不同剂量阿托伐他汀对稳定性心绞痛患者TNF-α 和LDL-C 水平的影响

目的:观察不同剂量阿托伐他汀对冠心病稳定性心绞痛患者血清肿瘤坏死因子a(TNF-α)和低密度脂蛋白胆固醇(LDL-C)水平的影响。方法:用酶联免疫吸附法和生化发光分析法测定40例正常对照组和40例阿托伐他汀10mg组及39例阿托伐他汀20mg组冠心病患者治疗前后血清TNF-α和LDL-C水平的变化。结果:阿托伐他汀10mg及20mg组患者治疗12周后血清TNF-α和LDL-C水平明显降低,并且阿托伐他汀20mg组比阿托伐他汀10mg组血清TNF-α下降更明显,差异有显著性(P<0.05),但两组间LDL-C水平降低无显著性差异(P>0.05)。结论:阿托伐他汀可以降低冠心病患者血清LDL-C和TNF-α水平,减轻冠心病的炎症反应,并且这种机制独立于降脂作用以外。     

小檗碱对动脉粥样硬化形成的抑制作用及机制探讨

目的:研究小檗碱(Berberine)对家兔动脉粥样硬化形成的抑制,并探讨其可能的作用机制。方法:将32只雄性新西兰大白兔随机分为正常组、模型对照组、小檗碱组和阿托伐他汀组,每组各8只。正常组以普通饲料喂养,其余各组高脂喂养,小檗碱组和阿托伐他汀组分别灌胃给予小檗碱(100 mg/kg,1次/d)和阿托伐他汀(5 mg/kg,1次/d),饲养12周。利用全自动生化分析仪测定兔血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,酶联免疫吸附法测定血清ox-LDL、MCP-1、MMP-9水平。观察斑块破裂和血栓形成情况,并进行苏木素-伊红(HE)染色,测量病变区域内膜与中膜的厚度。结果:小檗碱可显著降低高脂喂养家兔的血清TC、TG、LD-C水平,降低血清血清炎症因子ox-LDL、MCP-1、MMP-9水平(P0.01),与阿托伐他汀组相比无显著性差异。同时小檗碱组的内膜增生程度明显小于模型对照组,和阿托伐他汀组接近。结论:小檗碱可改善动脉粥样硬化病变的程度,抑制斑块的形成,同时降低血清中炎症因子标志物。     

不同剂量瑞舒伐他汀对老年冠心病患者疗效及安全性观察

目的:探讨不同剂量的瑞舒伐他汀对老年冠心病患者的疗效及安全性的影响。方法:抽取2012年6月至2013年6月于我院住院行冠脉造影检查示冠状动脉临界病变,诊断为冠状动脉粥样硬化性心脏病的患者210例(≥75岁),随机分为甲组,乙组,对甲组给予10 mg/d的瑞舒伐他汀药物口服治疗,乙组给予20 mg/d的瑞舒伐他汀药物口服治疗,其它协同药物服用方法均采集。收集患者开始服用瑞舒伐他汀药物前及服用后1月、6月、12月的血生化指标及颈动脉彩超结果,包括低密度脂蛋白胆固醇(Low-density Lipoprotein Cholesterol,LDL-C),总胆固醇(Total Cholesterol,TC),甘油三脂(Triglyceride,TG),高密度脂蛋白胆固醇(High-density Lipoprotein Cholesterol,HDL-C),超敏C反应蛋白(High Sensitivity C Reactive Protein,hs-CRP),颈动脉内-中膜厚度(Intima-media thickness,IMT),谷丙转氨酶(Alanine-Aminotransferase,ALT),观察这些指标服药前后变化的情况。结果:瑞舒伐他汀药物治疗1月、6月、12月后两组患者指标相比较,乙组患者较甲组患者TC、TG、LDL-C、hs-CRP、IMT降低更明显,而HDL-C升高水平则明显高于甲组,差别有统计学意义(P<0.05)。两组患者之间血生化指标ALT及药物治疗期间发生瑞舒伐他汀相关严重不良反应例数,无明显差别(P>0.05)。两组均无因心脏不良事件(MACE事件)而终止实验的患者。结论:对于老年冠心病患者,瑞舒伐他汀药物治疗可以获益,高强度的瑞舒伐他汀药物获益更显著,并且是安全的。     

