阿魏酸钠对增生性瘢痕成纤维细胞增殖及胶原合成的影响

探讨阿魏酸钠(SF)对增生性瘢痕成纤维细胞(HSFb)增殖及胶原合成的影响。体外培养HSFb,MTT法计算SF的LC50及最佳药物时间后,分为空白对照组、SF干预组(高、中、低浓度分别为0.3、0.03、0.003 mg/mL),培养72 h后,在倒置显微镜和透射电镜下观察HSFb微观形态学变化;MTT法、Western blot法检测SF对HSFb细胞增殖和I、Ⅲ胶原蛋白表达的影响。结果显示,与空白对照组相比,倒置显微镜下HSFb细胞明显减少,电镜下见核固缩,线粒体轻度肿胀,粗面内质网扩张呈囊泡状,有较多空泡、自噬的产生;MTT法显示各浓度SF干预组对HSFb增殖均有明显抑制作用(P<0.01);Western blot法检测显示低浓度SF对I胶原蛋白表达有一定的抑制作用(P<0.05),高、中浓度SF能明显抑制HSFb的I、Ⅲ胶原蛋白的表达(P<0.01)。本研究结果表明,SF能改变HSFb的微观形态,抑制HSFb的细胞增殖及Ⅰ、Ⅲ型胶原蛋白的表达。     

肥厚型心肌病患者在心肺运动中核心指标的特征性研究*

目的: 肥厚型心肌病（HCM）,以心肌肥厚为主要特征的心肌疾病,猝死率高。临床症状表现为呼吸困难、乏力、胸痛等。症状限制性极限运动心肺运动试验（CPET）在整体整合生理和医学（HIPM）理论指导下是唯一评估人体整体功能状态检查,肥厚型心肌病患者在心肺运动中核心数据变化值得进一步探讨。方法: 选择2017年4月至2020年1月在阜外医院就诊签署知情同意书后完成CPET受试者244例为研究对象,其中219例肥厚型心肌病（肥厚心组）和无诊断疾病健康人25例（正常组）,观察两组CPET核心指标的异同。结果: ①肥厚心组男163女56例,正常组11男14女;肥厚心组年龄（46.7±12.8,16.0~71.0）岁;正常组年龄（43.7±10.4,26.0~61.0）岁。②肥厚心组CPET核心指标的峰值摄氧量（Peak VO₂）为（65.2±13.8,22.8~103.4）%pred;无氧阈（AT）为（66.4±13.0,33.7~103.5）%pred;峰值氧脉搏（Peak O₂ pulse）为（84.3±19.0,90.9~126.0）%pred;摄氧效率平台（OUEP）为（99.2±13.4,69.1~155.5）%pred;分钟通气量和二氧化碳排出量比值最小值（Lowest VE/VCO₂）为（108.0±13.2,70.4~154.0）%pred;分钟通气量和二氧化碳排出量比值斜率（VE/VCO₂ Slope）为（108.5±17.9,66.9~164.9）%pred, 肥厚心组较正常组在峰值摄氧量,无氧阈,峰值氧脉搏,摄氧效率平台等百分预计值（%pred）等指标均显著降低（P<0.01或P<0.05）;而Lowest VE/VCO₂和VE/VCO₂ Slope（%pred）显著升高（P<0.05）,差异均有统计学意义。个体而言,部分患者就诊时整体功能状态尚在正常范围内。③CPET中Peak VO₂与其他核心指标AT、OUEP、Peak O₂ pulse、峰值收缩压呈正相关;与Lowest VE/VCO₂ 和VE/VCO₂ Slope呈负相关。结论: 肥厚型心肌病患者能安全完成CPET,CPET指标具有特异性,不仅可用于整体功能评测、疾病诊断与鉴别诊断、危险分层、疗效评估和精准预后预测,并可用于整体论指导下的个体化整体方案慢病有效管理,值得进一步深入研究和临床推广应用。     

肥厚型心肌病患者运动血压反应异常的两类表现及其相关因素分析*

目的: 运动血压反应不足及运动后恢复期血压降低是肥厚型心肌病（HCM）患者常见的异常表现,本研究的目的是分析HCM患者这两类异常血压反应表现的相关因素及其与心肺运动功能的关系。方法: 回顾性研究2018年4月至2020年1月期间在阜外医院功能检测中心行心肺运动试验（CPET）的HCM患者219例。111例行CPET的性别、年龄匹配的正常体检者作为正常对照组。比较正常对照组与HCM组的CPET运动血压反应。将HCM患者分为运动血压反应正常组及运动血压反应不足组,以及运动后血压正常组及运动后恢复期血压降低组,分别比较上述两类运动血压反应异常者的临床情况及CPET功能指标。结果: 与正常对照组相比,HCM患者运动血压反应不足（8.7%比1.8%,P=0.016）及运动后恢复期血压降低（6.8%比0.0%,P=0.003）的发生率显著升高。在HCM患者中,与运动血压反应正常者相比,运动血压反应不足的HCM患者更多合并冠心病（P=0.029）、肺动脉高压（P=0.002）及房颤/房扑（P=0.036）;与运动后血压正常者相比,运动后恢复期血压下降的HCM患者静息流出道压差（P=0.017）更高,合并流出道梗阻比例（P=0.015）、合并收缩期二尖瓣前移现象（P=0.022）及左室射血分数（P=0.043）更高。经过Logistic多元回归分析,运动血压反应不足的独立相关因素为冠心病（β=1.519,P=0.013）、肺动脉高压（β=2.292, P=0.000）。而运动后恢复期血压下降仅与左室流出道压差有独立的相关性（β=0.018, P=0.005）。运动血压反应不足的HCM患者峰值摄氧量（P=0.003）、峰值心率（P=0.014）及心率储备（P=0.003）更低,NT末端B型脑钠肽前体（P=0.019）及二氧化碳通气当量斜率（P=0.000）更高。运动后恢复期血压下降与各种心肺功能指标均无相关性。结论: HCM运动血压反应不足及运动后恢复期血压降低的发生率均较正常人群显著升高。HCM患者运动血压反应不足与合并冠心病和肺动脉高压有显著的独立相关性,而运动后血压下降仅与左室流出道压差独立相关。运动血压反应不足的HCM患者心肺运动功能降低,而运动后恢复期血压降低与心肺运动功能无显著相关性。     

