Cholinergic action of spleen‐derived cardioprotective factors
Authors: Lieder Helmut R. , Braczko Felix , Heusch Gerd , Kleinbongard Petra 
Published: May 2022

IntroductionThere is an ambivalent relationship between the spleen and the heart in myocardial infarction (Circ Res 124; 2019; 26‐8). Sympathetic activation of the spleen initially increases myocardial inflammatory infiltration but resolves it later by initiating a myocardial healing response. Vagal activation of the spleen induces the release of cardioprotective factors: Perfusion of an isolated rat spleen with the vagomimetic carbachol resulted in the release of factors which then reduced infarct size (IS) in an isolated perfused rat heart.AimTo characterize cardioprotection of spleen‐derived factors, with a focus on their cholinergic action.MethodsRat spleens and hearts were isolated and buffer‐perfused at constant pressure. Isolated spleens were either challenged by infusion of saline (as control) or the vagomimetic carbachol (500 pmol/L), and splenic effluate (SEff; 100 mL) was sampled after saline infusion (SEffsaline) or carbachol infusion (SEffcarbachol), respectively. Cell‐free SEff was prepared by centrifugation and filtration. SEffsaline or SEffcarbachol was infused into isolated hearts which were then subjected to 30 min global ischemia and 120 min reperfusion (I/R). In subsets of experiments, the hearts were pretreated with the nicotinic receptor antagonist hexamethonium (50 µmol/L) or the muscarinic receptor antagonist atropine (100 pmol/L). IS was demarcated by triphenyltetrazolium chloride staining and calculated as percent of ventricular mass. To study the relevance of spleen‐derived protection on the cardiomyocyte level, adult rat ventricular cardiomyocytes were prepared. Cells were incubated for 30 minutes with SEffsaline or SEffcarbachol, respectively, and then subjected to 30 min hypoxia/ 5 min reoxygenation (H/R) or exposed to SEffsaline or SEffcarbachol for 35 minutes as time control (TC). Since nicotinic and muscarinic receptors are also expressed on cardiomyocytes, all experiments were repeated after pretreatment with hexamethonium (1 µmol/L) or atropine (100 nmol/L). Cardiomyocyte viability was quantified before (baseline) and after H/R or TC, as the percent fraction of rod‐shaped, unstained (5% trypan blue) cells over all cells. The estimated final concentration of carbachol in the SEffcarbachol of ≤10 pmol/L and the SEffsaline did neither reduce IS in isolated perfused rat hearts nor improve cardiomyocyte viability in isolated rat cardiomyocytes.ResultsWith SEffsaline, IS was 34±7%. With SEffcarbachol, IS was reduced to 19±8%. Hexamethonium or atropine had no impact on IS per se in hearts with SEffsaline (33±8%; 34±6%), but attenuated the cardioprotection by SEffcarbachol (27±10%; 26±10%; Figure A). The viability of cardiomyocytes subjected to H/R was better preserved with SEffcarbachol than with SEffsaline or saline alone. Again, this protection was attenuated by hexamethonium or atropine (Figure B, insert).ConclusionThe cardioprotection by spleen‐derived factors, which were released in response to the vagomimetic carbachol, is mediated through nicotinic and muscarinic receptors within the heart. Apparently, this protection does not need to involve neuronal structures within the myocardium – nicotinic and muscarinic receptors on cardiomyocytes per se mediate protection.