阿托伐他汀治疗对肾脏衰老的影响

目的：观察长期应用不同剂量的阿托伐他汀对老年大鼠肾脏的影响。方法：正常20月龄Wistar雌性大鼠分为3组（n=9）：①给予大剂量阿托伐他汀10 mg/（kg.d）灌胃;②给予小剂量阿托伐他汀1 mg/（kg.d）灌胃;③给予等剂量生理盐水灌胃,三组均连续灌胃4个月后处死大鼠,以3月龄大鼠（n=9）为对照。测定肾重指数,血清肌酐及血清脂蛋白,行PAS染色、天狼猩红染色观察肾脏病理,计算肾小球硬化指数。结果：三组老年大鼠的肾脏重量均显著减轻。老年大鼠小剂量阿托伐他汀组显著降低老年大鼠的血清肌酐（P〈0.01）。老年大鼠血脂水平显著高于青年大鼠,大剂量阿托伐他汀组显著降低老年大鼠的总胆固醇（CH）和低密度脂蛋白胆固醇（LDL-C,P均〈0.05）,小剂量阿托伐他汀组显著降低老年大鼠的LDL-C（P〈0.05）。大剂量阿托伐他汀组降低血脂的作用强于小剂量阿托伐他汀组。老年大鼠肾脏病理改变为显著的肾小球局灶节段性硬化,肾小球硬化指数显著增高（P〈0.05）,肾间质内大量炎性细胞浸润,肾内小动脉明显硬化。阿托伐他汀组显著减轻肾小球的局灶节段性硬化的程度,减少肾间质内炎性细胞浸润,显著改善肾内小动脉粥样硬化的病变程度。大剂量阿托伐他汀改善肾组织异常病理表现的作用更为明显。结论：长期应用阿托伐他汀可以显著改善老年大鼠肾脏衰老的异常病理改变,这些作用可能是通过阿托伐他汀的降脂作用、显著减轻肾内小动脉硬化及显著减少肾间质内炎性细胞浸润而综合起效的。     

瑞舒伐他汀对兔动脉粥样硬化斑块及血清PAPP-A的影响

目的:探讨瑞舒伐他汀对兔动脉粥样硬化斑块及血清妊娠相关血浆蛋白(PAPP-A)的影响.方法:新西兰家兔18只,随机分为正常对照组(Normal组,n=6)、动物粥样梗化模型组(AS组,n=6)和瑞舒伐他汀治疗组(RSV组,n=6).于治疗前、治疗后,检测血清总胆固醇(TC)、三酰甘油(TG)、血清低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)含量,酶联免疲吸附法(ELISA)检测血清PAPP-A水平.同时,用血管内超声检查(IVUS)测定病变部位的血管外弹力膜面积(EEMA)、管腔面积(LA)和斑块面积(PA),计算管腔面积狭窄百分率(LAS%).结果:治疗前,AS组和RSV组兔的血清TC、TG、LDL-C及PAPP-A的水平较Normal组高(P<0.01),HDL-C的水平较Normal组低(P<0.01);治疗后,RSV组兔的血清TC、TG、LDL-C及PAPP-A比AS组低(P<0.01).HDL-C的水平比AS组高(P<0.01),且RSV组兔的血清TC、TG、LDL-C及PAPP-A的水平较治疗前低(P<0.01),HDL-C的水平较治疗前高(P<0.01).血管内超声检查结果显示,治疗后,RSV组兔的LAS%(30.87%±5.27%)比AS组低(37.42%±6.12%)(P<0.01).结论:瑞舒伐他汀能改善对AS兔血脂,减少AS斑块形成及降低血清PAPP-A水平.     

