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Selective Pharmacological Blockade of GPR39 Markedly Reduces No Reflow and Infarct Volumes in a Rat Acute Myocardial Infarction When Administered Prior to Reperfusion

Carmen Methner, Mary Plascencia, allura thompsoniD, Lijuan Liu, Masaki KajimotoiD, D. Elizabeth LeiD, Agostino CianciulliiD, Annalisa Pellacani, Jessica Franchi, chiara marcheselli, Alberto Parazzoli, Fabrizio MicheliiD, Sanjiv KauliD

PDFDOI

Abstract

Our aim was to determine whether selective pharmacological blockade of GPR39 by the novel drug, VC108, reduces no reflow (NRV) and infarct (INV) volumes during acute myocardial infarction (AMI). Immuocytochemistry and qPCR of isolated rat cardiac cells as well as immunohistochemistry and western blot of rat myocardium was performed for presence of GPR39. Rats underwent 1 h of coronary occlusion and 1 h of reperfusion. Groups 1 and 2 animals received drug/vehicle prior to or during coronary occlusion. Groups 3 and 4 received drug/vehicle 5 min prior to or 30 min after reperfusion. Readouts also included tissue pO2, hemodynamics, and wall thickening. In Groups 5 and 6 animals, drug was injected for measurement of plasma and tissue levels. Immunocytochemistry and qPCR of cells and immunohistochemistry and western blot of tissue revealed GPR39 expression in all cardiac cells analyzed as well as entire myocardial tissue. There was marked reduction in NRV and INV in groups 1 and 3 animals where both were measured and in Group 2 where INV was measured. In contrast, Group 4 animals failed to show reduction in NRV and INV with the drug. The reduction in NRV in all animals was associated with higher tissue pO2 in VC108 compared to vehicle treated animals. Similar results were obtained for INV in only in Group 2 animals. In Group 3 animals direct cardiomyocyte effect of VC108 was seen in myocardium as evidenced by reduced necrosis and apoptosis. We conclude that VC108 is very effective in reducing INV and NRV in an AMI model when given before coronary occlusion or just prior to reperfusion (the latter being clinically more relevant) both in male and female rats. This effect is not seen after reperfusion. VC108 acts by blocking GPR39, resulting in vasodilation through pericyte and VSMC relaxation. It also directly protects cardiomyocytes by preventing downstream effects of GPR39 stimulation. New and NoteworthyGPR39 is the receptor for 15-HETE, which is a vasoconstrictor with direct cardiomyocyte detrimental effects. Pharmacological inhibition of GPR39 by a novel inhibitor, VC108, reduces coronary no reflow after acute myocardial infarction by relaxing contracted pericytes surrounding capillaries, whereby increasing oxygen delivery. GPR39 inhibition also reduces necrosis and ferroptosis by interrupting aberrant downstream signaling responsible for cell death. Hence, pharmacological inhibition of GPR39 by VC108 offers a novel treatment of acute myocardial infarction. Graphical AbstractProposed mechanism of action of VC108 when given prior to and during coronary occlusion based on our results. The drug inhibits the action of the vasoconstrictor, 15-HETE, on GPR39. This causes vasodilation by relaxing contracted pericytes and increasing capillary perfusion, resulting in increased tissue pO2 and reduction in no reflow (left side). When tissue pO2 is not associated with necrosis, GPR39 inhibition by VC108 directly affects cardiomyocytes by inhibiting downstream signaling of GPR39 present in cardiomyocytes that can lead to cell injury and death. Hence, less necrosis and apoptosis are noted in VC108 versus vehicle treated animals. Created in https://BioRender.com. O_FIG O_LINKSMALLFIG WIDTH=137 HEIGHT=200 SRC="FIGDIR/small/699339v2_ufig1.gif" ALT="Figure 1"> View larger version (29K): org.highwire.dtl.DTLVardef@1058995org.highwire.dtl.DTLVardef@8bc0ceorg.highwire.dtl.DTLVardef@11f44e0org.highwire.dtl.DTLVardef@1e2e337_HPS_FORMAT_FIGEXP M_FIG C_FIG

In-depth summary

Claude Sonnet 4.6 · xhigh effort · 8 Nov 2026 · from the full text of version 2 (14 Aug 2026) · CC0 1.0

Single intravenous bolus of the GPR39 antagonist VC108 shrank infarct and no-reflow volumes in rat myocardial infarction when given before reperfusion, but not 30 min after reperfusion.

Coronary no reflow persists after reopening an infarct-related artery, and thrombus removal has not fixed it while tested vasodilators are limited by intracoronary delivery or systemic adverse effects. This work tests whether a selective intravenous GPR39 blocker can relax pericytes and also protect cardiomyocytes.

Key results

  1. ShownVC108 at 0.5 mg/kg lowered infarct volume (as a fraction of ischemic risk volume) when given before coronary occlusion, 15 min into occlusion, or 5 min before reperfusion.

