Role of Fingolimod in Attenuation of Lymphocyte Count Leading to Reduced Apoptosis in Myocardial Ischemia Reperfusion Injury

Background: FTY720 (Fingolimod) is a drug having immune-regulatory properties. It is a structurally analogous to Sphingosine-1-phosphate. S1P is a biologically active lipid mediator in various inflammatory pathways. Aim: To investigate the effects of FTY720 on myocardial ischemia reperfusion (IR) injury in cardiac surgery. Study design: Experimental study Place and duration of study: Aga Khan University, Karachi and Khyber Medical University, Peshawar Pakistan from 1st January 2017 to 31st December 2020 with collaboration of University of Verona, Italy. Methodology: Twenty Sprague-Dawley rats were segregated into two groups; treatment and control. In treatment group received FTY720 at 1 mg/kg, intravenously 15 minutes prior to the experiment. Both groups were exposed to myocardial ischemia (30 m) reperfusion (2 h). Blood gas analysis, lymphocyte count, myeloperoxidase assay and TUNEL assay were performed and analyzed to observe the effect of FTY720 on neutrophil infiltration and apoptosis. Results: FTY720 treated group had improvement in blood gas levels in contrast to the control, treatment group also experienced decrease in neutrophil infiltration, lymphocyte count and myeloperoxidase enzyme expression. Conclusions: FTY720 pre-treatment reduce lymphocyte count that leads to reduce the level of apoptosis and salvage the myocardial damage incurred by ischemia reperfusion.