枸杞子水提取物对Bel-7402人肝癌细胞增殖的影响

目的:探讨枸杞水提取物对Bel-7402人肝癌细胞增殖的影响。方法:用RPMI-1640完全培养液温育Bel-7402人肝癌细胞,分为空白对照组和药物组,空白对照组给予培养液处理,药物组分为低剂量组(100μg/m L)和高剂量组(200μg/mL),实验过程加入相应剂量的枸杞子水提取物。于倒置显微镜下观察三组细胞形态学变化,采用流式细胞仪观察细胞的凋亡状况及活性氧簇(ROS)含量,采用MTT法检测细胞增殖的抑制作用,采用反转录-聚合酶链式反应(RT-PCR)检测Bel-7402细胞中bax m RNA和bcl-2 m RNA的表达。结果:在倒置显微镜下观察,枸杞子水提取物使Bel-7402细胞生长受到抑制,表现为细胞贴壁减少、脱落增加,脱落的细胞浮悬于培养液中,呈圆形,体积缩小。枸杞子水提取物可促进Bel-7402细胞凋亡,药物组Bel-7402细胞的凋亡率比空白对照组明显增加(P0.01),G0/G1期细胞比率减少(P0.05),G2/M2期细胞比率增加(P0.05),且ROS含量增加(P0.05)。枸杞子水提取物对Bel-7402细胞的生长有明显抑制作用,且抑制率随着培养时间的延长而增加,且高剂量组在96小时时抑制率最高。药物组Bel-7402细胞中bax基因灰度比值显著高于空白对照组(P0.01),bcl-2基因灰度比值显著低于空白对照组(P0.01)。结论:枸杞子水提取物可抑制Bel-7402人肝癌细胞的增殖、阻滞细胞周期、诱导细胞凋亡,增加ROS含量,促进bax基因表达,抑制bcl-2基因表达,该实验结果可为枸杞子抗肝癌作用提供实验依据。     

不同剂量阿托伐他汀对冠心病患者心功能、血脂及血清TNF-α、ANF水平的影响

目的:探讨不同剂量阿托伐他汀对冠心病患者心功能、血脂及血清肿瘤坏死因子-α(TNF-α)、心钠素(ANF)水平的影响。方法:选取2016年1月到2017年1月在我院接受治疗的冠心病患者86例,根据随机数字表法将患者分为观察组和对照组,各43例,对照组给予10 mg剂量的阿托伐他汀进行治疗,观察组给予20 mg剂量的阿托伐他汀进行治疗,两组均治疗6个月。比较两组患者治疗前后的左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心房前后径(LAD)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、TNF-α、ANF水平。对所有患者进行1年的随访,比较患者出现心肌梗死、心律失常、心源性死亡等心血管事件的情况。结果:治疗后两组的LVEDD、LAD、TC、TG、LDL-C、TNF-α、ANF均显著降低,LVEF、HDL-C显著升高(P0.05),治疗后观察组的LVEDD、LAD、TC、TG、LDL-C、TNF-α、ANF低于对照组,LVEF高于对照组(P0.05)。两组的心血管事件发生率比较无统计学差异(P0.05)。结论:两种剂量的阿托伐他汀均能有效的改善冠心病患者的心功能和血脂,降低患者体内的炎症反应,但20 mg剂量的阿托伐他汀效果更佳。     

