Grape Seed Extract-Cardiac Impact and Drug Interaction

描述（由申请人提供）：商业上报道抗氧化剂可以减缓心脏病的进展或严重程度。因此，许多接受传统医疗保健的患者都在服用维生素、矿物质和植物类抗氧化剂补充剂。然而，人们对其潜在的作用机制知之甚少，混淆了安全性和有效性评估。植物药是植物化学物质的复杂混合物，其中任何一种都可能与处方药物相互作用并改变其生物效应。在某些疾病状态或医疗干预中，这些相互作用可能对患者的健康和治疗有害。心脏病通常涉及心脏缺血/再灌注损伤。缺血/再灌注损伤发生在心脏首次缺氧后再供氧，产生损伤性活性氧（ROS）。缺血/再灌注损伤发生在心脏病的各个阶段——以轻微的慢性充血性心力衰竭的方式，或以急性的方式，如心脏外科手术。缺血/再灌注损伤为

DESCRIPTION (provided by applicant): Antioxidants are commercially reported to slow the advance or severity of heart disease. As such, many patients of conventional health care are consuming antioxidant supplements from vitamins, minerals, and botanicals. However, little is understood of their potential mechanisms of action, confounding safety and efficacy evaluations. Botanicals represent a complex blend of phytochemicals, any of which may interact with prescribed drug regimens and alter their biological effects. In certain diseased states or medical interventions, these interactions could be deleterious to patient health and treatment. Heart disease commonly involves cardiac ischemia/reperfusion damage. Ischemia/reperfusion damage occurs when the heart is first denied then re-supplied with oxygen, generating damaging reactive oxygen species(ROS). Ischemia/reperfusion injury occurs across the span of heart disease - in a subtle, chronic fashion with congestive heart failure, or in an acute fashion as with cardiac surgical procedures. Ischemia/reperfusion damage is lowered through preconditioning, which occurs through brief periods of oxygen deprivation or through pretreatment with drugs such as opioids. Opioid pain-killers are used in emergent and surgical settings. One mechansism of opioid cardioprotection involves the generation of low levels of preconditioning ROS. Thus, ROS-quenching antioxidants may alter opioid cardioprotection. Synthetic antioxidants have been shown to experimentally decrease opioid cardioprotection, but no published studies have investigated the potential impact of dietary antioxidant supplementation. Our studies will utilize a standardized grape seed extract IH636, rich in antioxidant proanthocyanidins. Using rabbit cardiac myocyte and whole heart procedures, we will determine if three weeks of IH636 supplementation affects the expression of cardiac stress defense proteins or antioxidant reserve. We will also determine cardiac membrane integrity, cellular metabolism, heart function, and overall viability. In concert, we will evaluate cardiac effects of IH636 under ischemia/reperfusion conditions using the same endpoints. Finally, using knowledge of opioid mechansisms, our proposed studies will evaluate if IH636 supplementation interacts with opioid cardioprotection, and the nature of this interaction. For grape seed extract supplementation, both mechanisms of action and opioid interaction are currently unknown. Considering the increasing use of this botanical extract, improved knowledge of safety and efficacy is imperative.