Sodium pyruvate: mechanism of action and clinical applications

General Description

Sodium pyruvate is a compound that has shown potential in various clinical applications. One such application is in the treatment of allergic rhinitis, where it can serve as an additional therapeutic option. By administering antioxidants like sodium pyruvate, the body's antioxidant defenses can be strengthened, effectively intervening in the inflammatory responses associated with allergic rhinitis. In clinical settings, sodium pyruvate has been used safely in patients with different disorders, including Friedreich's ataxia and during open heart operations. Another important application of sodium pyruvate is in the treatment of hemorrhagic shock (HS). Overall, sodium pyruvate's antioxidant properties contribute to its ability to scavenge reactive oxygen species (ROS), activate antioxidant enzymes, reduce oxidative stress, and protect mitochondria. These qualities make sodium pyruvate a promising compound for various clinical applications, including allergic rhinitis and the treatment of hemorrhagic shock.

Figure 1. Sodium pyruvate

Mechanism of action

Sodium pyruvate exhibits antioxidant properties through several mechanisms. Firstly, it functions as a scavenger, directly neutralizing reactive oxygen species (ROS) like superoxide anions, hydroxyl radicals, and hydrogen peroxide. By intercepting these harmful molecules, sodium pyruvate helps prevent oxidative damage to cells and their components. Additionally, sodium pyruvate activates endogenous antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. These enzymes play vital roles in detoxifying ROS and maintaining cellular redox balance, further enhancing the antioxidant capacity of the cells. Furthermore, sodium pyruvate assists in reducing oxidative stress by rebalancing the ratio of oxidized to reduced forms of important antioxidants like glutathione. This adjustment helps restore cellular redox balance and reduces overall oxidative stress within cells. Moreover, sodium pyruvate offers protection to mitochondria—organelles responsible for cellular energy production. It helps maintain mitochondrial membrane potential, preserves ATP production, and prevents the release of pro-oxidant factors, thereby safeguarding mitochondria from oxidative damage. Overall, sodium pyruvate's antioxidant properties stem from its ability to scavenge ROS, activate antioxidant enzymes, reduce oxidative stress, and protect mitochondria. However, it is crucial to note that the specific mechanisms and extent of its antioxidant activity may vary depending on factors such as sodium pyruvate concentration, cell type, and experimental conditions. ¹

Clinical applications

Allergic rhinitis

Sodium pyruvate has shown potential as an additional therapeutic option for the treatment of allergic rhinitis. By administering early and sufficient doses of antioxidants like sodium pyruvate, the body's antioxidant defenses can be strengthened, which plays a crucial role in preventing and intervening in inflammatory responses associated with allergic rhinitis.，In clinical settings, sodium pyruvate has demonstrated a good safety profile and has been used in patients with various disorders, including Friedreich's ataxia and open heart operations. It can be administered through different routes, such as intravenous, topical administration, dietary supplementation, and intranasal application. The purpose of several studies conducted was to investigate the therapeutic benefits of sodium pyruvate in improving nasal inflammation specifically in patients with Allergic rhinitis. These studies aimed to evaluate the efficacy of sodium pyruvate in reducing the symptoms associated with allergic rhinitis by its antioxidant properties and its ability to mitigate oxidative stress and inflammation within the nasal passages. Overall, the research suggests that sodium pyruvate holds promise as a potential treatment option for allergic rhinitis. ²

Hemorrhagic shock

Sodium pyruvate, specifically hypertonic sodium pyruvate (HSP), has been proposed as a resuscitative fluid for the treatment of hemorrhagic shock (HS). It is considered beneficial due to its anti-inflammatory and antioxidant properties. The study aimed to compare HSP with Ringer's ethyl pyruvate regarding their effectiveness and mechanisms of action in rats during HS. The experiment involved subjecting Sprague-Dawley rats to simulated arterial hemorrhage followed by resuscitation with different solutions including HSP and Ringer's ethyl pyruvate. Hemodynamic parameters, inflammatory cascade, and stress/apoptosis-related proteins in the liver were evaluated. Continuous monitoring of hemodynamic and biochemical parameters in the blood was conducted throughout the experiment. The findings showed that HSP administration after hemorrhage led to reduced liver injury compared to Ringer's ethyl pyruvate. This effect was associated with increased levels of serum and tissue inflammatory cytokines, inflammatory mediators (such as NOS and cyclooxygenase 2), lipid peroxidation, and higher hepatocellular adenosine triphosphate. Additionally, cellular apoptotic events related to the activation of caspase-3 and poly(ADP-ribose)polymerase cleavage were decreased by sodium pyruvate. Overall, the study suggests that resuscitation with small-volume HSP can provide significant protection against inflammatory and oxidative stress, effectively preventing liver injury in cases of hemorrhagic shock when compared to large-volume Ringer's ethyl pyruvate. ³

Reference

1. Guarino VA, Oldham WM, Loscalzo J, Zhang YY. Reaction rate of pyruvate and hydrogen peroxide: assessing antioxidant capacity of pyruvate under biological conditions. Sci Rep, 2019, 9(1):19568.

2. Martin A, Lupfer C, Amen R. Sodium Pyruvate Nasal Spray Reduces the Severity of Nasal Inflammation and Congestion in Patients with Allergic Rhinitis. J Aerosol Med Pulm Drug Deliv, 2022, 35(6):291-295.

3. Sharma P, Mongan PD. Hypertonic sodium pyruvate solution is more effective than Ringer's ethyl pyruvate in the treatment of hemorrhagic shock. Shock, 2010, 33(5):532-540.

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