研究: PCSK9/LDLR通路介导姜黄素烟酸酯促进HepG2摄取脂质

为研究PCSK9/LDLR通路介导姜黄素烟酸酯(CurTn)降低血浆低密度脂蛋白胆固醇(LDL-C),减少动脉内膜下脂质沉积的分子机制,用5、10、15 μmo/L姜黄素烟酸酯与25 mg/L LDL共孵育HepG2细胞24 h,分别采用油红O染色、胆固醇荧光定量试剂盒、DiI-LDL摄取检测细胞内胆固醇含量及LDL摄取情况,用逆转录定量聚合酶链反应(RT-Q-PCR)检测LDLR及SREBP2的mRNA表达,蛋白质印迹检测LDLR、SREBP2及PCSK9蛋白表达．随姜黄素烟酸酯作用浓度的增高细胞内脂滴显著增多,细胞内游离胆固醇(FC)、总胆固醇(TC)含量增高,细胞内胆固醇摄取增多;RT-Q-PCR和蛋白质印迹检测发现,与对照组(Control)比较,5、10、15 μmo/L 姜黄素烟酸酯处理组LDLR 蛋白表达增高,SREBP2 mRNA表达水平升高,PCSK9蛋白表达降低,但对LDLR mRNA及SREBP2 蛋白表达无影响．结果表明：姜黄素烟酸酯通过降低PCSK9、减少LDLR降解、升高LDLR蛋白表达,促进HepG2细胞胆摄取胆固醇．初步说明CurTn可能通过抑制PCSK9介导LDLR溶酶体降解,促进肝脏清除血浆LDL-C水平．     

阿托伐他汀对兔缺血再灌注后白介素-6、P-选择素及无复流的影响

目的:评价不同剂量阿托伐他汀对兔急性心肌梗死(AMI)再灌注后白介素-6(IL-6)、P-选择素(Ps)的影响及对无复流的防治作用.方法:新西兰大白兔32只随机分为对照组、阿托伐他汀1组、阿托伐他汀2组及假手术组,每组8只.分组干预:阿托伐他汀1组予10mg.kg-1,冠脉结扎前12h喂药1次;阿托伐他汀2组予5mg.kg1.d-1,每日喂药1次,共3d.对照组、阿托伐他汀1组、阿托伐他汀2组均冠状动脉结扎240min,再灌注120min,分别建立AMI再灌注模型.各组于AMI前5 min、AMI后240min和再灌注后120min取血,采用酶联免疫吸附法(ELISA)测定血清IL-6,免疫组织化学法观察心肌Ps的变化,最终进行心肌无复流及梗死范围的病理学分析.结果:与对照组比较,阿托伐他汀1组及2组在兔AMI再灌注后血清IL-6水平均降低(P＜0.05-0.01):阿托伐他汀1组及2组在复流区及无复流区的Ps表达均明显减弱(P＜0.01);而血清IL-6、心肌Ps在阿托伐他汀1组及2组之间差异均无统计学意义(P＞0.05).阿托伐他汀1组及2组中,无复流范围分别为(47.01±6.89)%及(44.52±4.2))%(P＞0.05).与对照组(85.67±4.94)%相比均降低(P＜0.01)结论:炎症反应可能是AMI再灌注后无复流的发生机制之一;阿托伐他汀可有效降低血清IL-6、心肌Ps水平,具有抗炎作用,从而防治无复流的发生.     

双歧三联活菌胶囊联合阿托伐他汀对高脂血症患者肠道乳酸杆菌数量的影响及疗效观察

目的探讨双歧三联活菌胶囊联合阿托伐他汀对高脂血症患者肠道乳酸杆菌数量的影响及疗效观察。方法选取心内科就诊治疗的高脂血症患者86例,随机将其分为观察组(n=43例)和对照组(n=43例)。观察组患者予以双歧三联活菌胶囊联合阿托伐他汀治疗8周,其中双歧三联活菌胶囊420 mg/次,3次/d;阿托伐他汀片10 mg/次,1次/d。对照组患者予以单纯的阿托伐他汀治疗,剂量、方法及疗程同观察组。观察并记录两组患者治疗前后血脂总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平及肠道乳酸杆菌数量的变化。结果治疗8周后,两组患者TC、TG和LDL-C较前均有不同程度下降,HDL-C水平较前均有不同程度上升(P0.05),且观察组下降或上升幅度较对照组更明显(P0.05);同时两组患者肠道乳酸杆菌数量较前均有不同程度上升(P0.05),且观察组上升幅度较对照组更明显(P0.05)。结论双歧三联活菌胶囊联合阿托伐他汀治疗高脂血症能更明显降低TC、TG和LDL-C水平,升高HDL-C水平,具有良好的调脂效应,可能与其能调整肠道内的微生物菌群,大幅提升肠道乳酸杆菌数量密切相关。     

