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            <title xml:lang="en">Neutral sphingomyelinase inhibition participates to the benefits of N-acetylcysteine treatment in post-myocardial infarction failing heart rats.</title>
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                <title level="j">Journal of Molecular and Cellular Cardiology</title>
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                  <biblScope unit="volume">43</biblScope>
                  <biblScope unit="issue">3</biblScope>
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                <term xml:lang="en">tumor necrosis factor-alpha</term>
                <term xml:lang="en">chronic heart failure</term>
                <term xml:lang="en">glutathione</term>
                <term xml:lang="en">N-acetylcysteine</term>
                <term xml:lang="en">neutral sphingomyelinase</term>
                <term xml:lang="en">tumor necrosis factor-alpha.</term>
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              <p>Deficiency in cellular thiol tripeptide glutathione (l-gamma glutamyl-cysteinyl-glycine) determines the severity of several chronic and inflammatory human diseases that may be relieved by oral treatment with the glutathione precursor N-acetylcysteine (NAC). Here, we showed that the left ventricle (LV) of human failing heart was depleted in total glutathione by 54%. Similarly, 2-month post-myocardial infarction (MI) rats, with established chronic heart failure (CHF), displayed deficiency in LV glutathione. One-month oral NAC treatment normalized LV glutathione, improved LV contractile function and lessened adverse LV remodelling in 3-month post-MI rats. Biochemical studies at two time-points of NAC treatment, 3 days and 1 month, showed that inhibition of the neutral sphingomyelinase (N-SMase), Bcl-2 depletion and caspase-3 activation, were key, early and lasting events associated with glutathione repletion. Attenuation of oxidative stress, downregulation of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) and its TNF-R1 receptor were significant after 1-month NAC treatment. These data indicate that, besides glutathione deficiency, N-SMase activation is associated with post-MI CHF progression, and that blockade of N-SMase activation participates to post-infarction failing heart recovery achieved by NAC treatment. NAC treatment in post-MI rats is a way to disrupt the vicious sTNF-alpha/TNF-R1/N-SMase cycle.</p>
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