Continuously increased generation of ROS in human plasma after cardiac arrest as determined by Amplex Red oxidation

Muhammad Shoaib, Nancy Kim, Rishabh C. Choudhary, Blanca Espin, Mitsuaki Nishikimi, Ann Iverson, Tsukasa Yagi, Seyedeh Shadafarin Marashi Shoshtari, Koichiro Shinozaki, Lance B. Becker, Junhwan Kim

Research output: Contribution to journalArticlepeer-review


Oxidative stress is believed to be a major cause of injury after cardiac arrest (CA). While the effects of ROS generated within tissues have been extensively investigated, the potential of plasma-generated ROS in contributing to CA pathology has not been examined. We utilized Amplex Red (AR) to measure the real time-generation of ROS in isolated plasma from human CA patients. We first used post-CA rat plasma to identify interfering factors for AR oxidation, and then applied this knowledge to analyze human plasma samples, accounting for the identified confounders. We found significantly increased AR oxidation rates lasting for 4 h in post-CA rat plasma compared to baseline. AR oxidation was unchanged with removal of horseradish peroxidase or addition of catalase. However, adding carboxylesterase inhibitors significantly decreased AR oxidation in rat plasma, which implicated increased carboxylesterase activity, not ROS leading to increased AR oxidation. AR oxidation rates were also significantly increased in human CA patient plasma compared to control and this increase persisted even with carboxylesterase inhibition, suggesting continuously increased ROS-generation within plasma post-CA in humans. The increased ROS generation may be one major source of injury post-CA that may be mitigated with antioxidative therapeutic strategies that can manage the ROS systemically generated in plasma over time.KEY POLICY HIGHLIGHTS We examined the potential of plasma as a source of ROS generation post-cardiac arrest Rat cardiac arrest was used to guide the application of Amplex Red in human plasma ROS generation in plasma is significantly increased after cardiac arrest in humans Scavenging excessive ROS in post-resuscitation plasma may improve outcomes of patients.

Original languageEnglish
Pages (from-to)384-394
Number of pages11
JournalFree Radical Research
Issue number5
Publication statusPublished - 2023
Externally publishedYes


  • Amplex Red
  • Cardiac arrest
  • hydrogen peroxide
  • ischemia-reperfusion injury
  • oxidative stress
  • reactive oxygen species


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