Oleic acid decreases the expression of a cholesterol transport-related protein (NPC1L1) by the induction of endoplasmic reticulum stress in CaCo-2 cells

The reported data indicate that oleic acid (OA) decreases cholesterol absorption. To explore the underlying mechanisms, the effects of OA on the expression of cholesterol transport-related proteins (NPC1L1, ABCG5/8, ACAT2, MTP) and the unfolded protein response (UPR) pathway were studied in CaCo-2 enterocytes by incubating CaCo-2 cells with taurocholate micelles or taurocholate micelles containing different concentrations of OA (0.25–1.0 mM). We show that OA effectively induces XBP1 mRNA splicing, a key component of the UPR signaling, and the expression of BiP and mature ATF6 proteins in a concentration-dependent manner, leading to the induction of endoplasmic reticulum (ER) stress and activation of the UPR. Interestingly, OA decreases NPC1L1 expression in a dose-dependent manner while it has no effects on ABCG5 and MTP mRNA level or SREBP-2, ABCG8, and ACAT2 protein level. In CaCo-2 cells treated with 1.0 mM OA, both the NPC1L1 mRNA level and the NPC1L1 protein expression in brush-border membrane fractions were decreased by 39% and 37%, respectively (P < 0.01). A dose of 1 mM dithiothreitol (DTT), a positive control for ER stress induction, also decreases NPC1L1 mRNA and protein expression by 27% and 23%, respectively (P < 0.05). Furthermore, 4-phenyl-butyric acid, an UPR inhibitor, blocks OA- and DTT-induced reduction on NPC1L1 mRNA and protein levels. The results suggest that OA down-regulates NPC1L1 mRNA and protein expression via the induction of the UPR, which may play an important role in reducing intestinal cholesterol absorption.     

Anticancer drugs are synergistic with freezing in induction of apoptosis in HCC cells

Cryotherapy has been shown to be an important therapeutic alternative to surgery in the treatment of hepatocellular carcinoma (HCC). Here, the influence of cryo-chemotherapy on HCC was examined in vitro using the human HCC cell line Bel-7402, a drug-resistant HCC cell line originating from Bel-7402 cells (Bel-7402/R), as well as two control cell lines, the HCC cell line SMMC-7721 and a colorectal tumor cell line HIC-251. Cells were treated with either exposure to different freezing temperatures (ranging from −15 to −80 °C for 20 min), exposure to sub-lethal concentrations of anticancer chemotherapy drugs or a combination of cryotherapy and chemotherapy. Cell viability and apoptosis under each condition were investigated. We found that the combined treatment resulted in increases in both cell death and apoptosis compared to either treatment alone. The increased level of apoptosis observed in Bel-7402 cells after cryo-chemotherapy was inhibited in the presence of caspase inhibitors. Furthermore, Bax expression was increased 2- to 3-fold in cells exposed to the combination treatment compared with cells treated by freezing or drugs alone. In contrast, Bcl-2 levels remained constant. Although Bel-7402/R cells originated from the Bel-7402 cell line, they were more sensitive to the freezing procedure than the parental cell line. The level of Bax expression in Bel-7402/R cells was also higher than that observed in the parental cell line. In addition, we found that Bel-7402/R cells had lower levels of survivin mRNA than the parental Bel-7402 cells, in both untreated and treated cells. In conclusion, our data show that in HCC cells, apoptosis induced by cryotherapy can be synergistically enhanced using anticancer drugs.     

