间断性屈膝缺血预适应对小鼠缺氧耐力的影响

目的：观察和比较两种后肢缺血法产生的缺血预适应对小鼠耐受缺氧能力的影响。方法：昆明小鼠96只,分成对照组、间断屈膝固定组（KF）或束缚大腿组（TT）进行缺血预适应。每天预适应1次,7 d后各组小鼠再分为3组分别进行常压耐缺氧实验、亚硝酸钠中毒实验和断头后心、脑耐缺血实验。结果：两种后肢缺血法小鼠常压耐缺氧时间均显著延长（P<0.01）,断头后张口呼吸时间显著高于对照组（P<0.05）。但对亚硝酸钠中毒生存时间和心脏跳动时间没有明显影响。结论：肢体缺血预适应能显著增强小鼠缺氧耐力。     

脑缺血/缺氧预适应引起的基因、蛋白质表达谱的变化

缺血,缺氧预适应保护作用的分子机制目前尚未充分阐明。最近的研究在大鼠和小鼠脑缺血,缺氧预适应的模型上采用了基因芯片、双向电泳结合质谱分析技术,揭示了大鼠和小鼠脑缺血,缺氧预适应引起的基因和蛋白质表达谱的变化。这些研究发现预适应引起一些新的基因和蛋白质的表达发生改变,深入研究这些基因和蛋白质有可能发现治疗脑中风新的药物靶标。     

小鼠脑内甘氨酸含量在缺氧预适应中的变化

在小鼠重复缺氧预适应过程中,用HPLC方法,测定其全脑与不同脑区中的甘氨酸含量。结果表明,随着动物对低氧耐受性的增高,其全脑、间脑,特别是海马、脑干中的甘氨酸含量升高。结果提示,甘氨酸作为抑制性递质对低氧预适应的形成具有正面影响。     

蛋白激酶C在缺血／低氧损伤和预适应中作用研究进展

脑和心脏等重要器官的缺血,低氧损伤可导致患者语言障碍、瘫痪、意识丧失及死亡等一系列严重后果,因此一直是基础医学研究和临床治疗的重点。1986、1990年,美国学者Murry和日本学者Kitagawa等分别在心脏和脑发现了一种内源性保护机制,即缺血,低氧预适应现象（I／HPC）,为临床治疗中风等缺血／低氧性疾病开辟了新的道路。因此,对I／HPC机制的研究,尤其是对参与I／HPC形成的细胞信号传导通路的研究,已成为近年的研究热点。本文就蛋白激酶C家族（PKCs）在缺血广低氧损伤和预适应形成中作用做一简要概述。     

银杏内酯B和低氧预适应对小鼠急性缺氧损伤的保护作用

目的：通过观察缺氧预适应和银杏内酯B预处理对小鼠急性缺氧的影响,了解银杏内酯B的脑保护作用。方法：采用小鼠常压缺氧模型,观察小鼠的行为学并记录各组小鼠的最后死亡时间,脑组织含水量,用RT-PCR、Western blot分别检测各组小鼠皮层组织中RTP801mRNA表达和EPO蛋白表达。结果：银杏内酯B和低氧预适应均能明显延长常压缺氧小鼠的存活时间,降低脑水肿程度,并且银杏内酯组和低氧预适应组RTP801mRNA表达和EPO的表达均明显增加。结论：银杏内酯B与低氧预适应具有相类似的对抗小鼠急性低氧的作用,其脑保护作用与上调RTPS01mRNA和EPO蛋白的表达有关。     

缓激肽在骨骼肌缺血预适应对猪心肌坏死和凋亡中的作用

目的：研究缓激肽在骨骼肌缺血预适应对心肌坏死和心肌凋亡保护中可能的作用：方法：采用非开胸法建立猪心脏缺血／再灌注（I／R）模型,通过球囊堵塞左股动脉造成骨骼肌短暂缺血,使用缓激肽（BK）的B2受体拮抗剂烟酸已可碱（HOE-140）以及外源BK进行干预。分别观察各组对心肌坏死和凋亡的影响。结果：远端预处理后心肌坏死范围明显缩小,凋亡率明显降低：预处理前使用HOE-140可使对坏死范围的保护作用明显减弱;心肌I／R前使用外源BK注射,可缩小心肌梗死范围。但HOE-140及外源BK对以上凋亡指标无影响．结论：骨骼肌远端预适应可减少心肌坏死和心肌凋亡、BK可能参与对坏死面积的保护．但不参与对凋亡的保护作用。     

