• Joseph M McClung, Darin Van Gammeren, Melissa A Whidden, Darin J Falk, Andreas N Kavazis, Matt B Hudson, Ghislaine Gayan-Ramirez, Marc Decramer, Keith C DeRuisseau, and Scott K Powers.
• Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, FL, USA. joseph.mcclung@duke.edu
• Crit. Care Med. 2009 Apr 1;37(4):1373-9.

ObjectiveTo investigate whether apocynin protects the diaphragm from wasting and oxidative stress during mechanical ventilation (MV).DesignProspective, randomized, controlled study.SettingResearch laboratory.SubjectsAdult female Sprague-Dawley rats.InterventionsRats were randomly assigned to one of five experimental groups: 1) acutely anesthetized control, 2) spontaneous breathing control, 3) spontaneously breathing control with administration of the nicotinamide adenine dinucleotide phosphate oxidase inhibitor, apocynin, 4) mechanically ventilated, and 5) mechanically ventilated with apocynin.Measurements And Main ResultsApocynin attenuated MV-induced diaphragmatic oxidative stress, contractile dysfunction, and type I, type IIa, and type IIb/IIx myofiber atrophy. The apocynin-induced attenuation of MV-induced diaphragmatic atrophy and contractile dysfunction occurred in conjunction with a reduction in the small increase in nicotinamide adenine dinucleotide phosphate oxidase activity as well as the preservation of total glutathione levels, glutathione peroxidase protein abundance, and a decrease in the activation of the cysteine proteases, calpain-1 and caspase-3. Interestingly, independent of MV, apocynin increased diaphragmatic levels of calpastatin, an endogenous calpain inhibitor. Furthermore, treatment of skeletal muscle cells in culture (C2C12 myotubes) with apocynin resulted in an increase in both calpastatin mRNA levels and protein abundance.ConclusionsOur results suggest that the protective effects of apocynin on the diaphragm during prolonged MV seem to be linked to both its functions as an antioxidant and role in cellular signaling regulating the cysteine protease inhibitor calpastatin.

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