Sodium thiosulfate post-conditioning protects rat hearts against ischemia reperfusion injury via reduction of apoptosis and oxidative stress.

Pharmacological agents given at the time of reperfusion can protect the heart from ischemia reperfusion injury (IR). Being a calcium chelator, antioxidant and mitochondrial potassium channel modulator, sodium thiosulfate (STS) was chosen to treat myocardial IR injury. Isolated rat heart model was used to induce IR injury and the hemodynamic changes were monitored using PowerLab (AD Instruments, Australia). STS at a dose of 1 mM given at the early stage of reperfusion significantly reduced the infarct size and recovered the failing heart from reperfusion injury. Its action was based on reduction of apoptosis as evidenced from decreased activity of caspase-3 in the myocardium, lowered expression of casp-3 and PARP, which was supported by absence of significant DNA fragmentation and histological derangement of fibers compared to the injury control. An evaluation of the inter-dependency of H2S and STS biosynthesis in the STS treated groups showed no significant changes in the level of STS, H2S and rhodanese, except the cystathionine gamma lyase activity that improved upon treatment. The mechanism underlying the antiapoptotic, mitochondrial preservation and antioxidant effects of STS were related to the biosynthesis of H2S. The fact that inhibition of cystathionine gamma lyase limited the STS mediated cardio protection supports this observation.