雷米普利对糖尿病大鼠心肌缺血／再灌注损伤保护作用的超微结构研究

目的：研究雷米普利对糖尿病大鼠心肌缺血／再灌注损伤的保护作用,并从超微结构的角度初步探讨其作用机制。方法：链脲佐菌素致糖尿病大鼠被随机分为3组（n=16）：缺血／再灌注（I／R）、缺血预适应（IPC）和雷米普利（RAM）组。RAM组每天用雷米普利（1mg／kg）灌胃,I／R和IPC组用等体积生理盐水灌胃。4周后各组动物均经历心肌缺血／再灌注损伤,IPC组于缺血前行心肌缺血预适应。连续监测心电图变化,测定心肌梗死面积,光、电镜下观察心肌形态学改变。结果：与I／R组比较,RAM及IPC组缺血期心脏ST-段抬高幅度降低,室早出现时间推迟,持续时间缩短,室速、室颤发生率降低,心肌梗死面积缩小,形态学观察心肌损伤减轻,心肌纤维及线粒体特征性结构保持清晰,血管通畅,内皮损伤减轻。结论：连续4周使用RAM对实验性糖尿病大鼠具有与IPC相似的心脏保护效应,机制可能与保护心肌细胞及线粒体、改善内皮功能等有关。     

离子型NMDA受体在缺氧耐受中的作用

离子型ＮＭＤＡ受体在缺氧耐受中的作用谢静晖吕国蔚（首都医科大学神经生物系，北京１０００５４）机体缺氧时的脑损伤与脑内兴奋性氨基酸（ＥＡＡｓ）增多及其受体激活引起的兴奋毒性作用有关；而重复缺氧可形成预适应而显著提高小鼠对缺氧的耐受性。本研究观察ＥＡＡｓ...     

HIF在心肌缺血再灌注中的作用

缺氧诱导因子（HIF）是参与缺氧转录反应调控的转录调控因子,HIF的活化在缺氧时细胞中保护起重要作用,HIF及HIF依赖的基因如诱导型一氧化氪舍酶（iNOS）、血红素氧舍酶（HO-1）的激活可减轻心脏的缺血．再灌注损伤,HIF调节的基因表达可能介导了缺血预处理和缺血后处理的保护作用。本文对HIF在心肌缺血再灌注损伤中的保护作用予以综述。     

缺血预适应对大鼠肢体缺血/再灌注后小肠细胞凋亡的影响

目的：观察大鼠肢体缺血再灌注后小肠粘膜自由基及钙含量改变与细胞凋亡情况．以及缺血预适应对其变化的影响。方法：将雄性Wistar大鼠18只,随机分为对照（Control）组,缺血／再灌注（I／R）组和缺血预适应（IPC＋I／R）组,分别测定血浆和小肠组织超氧化物歧化酶（SOD）、黄嘌呤氧化酶（XOD）、丙二醛（MDA）的含量,小肠组织钙及线粒体钙含量;小肠组织的Bel-2和Bax蛋白的表达水平;检测小肠细胞凋亡情况。结果：肢体I／R后血浆和小肠粘膜SOD减少而XOD和MDA增加;小肠组织钙及线粒体钙含量增多;Bel-2蛋白表迭和Bax表达增多,但Bel-2／Bax比值降低;凋亡细胞增多。IPC减轻了I／R后引起的XOD、MDA含量的升高,并且增加了SOD的含量;减轻了组织和线粒体钙超载;Bel-2的表达则明显升高而Bax表达较I／R组明显减少,Bel-2／Bax比值升高;凋亡细胞减少。结论：肢体IR引起小肠粘膜自由基的增多,钙超栽,凋亡细胞增多;IPC可能通过减少自由基的产生及钙超载,抑制细胞凋亡而对肢体I／R继发的小肠功能损伤起保护作用。     

