儿茶酚胺激素剂和阻断剂对大鼠胃粘膜适应性细胞保护作用…

本文观察了儿茶酚胺激素剂和阻断剂对大鼠慢性应激诱发的胃粘膜适应性细胞保护作用的影响,并分析内源性生长抑素与保护作用的关系。结果表明,慢性应激诱导的大有粘膜性保护作用在交感神经切除后完全消失,多巴胺或异丙肾上腺素使保护作用部分恢复,去甲明上腺素无作用,在交感神经完整大鼠,心得安或氟哌啶醇可抑制慢性应激诱发的保护作用,酚妥拉明无作用。血浆生长抑素在应激及交感神经切除后均无显著变化,提示惯性应激时交感冒     

β-肾上腺素受体与乳腺癌相关性的研究进展

精神和情绪对于肿瘤的发生、发展具有重要作用。通常,在急性或慢性应激状态下,由交感神经系统介导的正常生理应激机制导致神经递质肾上腺素和去甲肾上腺素释放增多。对于恶性肿瘤患者,大量研究证实交感神经系统主要通过β-肾上腺素能受体途径介导的信号传导通路对肿瘤的进展和转移产生影响。乳腺癌患者多伴有焦虑预后不良而引起肾上腺素及去甲肾上腺素分泌增加,从而可能促进乳腺癌的进展和转移。本文就β-肾上腺素受体及其在其它恶性肿瘤中相关研究,着重探讨β-肾上腺素受体在乳腺癌中表达情况和使用β-肾上腺素受体阻断剂与乳腺癌预后的关系作以下综述,为进一步探究β-肾上腺素受体在乳腺癌中的作用机制提供相关理论依据。     

儿茶酚胺激动剂和阻断剂对大鼠胃粘膜适应性细胞保护作用的影响

本文观察了儿茶酚胺激动剂和阻断剂对大鼠慢性应激诱发的胃粘膜适应性细胞保护作用的影响,并分析内源性生长抑素与保护作用的关系。结果表明,慢性应激诱导的大鼠胃粘膜适应性保护作用在交感神经切除后完全消失,多巴胺或异丙肾上腺素使保护作用部分恢复,去甲肾上腺素无作用;在交感神经完整大鼠,心得安或氟哌啶醇可抑制慢性应激诱发的保护作用,酚妥拉明无作用。血浆生长抑素在应激及交感神经切除后均无显著变化。提示慢性应激时交感肾上腺系统的激活参与了大鼠胃粘膜适应性保护作用,且可能通过多巴胺及肾上腺能β受体介导。     

神经肽Y对心脏的作用

神经肽Y（NPY）广泛分布于心脏各个部位,主要与去甲肾上腺素共存于交感神经。当交感神经兴奋时,由末梢释放。NPY对心脏具有直接的变力、变时和电生理作用,可影响细胞的信号转导,调制心脏自主神经递质的释放,并参与心脏的自主神经调节。NPY在心脏的生理学和病理生理学上具有重要意义。     

交感神经系统内的递质共存及其相互作用

在外周交感神经系统内;神经递质或神经肽类物质主要存在于大、小囊泡内;递质共存的现象在交感神经内不断得以发现,去甲肾上腺素和乙酰胆碱、神经肽Y、脑啡肽、P物质、血管活性肠肽、生长抑素、神经降压素、降钙素基因相关肽等物质共存的证实,扩大了交感神经递质的调节范围,递质之间网络式的相互调节作用有着重要的生理意义。     

交感神经系统内递质共存及其相互作用

在外周交感神经系统内,神经递质或神经肽类物质主要存在于大、小囊泡内;递质共存的现象在交感神经内不断得以发现．去甲肾上腺素和乙酰胆碱、神经肽Y、脑啡肽、P物质、血管活性肠肽、生长抑素、神经降压素、降钙素基因相关肽等物质共存的证实,扩大了交感神经递质的调节范围,递质之间网络式的相互调节作用有着重要的生理意义。     

交感神经节细胞的迟慢兴奋性突触后电位与肽能性突触传递

节前神经刺激可在交感神经节细胞内引起一个迟慢兴奋性突触后电位(Is-EPSP),它不被N或M型胆碱能阻断剂所阻断,故属于非胆碱能性突触传递。Is-EPSP的有关神经递质可能是肽类物质,如P物质、促性腺激素释放激素(LHRH);这种肽能性传递有可能参与交感神经节的生理整合机能。     

