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。     

Role of the JAK-STAT pathway in protection of hydrogen peroxide preconditioning against apoptosis induced by oxidative stress in PC12 cells

The aim of this study was to investigate the role of JAK-STAT pathway in the cytoprotection afforded by preconditioning with H₂O₂. It was shown that (1) Preconditioning with 100 μmol/L H₂O₂ can markedly protect PC12 cells against apoptosis and cytotoxicity induced by 300 μmol/L H₂O₂; (2) The expression and tyrosine phosphorylation of JAK2, not JAK1 were rapidly increased at 5 min after H₂O₂ preconditioning; (3) The expression of STAT1 and STAT3 were significantly increased at 15 min after H₂O₂ preconditioning, and the pTyr-STAT1 and pTyr-STAT3 were markedly increased at 60 min after H₂O₂ preconditioning; (4) Pretreatment with the JAK inhibitor AG-490 (10 μmol/L) 20 min before H₂O₂ preconditioning blocked not only the activation of JAK2, STAT1 and STAT3, but also the cytoprotection of H₂O₂ preconditioning against apoptosis and cytotoxicity induced by oxidative stress. These findings suggested that preconditioning with H₂O₂ activated the JAK-STAT pathway that played an important role in the cytoprotection induced by H₂O₂ preconditioning.     

Effects of pharmacological preconditioning by emodin/oleanolic acid treatment and/or ischemic preconditioning on mitochondrial antioxidant components as well as the susceptibility to ischemia-reperfusion injury in rat hearts

Using an ex vivo rat heart model of ischemia-reperfusion (I-R) injury, we examined the effect of pharmacological preconditioning by chronic treatment with emodin (EMD)/oleanolic acid (OA) at low dose (25 μ mol/kg/day × 15) and/or ischemic preconditioning (IPC) (4 cycles of 5 min ischemia followed by 5 min of reperfusion) on myocardial I-R injury. The results indicated that EMD/OA pretreatment, IPC, or their combinations (EMD+IPC and OA+IPC) protected against myocardial I-R injury, as assessed by lactate dehydrogenase leakage and contractile force recovery. The cardioprotection was associated with a differential enhancement in mitochondrial antioxidant components. The combined EMD/OA and IPC pretreatment produced cardioprotective action in a semi-additive manner. This suggested that EMD/OA pretreatment and IPC protected against myocardial I-R injury via a similar but not identical biochemical mechanism.     

Role of the cyclooxygenase pathway in the protection against postischemic stunning in conscious sheep

Objective: There are controversial reports in conscious animals regarding the role of cyclooxygenase-2 in late preconditioning (LP). This study analyzed the effect of COX-2 involvement in non-preconditioned hearts (NP) and in mediation of LP protection against stunning in conscious sheep submitted to a prolonged reversible ischemia. Methods: Six groups were considered: NP: 12 min ischemia and 120 min reperfusion; LP consisting of six periods of 5 min-ischemia-5 min reperfusion 24 h before the 12 min ischemia; NP and LP with either the non-selective COX-1 and COX-2 inhibitor, aspirin (20 mg/kg), or the specific COX-2 inhibitor, celecoxib (3 mg/kg) before the 12 min ischemic period. Results: Mean postischemic wall thickening fraction (as % of preischemic values) improved from 49.6 ± 4.0% in NP to 72.5 ± 3.5% in LP (p < 0.01) and a similar protection was obtained with aspirin and celecoxib in NP hearts (p < 0.01). Neither aspirin nor celecoxib administration prior to the prolonged ischemia on day 2 abrogated LP improvement of postischemic dysfunction. Moreover, LP with aspirin improved the protective response (80.7 ± 2.6%) over that obtained with aspirin in NP hearts (66.6 ± 4.7%, p < 0.05). This effect was not obtained with celecoxib. Conclusions: Aspirin and celecoxib showed that COX-2 has a detrimental effect on mechanical cardioprotection in NP hearts of conscious sheep submitted to a prolonged reversible ischemia, and does not seem to participate as mediator of LP. Aspirin revealed a similar COX-1 deleterious action, since only when both COX-1 and COX-2 were inhibited, LP was put in evidence adding functional improvement over that obtained in NP hearts treated with aspirin.     

Ischemic preconditioning protects cardiomyocytes against ischemic injury by inducing GRP78

Ischemic preconditioning (IP) conferred by brief ischemia-reperfusion induces resistance to cell injury due to the following lethal ischemia. This study aimed to elucidate whether 78-kDa glucose-regulated protein (GRP78), a main ER molecular chaperone, contributes to IP-mediated protection against ischemic myocardial injury. In a rat coronary artery occlusion model, the GRP78 protein level increased to 210% of the sham level by early IP with three cycles of 4-min ischemia and 4-min reperfusion. The IP reduced infarct size in subsequent lethal ischemia. In primary cardiomyocytes, the simulated IP procedure, incubation in oxygen-glucose deprivation (OGD) medium, also increased the GRP78 expression and suppressed the cell death caused by lethal ischemia. Transfection of grp78 antisense oligonucleotide attenuated the IP-mediated resistance to ischemia. This study showed for the first time that early IP up-regulates myocardial GRP78. It was suggested that GRP78 induced by early IP contributes to protect cardiomyocytes against ischemic injury.     