低氧预处理对低氧／复氧心肌能量代谢的作用

目的：研究低氧预处理（HPC）对心肌的保护作用,方法：借助^31P－NMR图谱技术,在模拟Langendorff离体灌流大鼠心脏的正常生理条件下,跟踪心肌高能磷酸化合物含量的动态变化。结果：在30min低氧期,PCr、ATP相对含量及PCr/Pi值逐渐减小,但HPC组减小的速度比对照组慢;而在复氧期,HPC组能提高心肌高能磷酸化合物含量的恢复程度,特别是复氧初期,HPC组PCr 、ATP相对含量及PCr/Pi值立即有了恢复;在本实验中,HPC对pHi的改善不显著。结论：HPC能降低后续长时间低氧及复氧阶段的心肌能量代谢,对心肌的低氧／复氧损伤具有保护作用。     

Increased Membrane/Nuclear Translocation and Phosphorylation of p90 KD Ribosomal S6 Kinase in the Brain of Hypoxic Preconditioned Mice

Our previous studies have demonstrated that hypoxic precondition (HPC) increased membrane translocation of protein kinase C isoforms and decreased phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) in the brain of mice. The goal of this study was to determine the involvement of p90 KD ribosomal S6 kinase (RSK) in cerebral HPC of mice. Using Western-blot analysis, we found that the levels of membrane/nuclear translocation, but not protein expression of RSK increased significantly in the frontal cortex and hippocampus of HPC mice. In addition, we found that the phosphorylation levels of RSK at the Ser227 site (a PDK1 phosphorylation site), but not at the Thr359/Ser363 sites (ERK1/2 phosphorylated sites) increased significantly in the brain of HPC mice. Similar results were confirmed by an immunostaining study of total RSK and phospho-Ser227 RSK. To further define the cellular populations to express phospho-Ser227 RSK, we found that the expression of phospho-Ser227 RSK co-localized with neurogranin, a neuron-specific marker, in cortex and hippocampus of HPC mice by using double-labeled immunofluorescent staining method. These results suggest that increased RSK membrane/nuclear translocation and PDK1 mediated neuron-specific phosphorylation of RSK at Ser227 might be involved in the development of cerebral HPC of mice.     

Delayed cytoprotection induced by hypoxic preconditioning in cultured neonatal rat cardiomyocytes: role of GRP78

Hypoxic preconditioning (HPC) has been well demonstrated to have potent protective effects in many cell types; however, the mechanisms responsible for this phenomenon are not fully understood. Recently, glucose-regulated protein 78 (GRP78), an inducible molecular chaperon, was indicated to be associated with ischemic preconditioning. We hypothesized that HPC protects cardiomyocytes against hypoxia by inducing GRP78 in cultured neonatal rat cardiomyocytes. HPC was induced by exposing cardiomyocytes to brief hypoxia (1% O(2), 30 min) followed by reoxygenation. GRP78 was expressed constitutively in cultured cardiomyocytes and its expression was enhanced at 12 h, peaked at 24 h (207.3+/-23.6% of the baseline), and was sustained for up to 72 h after HPC. Twenty-four hours after HPC, the myocytes were subjected to prolonged hypoxia (1% O(2), 12 h). The lactic dehydrogenase (LDH) release and malondialdehyde (MDA) content were reduced, while cell viability and superoxide dismutase (SOD) activity were increased in the preconditioned cells compared with the non-HPC cells. The GRP78 protein level was higher in cells exposed to both HPC and hypoxia than in the cells exposed to HPC alone or hypoxia alone. Heat shock protein 70 (HSP70) was induced in parallel by late HPC. Transfection of GRP78 antisense oligonucleotides blocked GRP78 expression but not HSP70, resulting in attenuated cardioprotection afforded by late HPC. Furthermore, inducing GRP78 by gene transfer protected cardiomyocytes from hypoxic injury. These findings demonstrate that the induction of GRP78 partially mediates the late HPC, suggesting that GRP78 is a novel mechanism responsible for the late cytoprotection of HPC.     