甘氨酸神经递质研究进展

甘氨酸是化学结构最简单的氨基酸,但具有复杂的功能。甘氨酸在中枢神经系统中是介导快速抑制性神经传递的一种重要的神经递质,在控制神经元兴奋性方面发挥重要作用。就其神经递质功能对甘氨酸的生物合成、释放与调控以及作用模式等方面的近年研究进展做一综述,对甘氨酸神经递质的全面认识将有益于炎性痛、痉挛状态以及癫痫等中枢神经系统疾病的诊断、预防及治疗。     

交感神经调节外周血淋巴细胞再分布的机制

免疫细胞在机体各部位之间不停地迁徙,对于抗原识别和启动快速有效的免疫应答至关重要.大量研究表明:心理和身体应激可引起外周血免疫细胞亚群分布改变,而交感神经在调节应激引起的外周血淋巴细胞再分布的过程中扮演了重要角色.神经和免疫相互调节机制研究表明,交感神经活化时通过释放儿茶酚氨类神经介质,一方面通过引起血流动力学改变和对免疫细胞表面黏附分子表达的调节,引起外周血白细胞分布改变;另一方面通过诱导淋巴细胞凋亡参与调节慢性应激时淋巴细胞数目下降.     

应激性溃疡发病的中枢机制

在应激性溃疡形成过程中,中枢单胺类神经递质的代谢加快。去甲肾上腺素、多巴胺、γ-氨基丁酸、5-羟色胺和乙酰胆碱都可能参与应激性渍疡形成。脑内注射一些神经肽也有预防或加重应激性溃疡发生的作用。下丘脑外侧区、杏仁复合体以及与其联系的其他脑区的神经通路,亦与应激性溃疡的形成有关。     

HLA and beta-myosin heavy chain do not influence susceptibility to Chagas disease cardiomyopathy

An inflammatory dilated cardiomyopathy occurs in 30% of Chagas' disease patients, chronically infected by Trypanosoma cruzi, while the remaining infected individuals are asymptomatic. Studies have indicated a role for genetic factors in the susceptibility to Chagas' disease cardiomyopathy. In an attempt to identify the genetic factors influencing the development and outcome of Chagas' cardiomyopathy, we compared the frequencies of alleles from two candidate gene loci, class II HLA and a microsatellite marker for the human cardiac beta-myosin heavy chain gene in different clinical groups. Patients were grouped as asymptomatic or with severe or mild cardiomyopathy. The results indicate that the HLA and myosin microsatellite allele profiles in all cardiomyopathy and in asymptomatic groups are similar. In conclusion, these results establish that polymorphism of HLA-DR and -DQ molecules, as well as beta-cardiac myosin, do not influence the susceptibility to different clinical forms of Chagas' disease or the progression to severe Chagas' cardiomyopathy. On the other hand, male sex was identified as a risk factor for progression to the more severe forms of cardiomyopathy (relative risk = 8.75).     

Role of AMP-activated protein kinase in healthy and diseased hearts

The heart is capable of utilizing a variety of substrates to produce the necessary ATP for cardiac function. AMP-activated protein kinase (AMPK) has emerged as a key regulator of cellular energy homeostasis and coordinates multiple catabolic and anabolic pathways in the heart. During times of acute metabolic stresses, cardiac AMPK activation seems to be primarily involved in increasing energy-generating pathways to maintain or restore intracellular ATP levels. In acute situations such as mild ischemia or short durations of severe ischemia, activation of cardiac AMPK appears to be necessary for cardiac myocyte function and survival by stimulating ATP generation via increased glycolysis and accelerated fatty acid oxidation. Whereas AMPK activation may be essential for adaptation of cardiac energy metabolism to acute and/or minor metabolic stresses, it is unknown whether AMPK activation becomes maladaptive in certain chronic disease states and/or extreme energetic stresses. However, alterations in cardiac AMPK activity are associated with a number of cardiovascular-related diseases such as pathological cardiac hypertrophy, myocardial ischemia, glycogen storage cardiomyopathy, and Wolff-Parkinson-White syndrome, suggesting the possibility of a maladaptive role. Although the precise role AMPK plays in the diseased heart is still in question, it is clear that AMPK is a major regulator of cardiac energy metabolism. The consequences of alterations in AMPK activity and subsequent cardiac energy metabolism in the healthy and the diseased heart will be discussed.     

