The effects of insulin and β-adrenergic stimulation on glucose transport,glut 4 and PKB activation in the myocardium of lean and obese non-insulin dependent diabetes mellitus rats

Glucose uptake, glut 4 translocation and activation of protein kinase B were measured in Langendorff perfused hearts from (i) Wistar control, (ii) lean, neonatal Streptozotocin induced (Stz) and (iii) Zucker (fa/fa) obese diabetic rats of 10–12 weeks old. Hearts were subjected to stimulation with insulin, isoproterenol (-adrenergic agonist) or a combination of insulin and isoproterenol, during the perfusion protocol. Basal myocardial glucose uptake was impaired in both diabetic models, but could be stimulated significantly by insulin. In the Zucker rats, the time-course of insulin action was delayed. Insulin and -stimulation of glucose uptake were not additive. Evaluation of sarcolemmal membranes from these hearts showed that the affinity of glut 4 was significantly lower in the Zucker but not in the Stz hearts while a reduced affinity found with a combination of insulin and -stimulation in control hearts, was absent in both diabetic models. Total membrane lysates were analyzed for glut 4 expression while an intracellular component was generated to quantify translocation on stimulation as well as activity of protein kinase B (PKB). At this age, the neonatal Streptozotocin induced diabetic animals presented with more faulty regulation concerning adrenergic stimulated effects on elements of this signal transduction pathway while the Zucker fa/fa animals showed larger deviations in insulin stimulated effects. The overall response of the Zucker myocardium was poorer than that of the Stz group. No significant modulation of -adrenergic signaling on insulin stimulated glucose uptake was found. The PI-3-kinase inhibitor wortmannin, could abolish glucose uptake as well as PKB activation elicited by both insulin and isoproterenol.     

A self-perpetuating vicious cycle of tissue damage in human hibernating myocardium

Recently, we proposed the hypothesis that a vicious cycle exists in human hibernating myocardium (HM) between the progression of myocyte degeneration and the development of fibrosis [1]. We now investigated the pathomechanism of this cycle in more detail and established a correlation between the severity of the morphological changes and the degree of postoperative functional recovery of HM.HM was diagnosed by dobutamine echocardiography, thallium-201 scintigraphy and radionuclide ventriculography. Functional recovery was present at 3 months after coronary bypass surgery but remained unchanged at 15 months. Forty patients were subdivided into 2 groups: A with complete and B with incomplete recovery. Biopsies taken during surgery and studied by electron microscopy, immunocytochemistry, rt-PCR, and morphometry revealed myocyte degeneration and inflammatory and fibrinogenic changes in a widened interstitial space. We report here for the first time an upregulation of TGF-₁ evident by a 5-fold increase of fibroblasts and macrophages exhibiting a TGF-₁ content 3-fold larger than in control, and a > 3-fold increase in TGF-₁ mRNA by rt-PCR. The number of angiotensin converting enzyme (ACE) containing structures was increased (n/mm²: control - 11.4, A - 17.6, B - 19.2, control vs. A and B, p < 0.05). Fibrosis was more severe in group B than A or control (%: C - 10.1; A - 21.2; B - 40.6; p < 0.05). Capillary density was significantly reduced (n/mm²: C - 1152; A - 782; B - 579, p < 0.05) and intercapillary distance was widened (m: C - 29.5, A - 36.1, B - 43.3, p < 0.05). The number of CD 3 (n/mm²: C - 5.0; A - 9.6; B - 9.4, ns) and CD 68 positive cells (n/mm²: C - 37.2; A - 80.7; B - 55.0, C vs. A p < 0.05) was elevated in HM as compared to control indicating an inflammatory reaction. Cut-off points for functional recovery are fibrosis > 32%, capillary density < 660/mm² and intercapillary distance > 39.0 m.In HM a self-perpetuating vicious cycle of tissue alterations leads to progressive replacement fibrosis and continuous intracellular degeneration which should be interrupted by early revascularization.     

