老年缺血性心力衰竭的心脏DNA甲基化编码重编程与心肌细胞焦亡、铁死亡的关联

摘要 目的：探讨老年缺血性心力衰竭的心脏DNA甲基化编码重编程与心肌细胞焦亡、铁死亡的关联性。方法：2019年12月到2021月2月,选择在本院诊治的老年缺血性心力衰竭115例作为心衰组,同期选择在本院体检的非心血管疾病老年人群115例作为对照组。检测心脏DNA甲基化编码重编程、心肌细胞焦亡、铁死亡指标表达情况并进行相关性分析。结果：心衰组的心脏DNA甲基化编码重编程指标-miR-92a、miR-130a相对表达水平高于对照组（P<0.05）。心衰组的Caspase-1蛋白、Caspase-4蛋白相对表达水平高于对照组（P<0.05）。心衰组的铁调素含量高于对照组（P<0.05）。在两组230例入选者中,Spearsman相关分析显示：缺血性心力衰竭与miR-92a、miR-130a、半胱氨酸蛋白酶1（Caspase-1）、半胱氨酸蛋白酶4（Caspase-4）、铁调素存在正向相关性（P<0.05）。Logistic回归分析显示：miR-92a、miR-130a、Caspase-1、Caspase-4、铁调素为导致缺血性心力衰竭发生的重要因素（P<0.05）。结论：老年缺血性心力衰竭患者多伴随有心脏DNA甲基化编码重编程与心肌细胞焦亡、铁死亡,后三者与缺血性心力衰竭的发生存在关联性,也是导致缺血性心力衰竭发生的重要因素。     

Mechanisms of cardioprotection by lysophospholipids

The lysophospholipids sphingosine 1-phosphate (S1P) and lysophosphosphatidic acid (LPA) reduce mortality in hypoxic cardiac myocytes. S1P is also cardioprotective in both mouse and rat models of cardiac ischemia/reperfusion (I/R) injury. Although these results are consistent with prior work in other cell types, it is not known what signaling events are critical to cardioprotection, particularly with respect to ceramide and the preservation of mitochondrial function, which is essential for cardiac cell survival. Neither receptor regulation nor signaling has been studied during I/R in the heart with or without the application of S1P or LPA. The role of sphingosine kinase in I/R and in ischemic preconditioning (IPC) has not been defined, nor has the fate or function of S1P generated by this enzyme, particularly during preconditioning or I/R, been elucidated. Whether S1P infused systemically in animal models of myocardial infarction in which survival is an end-point will be hemodynamically tolerated has not been determined. If not, the substitution of agents such as the monosialoganglioside GM-1, which activates sphingosine kinase, or the development of alternative ligands for S1P receptors will be necessary.     

大鼠肢体预缺血减小心肌缺血-再灌注后的梗塞范围

在氨基甲酸乙酯麻醉大鼠上观察肢体预缺血(limb ischemic preconditioning,LIP)对缺血-再灌注(ischemia—reperfusion,IR)心肌的影响,旨在探讨LIP对IR心肌有无保护效应,并明确腺苷和神经通路是否参与此效应。所得结果如下:(1)在心脏缺血30 min和再灌注120 min过程中,梗塞心肌占缺血心肌的51.48±0.82％。(2)LIP时心肌梗塞范围为35.14±0.88％,较单纯心肌缺血-再灌注时显著减小(P<0.01),表明LIP对心肌有保护作用。(3)事先切断股神经可取消LIP的保护效应。(4)股动脉内局部给予腺苷(10nmol/kg),可模拟LIP对心肌的保护作用;心肌梗塞范围是37.28±1.68％,而股静脉内注射同等剂量腺苷则无保护作用。(5)股动脉内预先应用腺苷A.受体拈抗剂8-环戊-1,3-二丙基嘌呤(DPCPX)(32 nmol/kg)可部分阻断LIP诱发的心肌保护效应。以上结果表明,肢体短暂预缺血可减小心肌缺血-再灌注后的梗塞范围,而局部释放的腺苷和由此所激活的相关的神经通路在LIP的心肌保护中起重要作用。     

Ischemic preconditioning ameliorates microcirculatory disturbance through downregulation of TNF-alpha production in a rat cremaster muscle model

