Donors of nitric oxide mimic effects of ischaemic preconditioning on reperfusion induced arrhythmias in isolated rat heart

NO has been implicated in the mechanism of ischaemic preconditioning. To verify this hypothesis further we have attempted to reproduce effects of ischaemic preconditioning by nitric oxide donors administration prior to the ischaemia. The effect of glyceryl trinitrate (GTN) and 3-morpholino-sydnonimine-hydrochloride (SIN- 1), NO donors, on reperfusion induced ventricular tachycardia (VT) and ventricular fibrillation (VF) in Langendorff perfused rat hearts subjected to 10 min regional ischaemia followed by 10 min reperfusion were examined. Results: GTN, 500 M and SIN-1, 10 M, administered for 5 min and washed for another 5 min prior to ischaemia (to mimic ischaemic preconditioning), almost completely abolished reperfusion induced VF. GTN and SIN-1, administered at the time of reperfusion, increased the incidence of sustained VF and the duration of VT and VF. When given 5 min before the ischaemia and throughout the ischaemia and the reperfusion, SIN-1 abolished VF. Adenosine, 10 M, applied according to the above three protocols, did not affect reperfusion arrhythmias, although adenosine induced changes in coronary flow and post-ischaemic reflow were similar to those produced by the NO donors. In conclusions: (1) NO is able to mimic the effect of ischaemic preconditioning on reperfusion arrhythmias in rat heart, supporting the view that NO may be one of the endogenous substances triggering ischaemic preconditioning; (2) In crystalloid-perfused heart, NO may be deleterious when its administration is restricted to the reperfusion period.     

应变率成像技术评价吗啡预处理对兔心肌缺血再灌注损伤时左室功能的影响

目的:应用应变率成像技术(SRI)动态观察和评价吗啡预处理对兔心肌缺血再灌注损伤时左室长轴功能的影响。方法:建立新西兰大白兔心肌缺血再灌注模型,随机分为假手术组(SH组)、吗啡预处理组(MF组)和生理盐水预处理组(NS组)。于手术前1天及手术术后28天内不同时间点测量超声心动图常规数据及左室各壁收缩期峰值速度与应变率参数。结果:术后1天,MF组与NS组左室整体与局部心肌收缩功能较术前和SH组明显减低(P0.05),并随缺血再灌注时间的延长呈减低趋势(P0.05),且NS组减低更明显(P0.05)。结论:SRI技术能够客观、准确地评价缺血再灌注损伤心肌的局部收缩功能的变化,而吗啡预处理对兔心肌缺血再灌注损伤存在明显的弱化作用。     

Renalase contributes to the renal protection of delayed ischaemic preconditioning via the regulation of hypoxia‐inducible factor‐1α

Ischaemic preconditioning (IPC) attenuates acute kidney injury (AKI) from renal ischaemia reperfusion. Renalase, an amine oxidase secreted by the proximal tubule, not only degrades circulating catecholamines but also protects against renal ischaemia reperfusion injury. Here, it has been suggested that the renoprotective effect of renal IPC is partly mediated by renalase. In a model of brief intermittent renal IPC, the increased cortex renalase expression was found to last for 48 hrs. IPC significantly reduced renal tubular inflammation, necrosis and oxidative stress following renal ischaemia reperfusion injury. Such effects were attenuated by blocking renalase with an anti‐renalase monoclonal antibody. We further demonstrated that renalase expression was up‐regulated by hypoxia in vitro via an hypoxia‐inducible factor (HIF)‐1α mechanism. The IPC‐induced up‐regulation of renalase in vivo was also reduced by pre‐treatment with an HIF‐1α inhibitor, 3‐(5′‐Hydroxymethyl‐2′‐furyl)‐1‐benzyl indazole. In summary, the renoprotective effect of IPC is partly dependent on the renalase expression, which may be triggered by hypoxia via an HIF‐1α mechanism. Endogenous renalase shows potential as a therapeutic agent for the prevention and treatment of AKI.     

Effects of hypoxic preconditioning on the expression of iron influx and efflux proteins in primary neuron culture

The mechanisms of neuroprotection induced by hypoxic preconditioning (HP) and the effects of HP on iron metabolism proteins in the brain have not been fully elucidated. Based on the accumulated information, we hypothesized that HP would be able to affect the expression of iron metabolism proteins in the brain and that the changes in the expression of these proteins induced by HP might be partly associated with the HP-induced neuroprotection. Here, we demonstrated for the first time that HP could induce a significant increase in the expression of HIF-1alpha as well as iron uptake (TfR1 and DMT1) and release (Fpn1) proteins and thus increase transferrin-bound iron (Tf-Fe) and non-transferrin-bound iron (NTBI) uptake and iron release, and also a progressive increase in cellular iron content in the cultured neurons. We concluded that HP has the ability to speed iron transport rate and proposed that the increase in iron transport rate and cellular iron in neurons might be one of the mechanisms involved in neuroprotection in the HP neurons. We also demonstrated that Fpn1 expression was significantly affected by HIF-1alpha, implying that the gene encoding this iron efflux protein is hypoxia-inducible.     

Brief antecedent anoxia preserves mitochondrial function after sustained undersupply: A subcellular correlate to ischemic preconditioning?