Calreticulin induces delayed cardioprotection through mitogen-activated protein kinases

Hypoxic preconditioning (HPC) attenuates tissue injury caused by ischemia/reperfusion. The protective mechanisms of HPC involve up-regulation of the protective proteins and mitigation of cellular calcium overload. Calreticulin (CRT), a Ca(2+)-binding chaperone, plays an important role in regulating calcium homeostasis and folding of proteins. The role of CRT in cardioprotection of HPC and the pathways determining CRT expression during HPC are not clear. In this work, 2-DE and MALDI-MS were employed to analyze CRT differential expression in cardiomyocytes subjected to transient hypoxia. Western blotting analysis was used to detect the CRT expression and activities of p38 mitogen-activated protein kinase (p38 MAPK) and c-Jun NH(2)-terminal kinase (JNK) in myocardium subjected to ischemia with and without HPC and sham operation. The hearts from HPC group were more resistant to sustained ischemia and had much stronger phosphorylation of p38 MAPK, with a reduced phosphorylation of JNK, than controls. The CRT expression was positively correlated with the phosphorylation of p38 MAPK and negatively correlated with the level of JNK phosphorylation. Furthermore, inhibition of the p38 MAPK with SB202190 abolished, while inhibition of the JNK with SP600125 enhanced the CRT up-regulation in cardiomyocytes induced by HPC. The results indicate that HPC up-regulates CRT expression through the MAPK signaling pathways.     

低氧预适应大鼠脑脊液减轻氧糖剥夺对培养新生鼠海马神经元的损伤及可能的机制

本文旨在观察低氧预适应(hypoxic preconditioning,HPC) Wistar大鼠脑脊液对新生鼠海马神经元氧糖剥夺(oxygen glucose deprivation,OGD)损伤的影响及机制.原代培养大鼠新生鼠(出生12 h)海马神经元,随机分为正常对照组、OGD组(OGD培养1.5 h)、正常脑脊...     

Development of an in vitro model for study of the efficacy of ischemic preconditioning in human skeletal muscle against ischemia-reperfusion injury.

Ischemia-reperfusion (I/R) injury causes skeletal muscle infarction and ischemic preconditioning (IPC) augments ischemic tolerance in animal models. To date, this has not been demonstrated in human skeletal muscle. This study aimed to develop an in vitro model to investigate the efficacy of simulated IPC in human skeletal muscle. Human skeletal muscle strips were equilibrated in oxygenated Krebs-Henseleit-HEPES buffer (37 degrees C). Aerobic and reperfusion phases were simulated by normoxic incubation and reoxygenation, respectively. Ischemia was simulated by hypoxic incubation. Energy store, cell viability, and cellular injury were assessed using ATP, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), and lactate dehydrogenase (LDH) assays, respectively. Morphological integrity was assessed using electron microscopy. Studies were designed to test stability of the preparation (n = 5-11) under normoxic incubation over 24 h; the effect of 1, 2, 3, 4, or 6 h hypoxia followed by 2 h of reoxygenation; and the protective effect of hypoxic preconditioning (HPC; 5 min of hypoxia/5 min of reoxygenation) before 3 h of hypoxia/2 h of reoxygenation. Over 24 h of normoxic incubation, muscle strips remained physiologically intact as assessed by MTT, ATP, and LDH assays. After 3 h of hypoxia/2 h of reoxygenation, MTT reduction levels declined to 50.1 +/- 5.5% (P < 0.05). MTT reduction levels in HPC (82.3 +/- 10.8%) and normoxic control (81.3 +/- 10.2%) groups were similar and higher (P < 0.05) than the 3 h of hypoxia/2 h of reoxygenation group (45.2 +/- 5.8%). Ultrastructural morphology was preserved in normoxic and HPC groups but not in the hypoxia/reoxygenation group. This is the first study to characterize a stable in vitro model of human skeletal muscle and to demonstrate a protective effect of HPC in human skeletal muscle against hypoxia/reoxygenation-induced injury.     

