Potential mechanism of action of trientine in HCM
OXIDATIVE STRESS
Unbound/loosely bound tissue copper II ions are powerful catalysts of reactive oxygen species (ROS) and oxidative stress, and inhibitors of enzymatic antioxidants such as extracellular superoxide dismutase. Trientine has a range of actions thought to result from its removal of copper II ions from tissue. Trientine is associated with restoration of mitochondrial ultrastructure and normalisation of myocardial expression and enzymatic activity of proteins involved with energy metabolism, components of the mitochondrial respiratory chain and enzymes involved in fatty acid oxidation.