Ischemia-reperfusion (I/R) injury is a complex process involving the generation and release of inflammatory cytokines, and the accumulation and infiltration of neutrophils and macrophages, which disturbs the microcirculatory hemodynamics. Nonetheless, ischemic preconditioning (IPC) is known to produce immediate tolerance to subsequent prolonged I/R insults, although its underlying mechanism largely remains unknown. Our study investigated the role of the IB--NF-B-TNF- (tumor necrosis factor-) pathway in IPC's ability to ameliorate I/R-induced microcirculatory disturbances in rat cremaster muscle flaps. Male Sprague-Dawley rats were randomized (n=8 per group) into 3 groups: a sham-operated control group, an I/R group (4 h of pudic epigastric artery ischemia followed by 2 h of reperfusion), and an IPC+I/R group (3 cycles of 10 min of ischemia followed by 10 min reperfusion before I/R). Intravital microscopy was used to observe leukocyte/endothelial cell interactions and quantify functional capillaries in cremaster muscles. I/R markedly increased the number of rolling, adhering, and migrating leukocytes. It was also observed that I/R significantly increased TNF- expression in these injured tissues. On the other hand, IPC prevented I/R-induced increases in leukocyte rolling, adhesion, and transmigration. Moreover, TNF- protein production and its mRNA expression were downregulated in the IPC group. Finally, I/R-induced IB- phosphorylation and NF-B (p65) nuclear translocation were both suppressed by IPC. These results indicated that IPC attenuated NF-B activation and subsequently reduced TNF- expression, which resulted in the amelioration of microcirculatory disturbances in I/R-injured cremaster muscles.     

p38 MAPKα/β和ERK1/2在心肌缺氧预处理信号传递中的不同作用

建立培养乳鼠心肌细胞的缺氧／复氧(A／R)损伤模型和缺氧预处理(APC)模型,以细胞存活率、细胞内超氧化物趋化酶(SOD)活性、丙二醛(MDA)含量、培养上清液乳酸脱氢酶(LDH)活性作为反映心肌细胞损伤的指标。采用细胞外信号调节蛋白激酶(ERK1／2)抑制剂PD98059及丝裂素活化蛋白激酶p38α/β(p38α/β)阻滞剂SB203580干预模型,并以胶内原位磷酸化法测定ERK1／2和p38活性,借以探讨ERK1／2和p38α/β在缺氧预处理保护机制中的作用。结果表明：(1)在APC组,于预处理的缺氧时相给予PD98059,可以完全消除APC的延迟保护作用;在A／R组的缺氧时相加入PD98059对细胞损伤无影响;(2)在APC组的预处理缺氧时相给予p38α／β抑制剂SB203580并不能消除APC的保护作用,而在A／R组的持续缺氧时相给予SB203580则可显著减轻缺氧对细胞的损伤;(3)ERK1／2和p38总活性测定表明,缺氧可激活ERK1／2和p38,它们的活性在缺氧后4h时达到高峰,而经过APC处理后,两者活性高峰提前于缺氧后3h时出现,且峰值显著降低。上述结果提示,预处理过程中ERK1／2的激活可能是缺氧预处理延迟保护机制中细胞信号传递的重要环节,预处理阶段p38α/β的活化不参与APC诱导的延迟保护信号传递过程,p38的过度激活可能是缺氧／复氧损伤过程中的一个致损伤参与因素,而预处理抑制随后持续缺氧阶段p38的过度激活可能是其保护机制的一个环节。     

Kappa 阿片受体的抗缺血性心脏保护作用--信息机制

有证据表明,心脏细胞产生强腓肽和强腓肽类多肽,它们是kappa阿片受体(κ-0R)的激动剂。κ-0R是心脏一种优势的阿片受体,其激活可改变在体和离体心脏的功能。在正常和病理情况下,内源性κ-阿片肽可能通过自分泌或旁分泌的方式调节心脏功能。心肌缺血是导致心脏功能紊乱的一个常见原因,主要表现为心肌功能减弱,心律失常及心肌梗塞等。心肌缺血时,交感神经发放增强,从而增加作功负荷及氧消耗量;而这又使缺血引发的状况更为恶化。机体抵抗缺血引发心肌损害／心律失常的保护机制之一是抑制β-肾上腺素受体(β—AR)的兴奋。κ-0R确实能抑制β-AR的激动。这种抑制主要是由于GS蛋白受到抑制,也在较小程度上由于信息通路的腺苷酸环化酶的抑制。因为该种酶能通过对百日咳毒素敏感的G蛋白转导β—AR的激动。另一保护心肌对抗缺血性损害的机制是预处理。预处理是指预先受到缺血等损伤使心脏对随后更严重的损伤产生较强的耐受能力。这种保护作用可以在预处理后即时产生,也可延至预处理后1—3天。在采用缺血或其产生的后果之一——代谢抑制作为预处理而致的心脏保护中,κ-OR参与媒介预处理的作用。用κ—OR的特异性激动剂U50488H激活κ—OR(U50488H药理性预处理,UP)可激活蛋白激酶C(PKC),开放ATY敏感的钾通道(KATP channels)及增加热休克蛋白(HSP)的产生。阻断PKC的作用,关闭KATP通道或抑制HSP的合成,均可消除UP的心脏保护作用。这些发现表明,PKC、KATP通道和HSP在UP的心脏保护中均具重要作用。此外,UP也能减低缺血造成心肌损害的因素之一,即Ca^2 的超负荷。这个事实表明UP发挥心脏保护作用至少部分地是通过减低Ca^2 的超负荷。最有趣的是,以阻断剂阻塞KATP通道,在消除UP的延迟性心脏保护作用的同时也降低了UP对Ca^2 超负荷的抑制作用。这个事实揭示了KATP通道开放所致的心脏保护作用至少部分地可能是由于防止或减低了Ca^2 的超负荷。     