Differential responses to chronic hypoxia and dietary restriction of aerobic capacity and enzyme levels in the rat myocardium

Chronic exposure of mammals to hypoxia induces a state of anorexia. We aimed to determine the role played by diet restriction in the alterations of myocardial energy metabolism occurring under chronic hypoxia in order to detect the specific effects of hypoxia per se.Adult female rats were exposed to normobaric hypoxia (Fi O2 = 0.10) for three weeks; pair-fed rats, kept under normoxic conditions, received the same amount of food as hypoxic rats. The oxidative capacity of myocardial ventricles and some skeletal muscles was evaluated using permeabilized fibers. Several metabolic enzyme activities were measured on extracts from myocardium and soleus.Diet restriction increased the activity of lactate dehydrogenase in both ventricles while it augmented phosphofructokinase and pyruvate kinase activities only in the left ventricle and depressed the respiratory rate in the right ventricle only.Hypoxia per se induced a rise in hexokinase activity in all studied oxidative muscles and a fall of hydroxy-acyl CoA-dehydrogenase activity in both myocardial ventricles. The respiratory rate and the citrate synthase activities were unaffected by hypoxia.We conclude that chronic hypoxia per se leads to specific alterations in myocardial metabolism that could favor the use of exogenous glucose at the expense of free fatty acids without any change in the oxidative capacity.     

Induction of 72-kDa Inducible Heat Shock Protein (HSP72) in Cultured Rat Astrocytes After Energy Depletion

Abstract: Protein synthesis is important in the readaptive processes for cultured astrocytes after hypoxia and subsequent reoxygenation. We have identified 72-kDa inducible heat shock protein (HSP72) as a major stress protein in reoxygenated astrocytes. To assess the mechanism for reoxygenation-mediated induction of HSP72, a reporter gene that consists of a human HSP promoter fused to the luciferase gene was transfected into cultured astrocytes. Analysis of cellular energy nucleotides showed an increase of the ADP/ATP ratio after reoxygenation, which synchronized with activation of the HSP promoter. Activation of the HSP promoter was also observed after an addition of iodoacetic acid to hypoxic astrocytes, which reached the maximum when the ADP/ATP ratio reached 50%, but further decline in the energy profile caused inactivation of this promoter. Inhibition of protein synthesis after reoxygenation resulted in temporary restoration of the energy profile and suppression of the DNA binding activity of the heat shock factor. Addition of quercetin greatly decreased the [³H]leucine incorporation in the polysome fraction without any effect on the mature mRNA formation. These data suggest that the energy depletion in reoxygenation triggers induction of HSP72 after reoxygenation, which may act as a pivotal mediator in the stress response of reoxygenated astrocytes by facilitating protein synthesis.     

变温过程中大鼠心肌等长收缩发展张力呈双相变化

本实验旨在探明变温过程对心肌的影响,以及可能的内在机理。采用阶梯方式降、复温,测定３０℃、２５℃、２０℃、１５℃与１０℃条件下,大鼠乳头肌等长收缩的各参数值的变化。结果表明：在降温过程中,心肌发展张力（ＤＴ）呈双相变化,即从３０℃降温到２５℃,ＤＴ增大,而后ＤＴ逐渐下降;温度降到２０℃时,静息张力（ＲＴ）保持不变,而降至１５℃以后ＲＴ明显上升。乳头肌等长收缩的时间参数如ＴＰＰ、ＴＰＮ、ＴＰＴ、Ｔ１／２Ｒ均随温度的降低而逐渐延长。在复温过程中,与降温过程中相同温度点相比,２０℃、２５℃、３０℃点发展张力明显降低,而１５℃、２０℃、２５℃点静息张力显著增高。这提示在降温过程中,心肌细胞肌钙蛋白Ｃ对Ｃａ２＋敏感性可能呈现双相变化,且低温造成的心肌细胞内游离Ｃａ２＋浓度增高,可能引起心肌细胞损伤。因而,心冷停搏液保护心肌功能的关键环节,应是如何防止在降温过程中心肌细胞内游离Ｃａ２＋浓度一过性增高。     

Coronary vascular volume remodelling in rainbow trout Oncorhynchus mykiss

The 34% increase in relative ventricular mass (M_rv) resulting from chronic anaemia (induced by an intraperitoneal injection of phenylhydrazine hydrochloride) was accompanied by a 117% increase in coronary vascular volume of diploid rainbow trout Oncorhynchus mykiss. Coronary vascular volume of normocythemic triploid fish was similar to that of normocythemic diploid fish despite a larger M_rv. These observations, in combination with previous studies, suggest that the vascularity of compact myocardium in O. mykiss can vary independently of M_rv.     

