The mitochondria-targeting peptide elamipretide diminishes circulating HtrA2 in ST-segment elevation myocardial infarction

What Was Tested

Researchers studied SS-31 (Elamipretide) in this randomized controlled trial publication.

The extent of myocardial damage in patients with ST-segment elevation myocardial infarction (STEMI) depends on both the time to reperfusion as well as injury induced by ischaemia-reperfusion resulting in a cascade of cellular and humoral reactions.

As a consequence of ischaemia-reperfusion in the heart, the high-temperature requirement serine peptidase 2 (HtrA2) is translocated from the mitochondria to the cytosol, whereupon it induces protease activity-dependent apoptosis mediated via caspases.

Who Took Part

According to the abstract, 10 patients were involved.

By PubMed's age tags, the people studied were middle-aged adults and older adults, both men and women.

After informed consent, peripheral blood was obtained from patients (n=19) with first-time acute anterior STEMI after percutaneous coronary intervention.

Within this group, 10 of the patients received the mitochondria-targeting peptide elamipretide (phase 2a clinical study EMBRACE (NCT01572909)).

How the Study Was Run

In design terms this was a randomized and placebo-controlled study.

The patients were allocated by chance, so the SS-31 (Elamipretide) group and the comparison group should start out alike.

A placebo (an inactive look-alike) gave the SS-31 (Elamipretide) group a baseline to be compared against.

Blood was also obtained from a control group of healthy donors (n=16).

The serum level of HtrA2 was measured by an enzyme-linked immunosorbent assay (ELISA).

In a murine model of myocardial ischaemia-reperfusion injury, HtrA2 was determined in plasma by ELISA after left anterior descending artery occlusion.

What Was Measured

The researchers examined the serum level of HtrA2 as a potentially novel biomarker for mitochondrial-induced cardiomyocyte apoptosis.

PubMed files the paper under topics including Apoptosis, Biomarkers, High-Temperature Requirement A Serine Peptidase 2, Mice, Mitochondria, Myocardial Infarction and Myocardium.

The authors tagged it with the keywords Elamipretide, HtrA2, ST-segment elevation myocardial infarction and ischaemia reperfusion injury.

What This Means in Plain Language

The paper is a randomized and placebo-controlled study of SS-31 (Elamipretide) in 10 patients.

With fewer than 40 people, it is a small study, so it is better read as an early signal for further research than as a settled answer.

Its findings take up roughly 9 sentences of the abstract and are left out here on purpose; the source paper is the place to read them.

The publication is from 2019 (European heart journal. Acute cardiovascular care), a journal based in England.

More context: the SS-31 (Elamipretide) compound page, all human trials.