The Akt1 isoform is an essential mediator of ischaemic preconditioning

Phosphatidyl-inositol-3-kinase (PI3K)-Akt pathway is essential for conferring cardioprotection in response to ischaemic preconditioning (IPC) stimulus. However, the role of the individual Akt isoforms expressed in the heart in mediating the protective response to IPC is unknown. In this study, we investigated the specific contribution of Akt1 and Akt2 in cardioprotection against ischaemia-reperfusion (I-R) injury. Mice deficient in Akt1 or Akt2 were subjected to in vivo regional myocardial ischaemia for 30 min. followed by reperfusion for 2 hrs with or without a prior IPC stimulus. Our results show that mice deficient in Akt1 were resistant to protection with either one or three cycles of IPC stimulus (42.7 ± 6.5% control versus 38.5 ± 1.9% 1 χ IPC, N = 6, NS; 41.4 ± 6.3% control versus 32.4 ± 3.2% 3 χ IPC, N = 10, NS). Western blot analysis, performed on heart samples taken from Akt1(-/-) mice subjected to IPC, revealed an impaired phosphorylation of GSK-3β, a downstream effector of Akt, as well as Erk1/2, the parallel component of the reperfusion injury salvage kinase pathway. Akt2(-/-) mice, which exhibit a diabetic phenotype, however, were amenable to protection with three but not one cycle of IPC (46.4 ± 5.6% control versus 35.9 ± 5.0% in 1 χ IPC, N = 6, NS; 47.0 ± 6.0% control versus 30.8 ± 3.3% in 3 χ IPC, N = 6; *P = 0.039). Akt1 but not Akt2 is essential for mediating a protective response to an IPC stimulus. Impaired activation of GSK-3β and Erk1/2 might be responsible for the lack of protective response to IPC in Akt1(-/-) mice. The rise in threshold for protection in Akt2(-/-) mice might be due to their diabetic phenotype.     

高氧液预处理对兔心肌缺血再灌注损伤的影响

目的:研究高氧液预处理对兔心肌缺血再灌注损伤的影响。方法:雄性新西兰白兔32只,随机分为4组(n=8),结扎-开放冠状动脉左前降支(LAD)建立心肌缺血再灌注模型。假手术组(Sham组)只穿线环绕LAD不结扎;吸氧组(OX组)结扎前30 min经鼻吸纯氧2L/min;在结扎LAD前30 min分别静脉注射HO 10 ml/kg(HO1组)、20 ml/kg(HO2组)。于结扎LAD前即刻(T0,基础值)、开放LAD前即刻(T1)、再灌注60 min(T2)及再灌注120 min(T3)时记录HR和MAP,于T3时抽取动脉血样3 ml,测定血清肌酸激酶(CK)、肌钙蛋白I(cTNI)的活性和IL-6和TNF-α的浓度,并测定心肌梗死范围。结果:I/S组与T0时比较,T 1-3时各组HR、MAP进行性下降(P<0.05);三组间HR、MAP比较差异无统计学意义(P>0.05)。与Sham组比较,I/S组血清CK、cTNI、IL-6和TNF-α含量明显升高(P 0.01);与OX组比较,HO2组上述酶及炎症因子浓度显著下降(P<0.01),心肌梗死范围减小(P<0.05)。结论:高氧液预处理可减轻兔心肌缺血再灌注损伤,机制可能与其抑制炎性反应有关。     

关节镜清理术治疗前踝撞击征的疗效

目的:探讨踝关节镜对前踝撞击征的诊疗价值。方法:采用关节镜清理术治疗前踝撞击综合征33例,其中男23例,女10例。年龄平均39岁(18～72岁)。左踝16例,右踝17例。病史6个月至20年,有运动损伤史13例,踝关节扭伤病史17例,踝关节骨折史3例。临床表现为踝关节肿胀、疼痛和下蹲活动受限。X线片显示胫骨前唇和距骨骨质增生,MRI显示距骨软骨损伤,踝关节腔内积液。采用局麻关节镜下骨赘磨削,滑膜切除,踝关节清理术。结果:随访33例,平均时间35个月(4个月-6年)。术后踝关节背伸活动功能正常,按照McGuire踝关节评分系统对术前、术后踝关节功能进行评估,术前平均55分,术后平均80分,术后提高了25分。优13例,良15例,可3例,差2例,优良率84.8%。结论:局麻下踝关节镜骨赘切除、滑膜刨削和软骨修整可有效解除踝关节撞击症状,手术创伤小、功能恢复快,效果满意。     

In vitro and in vivo studies of F0F1ATP synthase regulation by inhibitor protein IF1 in goat heart

A method has been developed to allow the level of F₀F₁ATP synthase capacity and the quantity of IF₁ bound to this enzyme be measured in single biopsy samples of goat heart. ATP synthase capacity was determined from the maximal mitochondrial ATP hydrolysis rate and IF₁ content was determined by detergent extraction followed by blue native gel electrophoresis, two-dimensional SDS-PAGE and immunoblotting with anti-IF₁ antibodies.Anaesthetized open-chest goats were subjected to ischemic preconditioning and/or sudden increases of coronary blood flow (CBF) (reactive hyperemia). When hyperemia was induced before ischemic preconditioning, a steep increase in synthase capacity, followed by a deep decrease, was observed. In contrast, hyperemia did not affect synthase capacity when applied after ischemic preconditioning. Similar effects could be produced in vitro by treatment of heart biopsy samples with anoxia (down-regulation of the ATP synthase) or high-salt or high-pH buffers (up-regulation). We show that both in vitro and in vivo the same close inverse correlation exists between enzyme activity and IF₁ content, demonstrating that under all conditions tested the only significant modulator of the enzyme activity was IF₁. In addition, both in vivo and in vitro, 1.3-1.4 mol of IF₁ was predicted to fully inactivate 1 mol of synthase, thus excluding the existence of significant numbers of non-inhibitory binding sites for IF₁ in the F₀ sector.