Hypoxic preconditioning protects microvascular endothelial cells against hypoxia/reoxygenation injury by attenuating endoplasmic reticulum stress

Endothelial cells (ECs) are directly exposed to hypoxia and contribute to injury during myocardial ischemia/reperfusion. Hypoxic preconditioning (HPC) protects ECs against hypoxia injury. This study aimed to explore whether HPC attenuates hypoxia/reoxygenation (H/R) injury by suppressing excessive endoplasmic reticulum stress (ERS) in cultured microvascular ECs (MVECs) from rat heart. MVECs injury was measured by lactate dehydrogenase (LDH) leakage, cytoskeleton destruction, and apoptosis. Expression of glucose regulating protein 78 (GRP78) and C/EBP homologous protein (CHOP), activation of caspase-12 (pro-apoptosis factors) and phosphorylation of p38 mitogen-activated protein kinase (p38 MAPK) were detected by western blot analysis. HPC attenuated H/R-induced LDH leakage, cytoskeleton destruction, and cell apoptosis, as shown by flow cytometry, Bax/Bcl-2 ratio, caspase-3 activation and terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling. HPC suppressed H/R-induced ERS, as shown by a decrease in expression of GRP78 and CHOP, and caspase-12 activation. HPC enhanced p38 MAPK phosphorylation but decreased that of protein kinase R-like ER kinase (PERK, upstream regulator of CHOP). SB202190 (an inhibitor of p38 MAPK) abolished HPC-induced cytoprotection, downregulation of GRP78 and CHOP, and activation of caspase-12, as well as PERK phosphorylation. HPC may protect MVECs against H/R injury by suppressing CHOP-dependent apoptosis through p38 MAPK mediated downregulation of PERK activation.     

p38丝裂素活化蛋白激酶介导低氧预处理诱导的内质网应激相关的心肌细胞保护

钙网蛋白（calreticulin,CRT）和caspase-12是重要的内质网（endoplasmic reticulum,ER）应激分子,本实验在心肌细胞低氧／复氧（hypoxia／reoxygenation,H／R）模型上观察低氧预处理（hypoxic preconditioning,HPC）对CRT和caspase-12表达及活化的影响,探讨内质网应激（endoplasmic reticulum stress,ERS）在HPC保护机制中的意义及其细胞信号转导机制。原代培养的Sprague-Dawley乳鼠心肌细胞随机分为6组：H／R组、HPC＋H／R组、SB203580＋HPC＋H／R组、SP600125＋HPC＋H／R组、HPC组和对照组。以细胞存活率、乳酸脱氢酶（lactate dehydrogenase,LDH）活性及流式细胞术检测细胞损伤情况：Western blot方法检测CRT和caspase-12表达、活化及p38丝裂素活化蛋白激酶（mitogen—activated protein kinases,MAPK）、cJun N-terminal kinase（JNK）磷酸化水平。结果表明：（1）HPC具有细胞保护作用,与H／R组比较,HPC＋H／R组细胞凋亡率和LDH漏出分别降低6．6％和70．0％,存活率增高6．4％：HPC前以特异性p38MAPK抑制剂SB203580预孵育消除HPC的保护作用,与HPC＋H／R组相比,细胞凋亡率和LDH漏出分别增高5．4％和2．1倍,存活率降低5．4％,JNK特异性抑制剂SP600125预孵育对HPC的保护作用无明显影响。（2）H／R明显上调CRT表达（较对照组高8．1倍）和caspase-12活性（较对照组高33．2倍）;单独HPC可诱导CRT表达增多（较对照组高2．6倍）,但上调程度较H／R组低60％。H／R前进行HPC降低CRT过表达程度（降低72．4％）及caspase-12活化水平（降低59．6％）。（3）HPC前应用p38MAPK抑制剂,抑制CRT表达上调（分别较HPC＋H／R组和HPC组低63．9％和71．9％）,并消除HPC减轻H／R上调caspase-12活性的作用（较HPC＋H／R组高7．1倍）;HPC前抑制JNK活性对CRT、caspase-12表达和活化均无明显影响。上述结果提示：HPC可激发适当的ERS,抑制H／R诱导的过度ERS,减少ER凋亡信号介导的细胞凋亡。p38MAPK信号途径在HPC诱导的ER应激分子表达、抑制ER凋亡信号分子活化等机制中发挥重要作用。     

