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。     

Modelling changes in transmural propagation and susceptibility to arrhythmia induced by volatile anaesthetics in ventricular tissue

Volatile anaesthetics such as halothane, isoflurane and sevoflurane inhibit membrane currents contributing to the ventricular action potential. Transmural variation in the extent of current blockade induces differential effects on action potential duration (APD) in the endocardium and epicardium which may be pro-arrhythmic. Biophysical modelling techniques were used to simulate the functional impact of anaesthetic-induced blockade of membrane currents on APD and effective refractory period (ERP) in rat endocardial and epicardial cell models. Additionally, the transmural conduction of excitation waves in 1-dimensional cell arrays, the tissue's vulnerability to arrhythmogenesis and dynamic behaviour of re-entrant excitation in 2-dimensional cell arrays were studied. Simulated anaesthetic exposure reduced APD and ERP in both epicardial and endocardial cell models. The reduction in APD was greater in endocardial than epicardial cells, reducing transmural APD dispersion consistent with experimental data. However, the transmural ERP dispersion was augmented. All three anaesthetics increased the width of the tissue's vulnerable window during which a premature stimulus could induce unidirectional conduction block but only halothane reduced the critical size of ventricular substrates necessary to initiate and sustain re-entrant excitation. All three anaesthetics accelerated the rate of re-entrant excitation waves, but only halothane prolonged the lifespan of re-entry. These data illustrate in silico, that modest changes in ion channel conductance abbreviate rat ventricular APD and ERP, reduce transmural APD dispersion, but augment transmural ERP dispersion. These changes collectively enhance the propensity for arrhythmia generation and provide a substrate for re-entry circuits with a longer half life than in control conditions.     

Control of anesthesia-induced hypothermia by ambient temperature regulation in rats

(1)

The goal of this study was to control anesthesia-induced hypothermia in rats, which was addressed through four experimental steps.     

神经元型一氧化氮合酶在Ⅱ组代谢型谷氨酸受体介导的脑缺血耐受中的作用

目的：探讨神经元型一氧化氮合酶（nNOS）催化产生的一氧化氮（NO）在Ⅱ组代谢型谷氨酸受体（mGluR2／3）介导的脑缺血预处理（CIP）保护机制中的作用。方法：36只永久凝闭椎动脉的SD大鼠随机分为6组（n=6）：sham、CIP、损伤性缺血、CIP4-损伤性缺血、MqPG＋CIP和MTPG＋CIP＋损伤性缺血组。采用硫堇染色和免疫组化观察海马CA1区迟发性神经元死亡（DND）和nNOS表达的变化。结果：与Sham组相比,CIP组海马nNOS表达出现一定程度的上调,而损伤性脑缺血组则出现nNOS表达的明显上调,预先给与CIP可一定程度上防止损伤性脑缺血所致的nNOS表达的过度升高。在MTPG4-CIP组,预先侧脑室注射mGluR2／3阻断剂MTPG,可阻断CIP引起的nNOS表达增加,但对神经元的存活无影响。而在MTPG＋CIP＋损伤性缺血组中,出现大量锥体神经元DND,同时nNOS的表达较MTPG＋CIP组明显增加,该增加为损伤性脑缺血所致,而非MTPG的作用。结论：nNOS催化产生的NO作为mGluR2／3的下游分子参与脑缺血预处理过程中mGluR2／3介导的脑缺血耐受的形成。     

镁预处理对兔全脑缺血神经保护作用的实验研究

目的探讨硫酸镁预处理对兔全脑缺血神经保护作用及其机制.方法 45只兔随机分为3组:对照组(n=15)、缺血组(n=15)和镁预处理组(n=15).阻断血管,诱导全脑缺血,缺血时间为 6 min.测定缺血再灌注30 min 兔海马谷氨酸、天冬氨酸、γ-氨基丁酸和甘氨酸含量.检测缺血再灌注3 d 海马CA1区神经元密度和凋亡神经元密度.结果 (1)镁预处理组海马天冬氨酸和甘氨酸显著低于缺血组(P<0.01),而γ-氨基丁酸含量显著高于缺血组(P<0.05);(2)镁预处理组正常神经元密度显著高于缺血组 (P<0.01),缺血神经元密度显著低于缺血组(P<0.01);(3)镁预处理组凋亡神经元密度显著低于缺血组(P<0.01).结论 (1)硫酸镁预处理对兔全脑缺血有神经保护作用;(2)该保护作用的机制可能有:1)抑制兔全脑缺血再灌注30 min 海马天冬氨酸和甘氨酸的过度释放以及抑制γ-氨基丁酸的耗竭;2)抑制兔全脑缺血再灌注3 d 海马CA1区神经元凋亡.     

瑞芬太尼复合丙泊酚静脉全麻与异氟醚吸入全麻在小儿眼科手术中比较

目的：比较瑞芬太尼复合丙泊酚静脉全麻用于小儿眼科手术麻醉的安全性、有效性及可控性。方法：选择择期眼科手术的小儿40例,随机分为两组：瑞芬太尼复合丙泊酚静脉全麻组（RP组）和异氟醚吸入全麻组（Ⅰ组）,每组20例。麻醉诱导采用咪唑安定0．05mg·kg^-1,丙泊酚2mg·kg^-1,维库溴胺0．1mg·kg^-1,观察组用瑞芬太尼2μg·kg^-1,对照组用芬太尼3μg·kg^-1,气管插管后机械通气,RP组麻醉维持采用静脉持续输注瑞芬太尼0．1μg·kg^-1min^-1和丙泊酚,Ⅰ组麻醉维持用异氟醚吸入,术中根据麻醉深度调整异氟醚吸入浓度和丙泊酚输注速度。观察围术期两组血流动力学变化、自主呼吸恢复、气管拔管和清醒的时间,苏醒后躁动和恶心呕吐的发生率。结果：两组病人平均动脉压（MAP）变化：两组T1、T2、T3、T4与T0比较,MAP明显降低（P〈0．05）,T5与T0比较,MAP无明显差异（P〉0．05）;组间比较,两组在T0、T1、T2、T3、T4、T5点,MAP无明显差异（P〉0．05）。两组病人心率（HR）变化：Ⅰ组：T3、T4、T5与T0比较,心率显著增快（P〈0．05）,RP组：T1、T2、T3、T4与T0比较,心率明显降低（P〈0．05）,T5与T0比较,心率变化无明显差异（P〉0．05）。组间比较,两组在T0心率无明显差异,T1、T2、L、T4、T5观察组与对照组比较,心率明显降低（P〈0．01）。麻醉苏醒时间比较：RP组与Ⅰ组比较,病人自主呼吸恢复时间、意识恢复时间和拔管时间均明显缩短（P〈0．05）。RP组术后躁动、恶心呕吐发生率,均低于Ⅰ组（P〈0．05）。结论：瑞芬太尼复合丙泊酚静脉全麻可为小儿眼科手术提供稳定血流动力学状态,快速苏醒,适用于小儿眼科手术麻醉。