    INV/IRV significantly smaller than vehicle: Group 1A n=16 vs 11, Group 2 n=12 vs 14, Group 3A n=14 vs 15 (unpaired t-test). Exact means and p-values are not given in the text. · Groups 1 Animals; Group 2 animals; Groups 3 Animals; Figure legends

  2. ShownNo reflow volume fell in a dose-dependent way with a pre-reperfusion bolus, reaching a plateau at 0.3 mg/kg. Pre-occlusion dosing (Group 1B) also reduced it.

    NRV/IRV at 0.1 mg/kg (about 80% receptor occupancy) did not differ from vehicle. 0.3, 0.5 and 1.0 mg/kg each gave >50% reduction, with no differences among them. n=15 vehicle, 15, 11, 13, 12 per dose. Group 1B: n=11 vs 11. · Groups 1 Animals; Groups 3 Animals; Figure legends

  3. ShownGiving VC108 30 min after reperfusion had no effect on either infarct or no reflow size, so the therapeutic window closes after reperfusion.

    Group 4A INV/IRV similar for VC108 (n=19) vs vehicle (n=19); Group 4B NRV/IRV similar for VC108 (n=19) vs vehicle (n=15). Tissue pO2 was unrelated to either ratio. · Group 4 animals; Discussion; Figure legends

  4. SuggestedIn a small subset, VC108 given before reperfusion reduced histologic markers of necrosis and apoptosis but not iron staining (ferroptosis), pointing to a cardiomyocyte-level effect beyond perfusion.

    Group 3C, n=6 VC108 vs n=6 vehicle; propidium iodide and annexin V reduced on a semi-quantitative 0 to +4 blinded score; no iron-stain difference. No test statistics reported. · Groups 3 Animals; Measurement of Necrosis, Apoptosis, and…; Discussion

  5. ShownGPR39 was detected in rat cardiomyocytes as well as pericytes and vascular smooth muscle cells. Cardiomyocyte mRNA was comparable to smooth muscle cells, while protein was lower than mRNA.

    qPCR (ΔΔCt, β-actin) on whole heart n=6, cardiomyocytes n=5, pericytes n=5, VSMCs n=5; Western blot n=3; ICC and IHC colocalization with troponin I. · In vitro Experiments; qPCR; Discussion

Methods, data and reproducibility

Anesthetized Sprague Dawley rats had 60 min of coronary occlusion, followed by 60 min of reperfusion in all but Group 5. Groups 1 to 4 were randomized to a single VC108 or vehicle bolus at different times. Infarct (TTC), no reflow (Thioflavin-S) and risk area (Evans blue) were quantified post mortem; tissue pO2 and drug levels were also measured.

  • In vitro GPR39 expression: cardiomyocyte, pericyte and VSMC isolation, ICC, IHC, qPCR, Western blot · Rat (Sprague Dawley) · n = 12 animals (6 males, 6 females)
  • In vivo AMI efficacy groups 1 to 4 (vehicle vs VC108, varied timing and dose) plus Group 3C histopathology · Rat (Sprague Dawley) · n = 357 underwent occlusion; 280 survived (22% mortality)
  • Plasma and tissue drug levels after dosing during occlusion (Group 5) or before reperfusion (Group 6) · Rat (Sprague Dawley) · n = 6 animals per dose in Group 5
  • Pharmacokinetic studies of VC108 at Aptuit (single IV dose and 14-day repeat dosing) · Rat (Sprague Dawley) · n = 63 animals
  • Source data for supplemental material · 10.6084/m9.figshare.32948612
Methods & tools
Langendorff perfusion, TaqMan qPCR (QuantStudio 7 Flex), Oxyphor G4 phosphorescence oximetry (OxyLED), TTC staining, Thioflavin-S, Evans blue, 2D echocardiography (Sonos 5500), Propidium iodide, Annexin V staining, Iron stain kit, LC-MS/MS (AB Sciex 6500QTrap), Mann-Whitney, ANOVA, unpaired t-test
Reagents & environment
Pressure recording used AxoScope 10.7; no analysis code, containers or software environment for statistics are stated.
Reproducibility gaps
The senior author provides source data on request; a figshare DOI (10.6084/m9.figshare.32948612) is listed for the supplemental source data. No code repository is mentioned. The results text gives no exact means or p-values.
Limitations (5)
  • Tissue pO2 by Oxyphor reflects only the injected region, not the whole ischemic risk area, and tissue perfusion was not measured directly. · stated by the authors
  • Infarct and no reflow cannot be measured in the same animal, so separate animal sets were used for each readout. · stated by the authors
  • Ferroptosis assessment was limited to iron staining without glutathione or GPX4 measurement, and inflammation was not assessed. · stated by the authors
  • Statistical reporting is inconsistent: Methods cite Mann-Whitney testing while figure legends cite unpaired t-tests. The results text gives no exact p-values or effect sizes for the main comparisons, and the necrosis and apoptosis scores come from n=6 per arm. · noted in this summary
  • Only one acute endpoint (1 h reperfusion) in a single rodent species was studied, and the authors include the developing company's founder; there is no independent replication or long-term outcome data. · noted in this summary

Read this if you study coronary no reflow, pericyte-targeted therapy, or GPR39 pharmacology and want the timing, dose and exposure data for an intravenous antagonist in a rat infarct model.

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