缺氧诱导因子-1α在缺氧预处理预防心肌细胞损伤中的作用

本工作旨在研究缺氧预处理(hypoxic preconditioning,HPC)对于心肌细胞外信号调节激酶(extracellular signal-regulated proteinkinases,ERK)活性、缺氧诱导因子-1α(hypoxia-inducible factor-1α,HIF-1α)表达的影响,及其在缺氧复氧诱导心肌细胞损伤中的作用。通过在培养的SD乳鼠心肌细胞缺氧／复氧(H／R)模型上,观察HPC对于24h后H／R诱导心肌细胞损伤的影响,以台盼蓝排斥实验检测心肌细胞存活率、以TUNEL法检测细胞凋亡、并用荧光素染料Hoechst33258测定心肌细胞凋亡率：制备心肌细胞蛋白提取物,以磷酸化的ERK1／2抗体测定ERK1／2活性,以抗HIF-1α抗体检测HIF-1α的表达,并观察ERKs的上游激酶(MEK1／2)抑制剂PD98059对于HPC诱导的ERKs磷酸化、HIF-1α表达以及心肌细胞保护作用的影响,并分析细胞损伤与ERK1／2活性、HIF-1α表达量之间的相互关系。结果 显示缺氧复氧造成心肌细胞损伤,HPC可以增加心肌细胞H／R后存活率,降低凋亡率,并激活ERKll2,诱导HIF-1α表达：细胞凋亡与ERKs活性、HIF-1α表达量之间存在负相关,即ERKs活化、HIF-1α表达与预防细胞损伤有关：而ERKs活性与HIF-1α表达量之间存在正相关,ERKs的上游激酶MEK抑制剂PD98059可以消除HPC诱导的ERKs磷酸化、HIF-1α表达和心肌细胞保护作用。由此得出的结论是HPC可以提高乳鼠心肌细胞对于H／R的耐受性,其机制涉及ERKs介导的HIF-1α表达。     

Hypoxic postconditioning enhances the survival and inhibits apoptosis of cardiomyocytes following reoxygenation: role of peroxynitrite formation

Objectives: Our previous study has shown that slow or “controlled” reperfusion for the ischemic heart reduces cardiomyocyte injury and myocardial infarction, while the mechanisms involved are largely unclear. In this study, we tested the hypothesis that enhancement of survival and prevention of apoptosis in hypoxic/reoxygenated cardiomyocytes by hypoxic postconditioning (HPC) are associated with the reduction in peroxynitrite (ONOO⁻) formation induced by hypoxia/reoxygenation (H/R). Methods: Isolated adult rat cardiomyocytes were exposed to 2 h of hypoxia followed by 3 h of reoxygenation. After 2 h of hypoxia the cardiomyocytes were either abruptly reperfused with pre-oxygenized culture medium or postconditioned by two cycles of 5 min of brief reoxygenation and 5 min of re-hypoxia followed by 160 min of abrupt reoxygenation. Results: H/R resulted in severe injury in cardiomyocytes as evidenced by decreased cell viability, increased LDH leakage in the culture medium, increased apoptotic index (P values all less than 0.01 vs. normoxia control group) and DNA ladder formation, which could be significantly attenuated by HPC treatment applied before the abrupt reoxygenation (P < 0.05 vs. H/R group). In addition, H/R induced a significant increase in ONOO⁻ formation as determined by nitrotyrosine content in cardiomyocytes (P < 0.01 vs. normoxia control). Treatment with the potent ONOO⁻ scavenger uric acid (UA) at reoxygenation significantly decreased ONOO⁻ production and protected myocytes against H/R injury, whereas the same treatment with UA could not further enhance myocyte survival in HPC group (P > 0.05 vs. HPC alone). Statistical analysis showed that cell viability closely correlated inversely with myocyte ONOO⁻ formation (P < 0.01). Conclusion: These data demonstrate that hypoxic postconditioning protects myocytes against apoptosis following reoxygenation and enhances myocytes survival, which is partly attributable to the reduced ONOO⁻ formation following reoxygenation. H.-C. Wang and H.-F. Zhang contributed equally to this study.