Effects of CYP7A1 overexpression on cholesterol and bile acid homeostasis

The initial and rate-limiting step in the classic pathway of bile acid biosynthesis is 7alpha-hydroxylation of cholesterol, a reaction catalyzed by cholesterol 7alpha-hydroxylase (CYP7A1). The effect of CYP7A1 overexpression on cholesterol homeostasis in human liver cells has not been examined. The specific aim of this study was to determine the effects of overexpression of CYP7A1 on key regulatory steps involved in hepatocellular cholesterol homeostasis, using primary human hepatocytes (PHH) and HepG2 cells. Overexpression of CYP7A1 in HepG2 cells and PHH was accomplished by using a recombinant adenovirus encoding a CYP7A1 cDNA (AdCMV-CYP7A1). CYP7A1 overexpression resulted in a marked activation of the classic pathway of bile acid biosynthesis in both PHH and HepG2 cells. In response, there was decreased HMG-CoA-reductase (HMGR) activity, decreased acyl CoA:cholesterol acyltransferase (ACAT) activity, increased cholesteryl ester hydrolase (CEH) activity, and increased low-density lipoprotein receptor (LDLR) mRNA expression. Changes observed in HMGR, ACAT, and CEH mRNA levels paralleled changes in enzyme specific activities. More specifically, LDLR expression, ACAT activity, and CEH activity appeared responsive to an increase in cholesterol degradation after increased CYP7A1 expression. Conversely, accumulation of the oxysterol 7alpha-hydroxycholesterol in the microsomes after CYP7A1 overexpression was correlated with a decrease in HMGR activity.     

l-Cysteine-induced up-regulation of the low-density lipoprotein receptor is mediated via a transforming growth factor-alpha signalling pathway

Sulphur-containing amino acids regulate plasma cholesterol levels in animals and humans. However, their mechanism of action remains unclear. Low-density lipoprotein receptor (LDLR) plays an important role in cholesterol metabolism. We therefore investigated the effects of sulphur-containing amino acids on the expression of LDLR in hepatocytes. HepG2 cells were cultured in Dulbecco’s Modified Eagle’s Medium with or without sulphur-containing amino acids and cysteine-containing compounds. We found that l-cysteine increased LDLR mRNA and enhanced LDLR gene promoter activity through the extracellular-signal-related kinase and p38 mitogen-activated protein kinase signalling pathways in HepG2 cells. Moreover, we observed that l-cysteine stimulated the release of transforming growth factor-alpha (TGF-α) and that TGF-α increased the LDLR mRNA levels. This study provides a report of the l-cysteine mediated up-regulation of the LDLR expression via TGF-α signalling pathway. Our findings provide insights into cholesterol homeostasis and amino acid signalling.     

Piperine Induces Hepatic Low-Density Lipoprotein Receptor Expression through Proteolytic Activation of Sterol Regulatory Element-Binding Proteins

Elevated plasma low-density lipoprotein (LDL) cholesterol is considered as a risk factor for atherosclerosis. Because the hepatic LDL receptor (LDLR) uptakes plasma lipoproteins and lowers plasma LDL cholesterol, the activation of LDLR is a promising drug target for atherosclerosis. In the present study, we identified the naturally occurring alkaloid piperine, as an inducer of LDLR gene expression by screening the effectors of human LDLR promoter. The treatment of HepG2 cells with piperine increased LDLR expression at mRNA and protein levels and stimulated LDL uptake. Subsequent luciferase reporter gene assays revealed that the mutation of sterol regulatory element-binding protein (SREBP)-binding element abolished the piperine-mediated induction of LDLR promoter activity. Further, piperine treatments increased mRNA levels of several SREBP targets and mature forms of SREBPs. However, the piperine-mediated induction of the mature forms of SREBPs was not observed in SRD–15 cells, which lack insulin-induced gene–1 (Insig–1) and Insig–2. Finally, the knockdown of SREBPs completely abolished the piperine-meditated induction of LDLR gene expression in HepG2 cells, indicating that piperine stimulates the proteolytic activation of SREBP and subsequent induction of LDLR expression and activity.