Therapeutic Effects of Procainamide on Endotoxin-Induced Rhabdomyolysis in Rats

PLoS One. 2016 Feb 26;11(2):e0150319. doi: 10.1371/journal.pone.0150319. eCollection 2016.

Abstract

Overt systemic inflammatory response is a predisposing mechanism for infection-induced skeletal muscle damage and rhabdomyolysis. Aberrant DNA methylation plays a crucial role in the pathophysiology of excessive inflammatory response. The antiarrhythmic drug procainamide is a non-nucleoside inhibitor of DNA methyltransferase 1 (DNMT1) used to alleviate DNA hypermethylation. Therefore, we evaluated the effects of procainamide on the syndromes and complications of rhabdomyolysis rats induced by lipopolysaccharide (LPS). Rhabdomyolysis animal model was established by intravenous infusion of LPS (5 mg/kg) accompanied by procainamide therapy (50 mg/kg). During the experimental period, the changes of hemodynamics, muscle injury index, kidney function, blood gas, blood electrolytes, blood glucose, and plasma interleukin-6 (IL-6) levels were examined. Kidneys and lungs were exercised to analyze superoxide production, neutrophil infiltration, and DNMTs expression. The rats in this model showed similar clinical syndromes and complications of rhabdomyolysis including high levels of plasma creatine kinase, acute kidney injury, hyperkalemia, hypocalcemia, metabolic acidosis, hypotension, tachycardia, and hypoglycemia. The increases of lung DNMT1 expression and plasma IL-6 concentration were also observed in rhabdomyolysis animals induced by LPS. Treatment with procainamide not only inhibited the overexpression of DNMT1 but also diminished the overproduction of IL-6 in rhabdomyolysis rats. In addition, procainamide improved muscle damage, renal dysfunction, electrolytes disturbance, metabolic acidosis, hypotension, and hypoglycemia in the rats with rhabdomyolysis. Moreover, another DNMT inhibitor hydralazine mitigated hypoglycemia, muscle damage, and renal dysfunction in rhabdomyolysis rats. These findings reveal that therapeutic effects of procainamide could be based on the suppression of DNMT1 and pro-inflammatory cytokine in endotoxin-induced rhabdomyolysis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis / drug therapy
  • Acidosis / etiology
  • Animals
  • Bicarbonates / blood
  • Biomarkers
  • Creatinine / blood
  • DNA (Cytosine-5-)-Methyltransferase 1
  • DNA (Cytosine-5-)-Methyltransferases / antagonists & inhibitors*
  • DNA (Cytosine-5-)-Methyltransferases / biosynthesis
  • DNA Methylation / drug effects
  • DNA Methyltransferase 3A
  • DNA Methyltransferase 3B
  • Drug Evaluation, Preclinical
  • Electrolytes / blood
  • Endotoxemia / complications
  • Endotoxins / toxicity*
  • Hydralazine / pharmacology
  • Hydralazine / therapeutic use
  • Hypertension / drug therapy
  • Hypertension / etiology
  • Interleukin-6 / blood
  • Kidney / immunology
  • Kidney / pathology
  • Kidney / physiopathology
  • Lung / enzymology
  • Lung / pathology
  • Male
  • Muscle, Skeletal / pathology
  • Neutrophils / pathology
  • Procainamide / pharmacology
  • Procainamide / therapeutic use*
  • Random Allocation
  • Rats
  • Rats, Wistar
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / chemically induced
  • Rhabdomyolysis / complications
  • Rhabdomyolysis / drug therapy*
  • Superoxides / analysis
  • Tachycardia / drug therapy
  • Tachycardia / etiology

Substances

  • Bicarbonates
  • Biomarkers
  • Electrolytes
  • Endotoxins
  • Interleukin-6
  • Superoxides
  • Hydralazine
  • endotoxin, Escherichia coli
  • Creatinine
  • DNA (Cytosine-5-)-Methyltransferase 1
  • DNA (Cytosine-5-)-Methyltransferases
  • DNA Methyltransferase 3A
  • Dnmt1 protein, rat
  • Procainamide

Grants and funding

This study was supported by grants 103-M023 (CCW) and 103-M025 (CCS) from National Defense Medical Center, R.O.C., Taiwan and MOST 103-2320-B-016-020 (CCW) from the Ministry of Science and Technology, R.O.C., Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.