The role of cardiac magnetic resonance imaging in differentiating the underlying causes of left ventricular hypertrophy

The onset of sudden cardiac death and large inter- and intra-familial clinical variability of hypertrophic cardiomyopathy pose an important clinical challenge. Cardiac magnetic resonance imaging is a high-resolution imaging modality that has become increasingly available in the past decade and has the unique possibility to demonstrate the presence of fibrosis or scar using late gadolinium enhancement imaging. As a result, the diagnostic and prognostic potential of cardiac magnetic resonance imaging has been extensively explored in acute and chronic ischaemic cardiomyopathy, as well as in several nonischaemic cardiomyopathies. This review aims to provide a critical overview of recently published studies on hypertrophic cardiomyopathy and discusses the role of cardiac magnetic resonance imaging in differentiating underlying causes of hypertrophic cardiomyopathy, such as familial hypertrophic cardiomyopathy, cardiac involvement in systemic disease and left ventricular hypertrophy due to endurance sports. Also, it demonstrates the use of cardiac magnetic resonance in risk stratification for the onset of sudden cardiac death, and early identification of asymptomatic family members of hypertrophic cardiomyopathy patients who are at risk for the development of hypertrophic cardiomyopathy. (Neth Heart J 2010;18:135-43.)     

TNF gene polymorphisms are associated with reduced survival in severe Chagas' disease cardiomyopathy patients

Chronic Chagas' disease cardiomyopathy (CCC) is the most important clinical outcome of infection by the parasite Trypanosoma cruzi, affecting 18 million individuals in Latin America. One-third of CCC patients develop heart failure due to end-stage dilated cardiomyopathy, and their survival is reduced by 50% compared to patients with other cardiomyopathies. Genetic susceptibility may play a role in the differential survival of severe CCC patients. Given the role of TNF-alpha in the progression of heart failure, and the increased TNF-alpha plasma and heart tissue levels observed in these patients, we chose TNF as a candidate gene for increased mortality in severe CCC patients. We typed the TNFa microsatellite and the -308 TNF promoter polymorphism and then analyzed the survival curves of 42 patients with severe ventricular dysfunction (left ventricular ejection fraction相似文献   

The importance of cardiac MRI as a diagnostic tool in viral myocarditis-induced cardiomyopathy

Myocarditis is an acute or chronic inflammatory disease of the myocardium which can be viral, postinfectious immune or primarily organ-specific autoimmune. Clinical manifestations of acute and chronic myocarditis are extremely varied, ranging from mild to severe. Affected patients may recover or develop (dilated) cardiomyopathy (DCM) with life-threatening symptoms including heart failure, conduction disturbances, arrhythmias, cardiogenic shock or sudden cardiac death. The diagnosis of myocarditis is a challenging process and not only because of a diverse presentation; other problems are limited sensitivity of endomyocardial biopsies (EMB) and overlapping symptoms. Furthermore, the diagnosis is not well defined. However, early diagnosis is mandatory to address specific aetiology-directed therapeutic management in myocarditis that influences patient morbidity and mortality. Currently, EMB remains the only way to confirm the presence of a viral genome and other histopathological findings allowing proper treatment to be implemented in cases of myocarditis. Increased recognition of the role of myocardial inflammatory changes has given rise to interest in noninvasive imaging as a diagnostic tool, especially cardiovascular magnetic resonance imaging (CMR). In this review we discuss the current role of CMR in the evaluation of myocarditis-induced inflammatory cardiomyopathies. (Neth Heart J 2009;17:481–6.)     

Role of changes in cardiac metabolism in development of diabetic cardiomyopathy

In patients with diabetes, an increased risk of symptomatic heart failure usually develops in the presence of hypertension or ischemic heart disease. However, a predisposition to heart failure might also reflect the effects of underlying abnormalities in diastolic function that can occur in asymptomatic patients with diabetes alone (termed diabetic cardiomyopathy). Evidence of cardiomyopathy has also been demonstrated in animal models of both Type 1 (streptozotocin-induced diabetes) and Type 2 diabetes (Zucker diabetic fatty rats and ob/ob or db/db mice). During insulin resistance or diabetes, the heart rapidly modifies its energy metabolism, resulting in augmented fatty acid and decreased glucose consumption. Accumulating evidence suggests that this alteration of cardiac metabolism plays an important role in the development of cardiomyopathy. Hence, a better understanding of this dysregulation in cardiac substrate utilization during insulin resistance and diabetes could provide information as to potential targets for the treatment of cardiomyopathy. This review is focused on evaluating the acute and chronic regulation and dysregulation of cardiac metabolism in normal and insulin-resistant/diabetic hearts and how these changes could contribute toward the development of cardiomyopathy.     