代谢性谷氨酸受体配体(s)-4C3HPG对大鼠脑缺血耐受性诱导的影响

目的：观察侧脑室注射代谢型谷氨酸受体1／5亚型（mGluR1/5)配体（s)-4C3HPG对海马脑缺血耐受（BIT）诱导的影响,以探讨mGLUR1/5在BIT诱导中的作用。方法：采用大鼠四血管闭塞全脑缺血模型（4－vessel occlusion,4VO),应用硫堇染色和GFAP免疫组化法。36只大鼠椎动脉凝闭后分为sham组、单纯缺血组、BIT组和（s)-4C3HPG组,其中（s)-4C3HPG组又按所给药物剂量不同,分为0．2、0．04和0．008mg三个亚组。所有动物均在手术后或末次缺血后7d处死取材观察。结果：（1）单纯8min缺血可使海马CA1区组织学分级升高、锥体神经元密度降低和胶质纤维酸性蛋白（glial fibrillary acidic protein,GFAP)阳性表达增加（P＜0．05vs sham）.(2)BIT组未见单纯缺血组的上述变化,表明CIP可防止后续8min缺血造成的神经元损伤。（3）CIP的这种保护作用可被（s)-4C3HPG阻断,表现为海马CA1区组织学分级升高和锥体神经元密度降低（P＜0．05 vs sham)。这种变化与（s)-4C3HPG的剂量呈现明显的相关性,即剂量越大,上述改变越明显。结论：（s)-4C3HPG可阻断CIP诱导BIT的作用,提示mGluR1/5参与BIT的诱导。     

The role of thrombin and thrombin receptors in ischemic,hemorrhagic and traumatic brain injury: deleterious or protective?

In the last two decades it has become apparent that thrombin has many extravascular effects that are mediated by a family of protease-activated receptors (PARs). PAR-1, -3 and -4 are activated via cleavage by thrombin. The importance of extravascular thrombin in modulating ischemic, hemorrhagic and traumatic injury in brain has recently become clear. Thus, in vitro, thrombin at low concentration protects neurons and astrocytes from cell death caused by a number of different insults. In vivo, pretreating the brain with a low dose of thrombin (thrombin preconditioning), attenuates the brain injury induced by a large dose of thrombin, an intracerebral hemorrhage or by focal cerebral ischemia. Thrombin may also be an important mediator of ischemic preconditioning. In contrast, high doses of thrombin kill neurons and astrocytes in vitro and cause disruption of the blood-brain barrier, brain edema and seizures in vivo. This review examines the role of thrombin in brain injury and the molecular mechanisms and signaling cascades involved.     

缺血预处理对缺血再灌注后兔脊髓磷酸腺苷代谢的影响

目的：研究缺血参处理对缺血再灌注后兔脊髓磷酸腺苷代谢的影响。方法：往置入腹主动脉的Swan-Ganz导管气囊内注气造成兔腰髓缺血模型。将实验兔分为假手术组、缺血组和预处理组。应用反相高效液相色谱方法（reverse phase HPLC),对缺血再灌注后不同时间点腰髓组织中磷酸腺苷（ATP、ADP、AMP）的含量进行检测。结果：和假手术组相比,缺血组兔再灌后各时间点腰髓组织ATP含量有明显下降（P＜0．01）。与缺血组相应时间点相比,预处理组兔再灌注后腰髓组织ATP含量明显提高（P＜0．01）。结论：缺血预处理显著提高缺血再灌注后兔脊髓组织ATP含量,这可能是缺血预处理对脊髓缺血再灌注损伤产生保护作用的机制之一。     

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。