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Integrin ₃ Blockade With Abciximab and Protection From Myocardial Ischemic Events

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To the Editor.—As reported by Dr Topol and colleagues¹ and Drs Fischman and Savage,² the mechanism by which the blockage of ₃ integrin with abciximab results in improved cardiac preservation is unclear. We suggest a possibility not mentioned in their speculations: ₃ integrin was shown to be a mediator in the transport of iron into cells independent of transferrin. Therefore, blockage of ₃ integrin might be expected to reduce intracellular concentrations of iron.^3-4 Iron mediates free radical formation and reperfusion injury. Iron chelators such as desferrioxamine, which diminish iron transport into cells, have a protective effect on cardiac damage during reperfusion⁵ and may be analogous to the use of substances that impair uptake of iron into cells by ₃ integrin. Protection of the cell from exposure to iron may be an important factor in the beneficial results of ₃ integrin blockage as reported by Topol et al.¹

Marcel E. Conrad, MD; Jay N. Umbreit, . . . [Full Text of this Article]