TLR9信号通路介导缺血性脑损伤的研究进展

炎症反应是缺血性脑损伤的重要机制之一,过度的炎症免疫反应会加剧脑损伤的程度。作为先天免疫系统的重要组成部分,Toll样受体9(Toll like receptor 9,TLR9)通过识别其特异性的配体Cp G-DNA,从而激活先天免疫系统,释放大量前炎症细胞因子,参与缺血性脑损伤的炎症反应过程。近年来,有学者提出将TLR9作为一个新的缺血预处理靶点,即通过启动TLR9信号转导通路增加体内炎症细胞因子的水平来对抗缺血损伤。本文通过对近年TLR9信号通路介导的炎症反应与缺血性脑损伤相关研究进展作一综述,为寻求临床安全高效的缺血性脑损伤防治措施提供理论依据。     

多模式磁共振指导超时间窗急性缺血性卒中的静脉溶栓治疗研究

目的:评价多模式磁共振指导下超时间窗静脉应用重组组织型纤溶酶原激活剂rt PA治疗急性缺血性卒中的疗效及安全性。方法:将68例急性脑梗塞患者分为rt PA静脉溶栓组A组、强化抗栓治疗组B组,各组按药物干预时间再分为4.5小时亚组及4.5-6小时亚组。A组给予rt PA静脉溶栓治疗和常规治疗,B组给予首剂氯吡格雷300毫克+阿司匹林100毫克和常规治疗。治疗前行急诊头多模式磁共振检查,治疗24小时后复查头CT,分别于治疗前后不同时间点进行NIHSS评分和3个月MRS评分,记录不良事件的发生情况。结果:A组两个亚组治疗后各时间点NIHSS评分均明显低于B组,且A组4.5小时亚组治疗后NIHSS评分低于其4.5-6小时亚组,A组3个月预后良好患者比例显著高于B组,差异均有统计学意义(P0.05)。A组症状性颅内出血的发生率高于B组。结论:多模式头磁共振指导下超时间窗rt PA静脉溶栓治疗安全有效,远期疗效优于强化抗栓治疗,但颅内症状性出血风险略高于强化抗栓治疗。     

血栓通配合康复训练对缺血性脑卒中恢复期患者肢体康复的疗效

目的:探究血栓通配合康复训练对缺血性脑卒中(cerebral arterial thrombosis,CAT)恢复期患者肢体康复的疗效情况。方法:选取2011年3月-2013年3月我院收治的84例CAT患者按数字表法随机分为观察组和对照组,各42例。对照组单纯采用康复训练治疗,观察组在对照组康复训练的基础上服用血栓通配合治疗,分别观察治疗前、治疗后1个月、3个月、6个月的各项基本指标并对比研究。结果:两组患者治疗前和治疗1月后Barthel评分无明显差异(P0.05);观察组治疗后3、6个月Barthel评分显著高于对照组,差异有统计学意义(P0.05),两组患者治疗前和治疗1月后肢体Fugl-Meyer评分无明显差异(P0.05);观察组治疗后3、6个月肢体Fugl-Meyer评分显著高于对照组,差异有统计学意义(P0.05),且对照组出院时上肢依然未完全恢复。通过对对照组和观察组患者的生活质量评分比较,观察组生活质量的各项评分均明显高于对照组,两组比较差异有统计学意义(P0.05)。结论:对缺血性脑卒中恢复期患者采用血栓通药物配合适当的康复训练疗效较好,术后肢体恢复理想,值得作为治疗CAT的首选方法在临床上推广应用。     

骨髓基质干细胞与激素相关缺血性骨坏死

骨髓基质干细胞(Bone marrow stromal cells,BMSCs)是一种具有组织修复和免疫调节功能的多能干细胞,它主要存在于骨髓中,然而,如今我们发现,在其他的一些组织中也存在它的身影,例如:脂肪组织、肌肉组织和肌腱组织等。通过骨髓穿刺的方法可以很容易的获得骨髓基质干细胞,它在体外有很强的增殖能力,即使没有动物血清和人工生长因子也可以用进行细胞培养。缺血性骨坏死可以由很多病因引起,研究发现,自身免疫性疾病和血液系统疾病治疗应用的激素与缺血性骨坏死的发生具有很大的相关性,但是,激素的应用在一些严重的疾病中往往又是不可避免的,这就需要我们找到一种方法来预防和治疗激素相关缺血性骨坏死。现在,治疗缺血性骨坏死的标准方法是髓芯减压术,但到了疾病晚期的时候,髓芯减压术治疗的效果就已经微乎其微了,由于骨髓基质干细胞所具有的分化潜能、易于获得和增殖的能力,使它可能成为治疗缺血性骨坏死的一种潜在的补充方式。