Mifepristone and Its Role to Induce Apotosis In Cardiomyocetes

What Is Mifepristone?

Mifepristone is a medication used to terminate a pregnancy during its early stages, mainly the tenth week of pregnancy or 70 days starting from the first day of the last menstrual cycle. It inhibits progesterone, the female hormone needed for the pregnancy's progression, thus causing abortion. Mifepristone is a synthetic drug that produces anti-glucocorticoid and anti-progesterone effects. The medication is only available at the doctor's advice and can be taken under proper medical guidance only. It is not available over the counter at pharmacies without an appropriate prescription.

What Is Apoptosis in Cardiomyocytes?

Apoptosis is the natural cell death in multicellular organisms and is usually not similar to cell necrosis caused by myocardial infarction. Instead, these cardiomyocytes are responsible for forming septa between the valves and heart chambers, leading to apoptosis in the heart and causing congenital diseases.

How Does Mifepristone Induce Apoptosis in Cardiomyocytes?

Mifepristone induces apoptosis in cardiomyocytes in the following ways:

• First, Mifepristone, used for abortion, inhibits the action of the progesterone hormone, which is essential for pregnancy.

• Progesterone protects the cardiomyocytes against apoptosis or cell death in a dose and time-dependent manner. The hormone also causes progesterone receptors to relocate in 20 minutes to preserve the cardiomyocytes from apoptosis.

• The progesterone antagonist, Mifepristone, inhibits the progesterone anti-apoptotic effect.

• Therefore, Mifepristone induces apoptosis in cardiomyocytes by acting against the progesterone hormone activity during pregnancy.

• Apoptosis is the pathological cause of heart failure and cardiac injury. Therefore, cell death caused due to the inhibition of the progesterone hormone induced by Mifepristone can lead to cardiac dysfunction.

What Are the Other Causes of Cardiomyocyte Apoptosis?

• Myocardial infarction causes the metabolism of cellular energy, thus, leading to both apoptosis and necrotic cell death.

• Ischemic heart conditions can also cause apoptosis and cardiomyocyte necrosis in vitro because of a lack of necessary glucose, oxygen, and serum levels.

• Also, aging can cause the loss of myocardial cells leading to apoptosis of cardiomyocytes. This condition further leads to cardiac failure.

• Low incidences of apoptosis occur in blood vessels, but the condition can become aggressive with factors like inflammatory cells, inflammatory cytokinin, cholesterol levels, and blood flow and pressure. These alter the normal apoptosis in various disease conditions.

What Are the Diseases Associated With Cardiomyocyte Apoptosis?

The diseases associated with cardiomyocyte apoptosis are as follows:

• Ischemic cardiomyopathy.

• Myocarditis.

• Acute myocardial infarction.

• Long QT syndrome.

• Heart block.

• Idiopathic dilated cardiomyopathy.

• Pre-excitation syndromes.

• Atherosclerosis.

• Arterial aneurysm formation.

• Vascular graft rejection.

• Congenital atrioventricular heart block.

What Are the Uses of Mifepristone?

Mifepristone is used for the following purposes:

• Abortion.

• Brain tumors.

• Endometriosis (tissue growth outside the uterus).

• Inducing labor.

• Fibroids (noncancerous tumors inside the uterus).

What Are the Side Effects Caused by Mifepristone?

Side effects caused by mifepristone are:

• Vaginal itching and burning sensation.

• Frequent vaginal discharge.

• Vaginal bleeding.

• Pelvic pain.

• Muscle cramps.

• Headache.

• Weakness and tiredness.

• Dizziness.

• Nausea and vomiting.

• Pale skin.

• Pain during sexual intercourse.

• Shortness of breath.

• Infection after abortion.

• Allergic reactions.

• Diarrhea.

• Low blood pressure.

• Rapid heartbeat.

• Unconsciousness.

What Is the Contraindication of Mifepristone?

Mifepristone is contraindicated in the following conditions:

• Ectopic pregnancy.

• Adrenal problems.

• Chronic adrenal failure.

• Abnormal vaginal bleeding.

• Heart failures.

• Hypotension.

• Autoimmune disorders.

• Cancer or endometrial hyperplasia.

• Severe anemia and blood clotting disorders.

• Hypokalemia.

• Liver disease.

• Diabetes.

• Kidney disease.

• Hypertension.

Why Is Mifepristone Medication Prescribed?

• Mifepristone is an anti-progestational drug used to abort pregnancy in its early stage within 70 days or ten weeks from the first day of the last menstrual period. Mifepristone medication is given in combination with Misoprostol to block the action of progesterone. Both these drugs are effective against pregnancy termination.

• Mifepristone is also used in different product forms for treating Cushing syndrome-induced high blood sugar levels in the body.

What Precautions Should Be Taken Before Taking Mifepristone?

• A person should always inform the doctor about medications such as corticosteroids and other drugs.

• One should always inform the doctor about their previous ectopic pregnancy, drug allergy, or inserted intrauterine devices (IUDs). The device has to be removed before taking Mifepristone medication.

• A person should inform the doctor about medications such as nutritional supplements, vitamins, calcium channel blockers, benzodiazepines, cholesterol-lowering medications, HIV (human immunodeficiency virus) protease inhibitors, or herbal medicine. In addition, a person's medical history can help them plan the Mifepristone dose accordingly and monitor any adverse side effects.

• A person must take regular follow-ups to ensure the termination of pregnancy entirely because there are chances of being pregnant even after taking Mifepristone doses, and the child is usually born with congenital disabilities. Therefore, regular follow-ups help to discuss other options for abortion in that case, which can be through surgical procedures. It also prevents the chances of being pregnant after taking the repeat dose to ensure the termination of the pregnancy.

• If a person is undergoing any major or minor surgical procedure, inform the doctor about taking Mifepristone.

• Use contraceptive measures to avoid getting pregnant after taking Mifepristone because having sexual intercourse before the next period can make you pregnant.

• Breastfeeding mothers should also inform doctors before taking doses of Mifepristone.

What Are the Therapeutic Options to Treat Cardiomyocyte Apoptosis?

Cardiomyocyte apoptosis can be treated in the following ways:

• First, interrupting the signaling pathway can prevent cell death due to apoptosis.

• Apoptosis can be treated by inhibiting the cell mechanism that leads to cell death.

• The treatment can alter apoptosis to avoid cell death.

• Inhibition of stimulation for cell death can also lead to the cessation of apoptosis.

Conclusion

Mifepristone can induce cell death in cardiac cells by blocking the hormone progesterone, which acts as an anti-apoptosis agent. The hormone is essential for the pregnancy to continue. Thus, Mifepristone helps in terminating the pregnancy by inhibiting the hormone. The medication is primarily used for abortion at an early stage of pregnancy and for treating various other medical conditions. However, different drug interactions with Mifepristone can cause adverse health effects. Therefore, medical information must be shared accurately with the doctor to avoid complications and fatal outcomes.