Background: There is increasing evidence that mitochondria – owning a high degree of autonomy within the cell – might represent the target organelles of the myocardial protection afforded by ischemic preconditioning. It was the aim of the study to investigate a possible subcellular correlate to ischemic preconditioning at the mitochondrial level. In addition, we tested whether this protection depends on mitochondrial ATP-dependent potassium channels (K _ATP) and an might involve an attenuation of mitochondrial ATP hydrolysis during sustained anoxia.Methods and Results: Sustained anoxia (A, 14 min) and reoxygenation (R) completely inhibited state 3 and state 4 respiration of isolated ventricular mitochondria from Wistar rats. An antecedent brief anoxic incubation (4 min) followed by reoxygenation (2 min) prevented this loss of mitochondrial function. The protection afforded by anoxic preconditioning could be mimicked by the K _ATP opener diazoxide (30 μmol/l) and was completely inhibited by the K _ATP blocker 5-hydroxydecanoic acid (300 μmol/l). Structural mitochondrial integrity, as estimated from externalization of the mitochondrial enzymes creatine kinase and glutamateoxalacetate transaminase, remained unchanged between the groups, as did mitochondrial ATP loss during anoxia.Conclusion: For the first time, we provide direct evidence for a subcellular preconditioning-like functional mitochondrial adaptation to sustained anoxia. This effect apparently depends on opening of K_ATP but is independent of ATP preservation.     

Synergistic protective effect of ischemic preconditioning and allopurinol on ischemia/reperfusion injury in rat liver

This study examined the effects of ischemic preconditioning (IPC), allopurinol (Allo) or a combination of both on the extent of mitochondrial injury caused by hepatic ischemia/reperfusion (I/R). I/R increased the serum aminotransferase activity and the level of mitochondrial lipid peroxidation, whereas it decreased the mitochondrial glutathione level. Either IPC or Allo alone attenuated these changes with Allo+IPC having a synergistic effect. Allo increased the serum nitrite and nitrate level after brief ischemia. The significant peroxide production observed after 10 min of reperfusion after sustained ischemia was markedly attenuated by Allo+IPC. The mitochondria isolated after I/R were swollen, which was reduced by Allo+IPC. At the end of ischemia, the hepatic ATP level was lower and there was significant xanthine accumulation, which was attenuated by Allo+IPC. These results suggest that IPC and Allo act synergistically to protect cells against mitochondrial injury and preserve the hepatic energy metabolism during hepatic I/R.     

在低氧预处理延迟心肌保护中钙网蛋白表达升高

本文分别在整体实验和细胞培养条件下研究钙网蛋白（calreticulin,CRT）在低氧预处理（hypoxic preconditioning,HPC）延迟心肌保护中的表达及其信号转导机制。（1）整体实验时Wistar大鼠随机分为3组：假手术（sham）组、仅结扎冠状动脉的心肌缺血（myocardial infarction,MI）组和HPC后再结扎冠状动脉的HPC＋MI组,分别于术后24h、14d和28d观察HPC对缺血后心功能和梗死区、危险区面积的影响;采用Western blot检测CRT表达以及p38丝裂素活化蛋白激酶（p38mitogenactivated protein kinase,p38MAPK）、应激活化蛋白激酶（stress-activated protein kinase,SAPK）活性。（2）原代培养Sprague—Dawley乳鼠心肌细胞,随机分为6组：低氧,复氧（hypoxia／reoxygenation,H／R）组、HPC组、HPC＋H,R组、p38MAPK抑制剂SB203580＋HPC＋H／R（SB＋HPC＋H／R）组、SAPK抑制剂SP600125＋HPC＋H瓜（SP＋HPC＋H／R）组和正常对照组;采用台盼蓝排斥实验、乳酸脱氢酶（1actate dehydrogenase,LDH）活性检测及流式细胞仪检测各组细胞损伤情况;采用Western blot检测CRT表达及p38MAPK、SAPK的磷酸化水平。主要结果如下：（1）整体动物实验结果表明,HPC改善缺血对心肌左室压力最大上升,下降速度（＋dp／dtmax）的抑制,限制心肌梗死面积;HPC后CRT表达呈动态变化：术后24h时HPC＋MI组CRT表达增高106％（P〈0．05vsMI组）,以危险区最为显著;14d至28d表达逐步降低。相关分析显示,术后24h时CRT表达量与心功能呈正相关（r=0．9867,P〈0．05）,与梗死面积呈负相关（r=-0．9709,P〈0．05）。（2）细胞培养实验结果表明,HPC可减轻H／R诱导的心肌细胞LDH漏出,增加心肌细胞存活率,降低细胞凋亡;单纯HPC可诱导CRT表达轻度增加（222％,P〈0．05vs对照组）,而损伤性H／R诱导CRT过表达（503％,P〈0．05vs对照组）,HPC可降低H／R诱导CRT表达升高的幅度;p38MAPK活性与HPC诱导的CRT表达呈正相关（r=0．9021,P〈0．05）,而SAPK活性与其呈负相关（r=-0．8211,P〈0．05）。由此得出结论：（1）整体实验中HPC可明显改善缺血后心脏的收缩与舒张功能,限制心肌梗死范围,促进危险区心肌恢复;心肌梗死早期,HPC诱导CRT表达上调,参与心肌保护;（2）细胞培养实验中HPC可诱导CRT适度表达,增强原代培养乳鼠心肌细胞对H／R损伤的抵抗力;p38MAPK可能介导HPC诱导的CRT表达,而SAPK激活可能不利于心肌保护。