The Syrian hamster as a model for the dilated cardiomyopathy of Chagas' disease: a quantitative echocardiographical and histopathological analysis

Chronic Chagas' disease cardiomyopathy (CCC) is caused by the protozoan Trypanosoma cruzi, and it affects 30% of the 16-18 million people infected in Latin America. A good rodent model that develops a dilated cardiomyopathy closely resembling human CCC after T. cruzi infection is still needed. We compared the cardiomyopathy developed by T. cruzi-infected Syrian hamsters with human Chagas' disease cardiomyopathy using quantitative methods. Female hamsters were infected with 3.5 x 10(4) (G1, n = 10) or 10(5) (G2, n = 10) T. cruzi Y strain blood trypomastigotes. Control animals (C, n = 10) were injected with saline solution. Cardiac function was assessed by echocardiography at 4, 8 and 12 months post-infection. Heart sections were submitted to histopathological/morphometric analysis 12 months post-infection. At this time, ventricular dysfunction and diffuse or multi-focal myocarditis were observed in 91% and 100% of G1 and G2 infected groups, respectively. Median interstitial collagen volumes in groups C, G1 and G2 were 1.2%, 1.9% and 3.9%, respectively, and were significantly higher in group G2 than in group C. Among infected animals, myocarditis showed a positive correlation with interstitial fibrosis. Deaths in the chronic phase (8-12 months post-infection) were more frequent among G2 than G1, and were associated with macroscopic ventricular dilation, severe myocarditis and increased fibrosis values, along with an earlier onset of ventricular dysfunction. The T. cruzi chronically infected Syrian hamster develops a cardiomyopathy which resembles human Chagas' disease cardiomyopathy, and might be an adequate tool to investigate pathogenic mechanisms of this disease and to search for novel therapeutic strategies.     

The tyrosine kinase p56lck is essential in coxsackievirus B3-mediated heart disease

Infections are thought to be important in the pathogenesis of many heart diseases. Coxsackievirus B3 (CVB3) has been linked to chronic dilated cardiomyopathy, a common cause of progressive heart disease, heart failure and sudden death. We show here that the sarcoma (Src) family kinase Lck (p56lck) is required for efficient CVB3 replication in T-cell lines and for viral replication and persistence in vivo. Whereas infection of wild-type mice with human pathogenic CVB3 caused acute and very severe myocarditis, meningitis, hepatitis, pancreatitis and dilated cardiomyopathy, mice lacking the p56lck gene were completely protected from CVB3-induced acute pathogenicity and chronic heart disease. These data identify a previously unknown function of Src family kinases and indicate that p56lck is the essential host factor that controls the replication and pathogenicity of CVB3.     

Stress cardiomyopathy: Medical studies and extensive review

Stress cardiomyopathy (SC) was first reported in the year 1983. It is narrated as critical but quite commutative left ventricular (LV) malfunction mostly caused by poignant or psychological disorder. Numerous variations of SC have been described as well as reverse stress cardiomyopathy (rSC) which is an adaptation identified by the decreased muscle movement related with hyperkinesis that reconciles impetuously. The signature of rSC is a medical demonstration alike to syndrome by an acute coronary, with no obvious difficult coronary artery disease. The occurrence of SC is approximated to be 4% of all victims conferring with gleaned syndrome by acute coronary. The portion of victims conferring with the rSC transfiguration out of all SC patients has been inconstant, varying from 1 to 24%. Reverse stress cardiomyopathy cases are found to be common with young people, less decrease in left ventricular ejection fraction (LVEF) and more neurological disease compared to the SC. While the correct phenomenon of rSC is undetermined, postulated methods comprises of coronary microvasculature impairment, coronary artery spasm, and estrogen deficiency. Patients with rSC typically suffer with chest pain after an emotional or Psychological stressful event. The rSC can also be happened by general anesthesia, or neurological conditions. The diagnosis of rSC demands the presence of new electrocardiogram (EKG) abnormalities or elevated cardiac troponin, and absence of obstructive coronary disease, pheochromocytoma, or myocarditis. The consideration of rSC is quite analogous to that of SC, which is predominantly supportive with the treatment of complications. The recrudescence rate of rSC is around 12%. The most frequent complications of rSC include pericardial effusions, and development of LV thrombi.