  present  adverse  reaction  or  complications  for  the application of this new radiopharmaco and method in six months of  “follow-up”.

DISCUTION:

Altough apoptosis ocure in normal condition  in  some  tissues:  it  seems  entirely  feasible  that inapropiate apoptosis feature in many diseases, in combination  with  a  necrotic  form  of cell death. This may ocurr  in  myocardial  infarction  and  have  obviously exciting clinical implications.   In the present work we demostrated  that  there  is  apoptosis in human myocardial infarction: and can seen “in vivo“ with scan using an  anticaspasa  inhibitor labell whit radionuclides gamma emisors.  This open a great research oportunity to investigate  the  of  apoptosis insuch patology and if it is possible to mangement for the health of the  patients; but deserves more studies.
 
 

CONCLUSIONS:

1.  We labell the compound: “Acety- DEVD- Aldehyd“ with Tecnesium 99 metaestabel. Radiactive (anticaspasa inhibitor).
2.  Whit this new radiopharmaco we take myocardial scan in six healthy volunteers.
3.  We also take this studies in six patient with acute myocardial infarction.
4.  The  normal  volunteers  present a negative  image  of  apoptosis  of the  hearth:  there   was   no captation of the raidiopharmaco.
5.  The patient with myocardial infarction presents a “positive image“ of apoptosis with captation of the radiopharmaco.
6.  Both patients and volunteers were observed during  six  month  of   “follow-up”  and  don’t   present adverse reactions or complications whit the new method and radiopharmaco.
7.  The  obviously  clinical  implication  of  this  findings; and the simplicity of the method open a new great  research  opportunity  in  clinical  cardiology;  that  requiered  much  more  work for the clear dilucidation of apoptosis implication in myocardial infarction.
 
ABSTRACT:

We  labell  an  anticaspasa  inhibitor compound with radionuclides (Tecnesium 99 metestabel) and take scan    image  in  six  normal  volunteers  and  six  patients  with  acute  myocardial  infarction.   The  normal volunteers  don’t  have captation of the radiactive anticaspasa (“Negative image“) vs. the “positive image“ that  occure in the myocardial infarction in all the patients studied.   No body of the patients or volunteers have reactions  or  complication  during  six  months  of   “follow- up“  after  the use of the new radiopharmaco and method.  The  roll  and  clinical  implication  of apoptosis in myocardial infarction and the facilities of his “in vivo” visualization without damage, deserves more research in this exciting new camp of cardiology.

BIBLIOGRAPHY:

1.- Kerr. J.F.R.; Wyllie. A.H.: Currie. A. R. Apoptosis. Br. J. Cancer 26. 239-257 ( 1972): 2.- Choi, D.W. Current Opinons in Neurobiology 6. 667-672 ( 1996                                    3.- Genong F. W. Review of medical physiology.  Capter VI.  Circulation Appleton & Lange ( 1997 ). 18 th. Ed. (1997).
4.- Genta Robert M. Helicobacter fylori. Informmation, mucosal  damage and apoptosis.  Gasstroenterology 113 : 552-s-55. (1997).
5.- Akiyama R. et. Al Apoptosis in experimental myocardial infarction. Tissue Cell. Dec. 29  (6). 733-43. (1997).
6.- Tewari M. Quan. L. T. O´Rouke K. Et. Al. Call 81. 801-809 (1995).
7.- Early Pal J. & Bruce Sodee Principles and practice of Nuclear Medicine. 2do. Ed. Capter 8; Radiopharmaceuticals. Mosby ed. (95).