Functional characterization of human myosin-binding protein C3 variants associated with hypertrophic cardiomyopathy reveals exon-specific cardiac phenotypes in zebrafish model

Myosin-binding protein C 3 (MYBPC3) variants are the most common cause of hypertrophic cardiomyopathy (HCM). HCM is a complex cardiac disorder due to its significant genetic and clinical heterogeneity. MYBPC3 variants genotype–phenotype associations remain poorly understood. We investigated the impact of two novel human MYBPC3 splice-site variants: V1: c.654+2_654+4dupTGG targeting exon 5 using morpholino MOe5i5; and V2: c.772+1G>A targeting exon 6 using MOe6i6; located within C1 domain of cMyBP-C protein, known to be critical in regulating sarcomere structure and contractility. Zebrafish MOe5i5 and MOe6i6 morphants recapitulated typical characteristics of human HCM with cardiac phenotypes of varying severity, including reduced cardiomyocyte count, thickened ventricular myocardial wall, a drastic reduction in heart rate, stroke volume, and cardiac output. Analysis of all cardiac morphological and functional parameters demonstrated that V2 cardiac phenotype was more severe than V1. Coinjection with synthetic human MYBPC3 messenger RNA (mRNA) partially rescued disparate cardiac phenotypes in each zebrafish morphant. While human MYBPC3 mRNA partially restored the decreased heart rate in V1 morphants and displayed increased percentages of ejection fraction, fractional shortening, and area change, it failed to revert the V1 ventricular myocardial thickness. These results suggest a possible V1 impact on cardiac contractility. In contrast, attempts to rescue V2 morphants only restored the ventricular myocardial wall hypertrophy phenotype but had no significant effect on impaired heart rate, suggesting a potential V2 impact on the cardiac structure. Our study provides evidence of an association between MYBPC3 exon-specific cardiac phenotypes in the zebrafish model providing important insights into how these genetic variants contribute to HCM disease.     

The Life Cycle of Lestes viridis (Odonata: Lestidae) in Two Seasonal Streams of the Sierra Morena Mountains (Southern Spain)

The life cycle of the zygopteran odonate Lestes viridis in two seasonal streams in the Sierra Morena Mountains is inferred from size-frequency analyses of handnet samples of larvae and records of presence and reproductive activity of adults during three consecutive years. The egg stage (duration 5–6 months) overwinters, larval development is brief (6–8 weeks) and adults undergo a protracted, prereproductive, summer diapause (up to 3 months) before mating and ovipositing in late September, about one week after the first appreciable fall of rain, but before surface water reappears in the streams after having been absent for about four months during the hot, dry summer. Comparison between this life cycle and those of more northerly populations reveals a latitude-correlated cline in phenology resembling that found in some other northern hemisphere odonates that, like L. viridis, maintain an obligatorily univoltine life cycle at different latitudes.     

利用寡核苷酸芯片分析Smad3基因敲除小鼠关节软骨细胞基因表达谱的改变

此前发现 Smad3 基因敲除小鼠(Smad3ex8/ex8)的关节软骨细胞异常肥大分化,出现类似于人类骨关节炎的表型。为了进一步明确转化生长因子-β(TGF-β)/Smad3 信号通过调节哪些靶基因的表达来抑制关节软骨细胞的肥大分化,以及研究骨关节炎发病的分子机制,利用寡核苷酸芯片技术分析了 5 日龄 Smad3 基因敲除小鼠与野生型对照小鼠关节软骨细胞基因表达谱的改变。通过对差异表达基因的分析,发现在 Smad3 基因敲除小鼠软骨细胞中骨形态发生蛋白(BMP)与 TGF-β/细胞分裂周期基因 42(Cdc42)信号通路活性增强。此外,还发现其他信号通路,如生长激素(growth hormone)/胰岛素样生长因子 1(Igf1)以及成纤维细胞生长因子(Fgf)信号通路相关基因表达的改变。值得注意的是,还发现了 Smad3 基因敲除小鼠软骨细胞中蛋白合成与电子传递链相关基因的表达水平普遍上调,这意味着蛋白质合成速率的加快与细胞有氧呼吸的增强可能与关节软骨细胞的肥大分化和骨关节炎的发生相关。     

Cellular aspects of pathogenesis of hypertrophic cardiomyopathy: Role of cardiomyocyte polyploidy and activation of nuclear antigen of the proliferating cell in myocardium

For a comparative analysis of cytomorphological characteristics of hypertrophied interventricular septum (IVS), both patients different ages with severe courses of obstructive hypertrophic cardiomyopathy (OHCMP) were examined, including children, and patients with essential arterial hypertension (EAH). The course of OHCMP in children as compared with adults was found to be characterized by considerable IVS hypertrophy that was accompanied by an acceleration of cardiomyocyte polyploidization. The mean ploidy level of cardiomyocytes in children with OHCMP was higher than in adult patients. The mean ploidy level of nuclei, the number of prolipherative cell nuclear antigen (PCNA)-positive nuclei, and the number of polyploid cardiomyocyte nuclei in adult patients with OHCMP were significantly higher statistically than in patients with EAH. The PCNA-positive labels in stromal cells were revealed only in patients with OHCMP. The obtained data indicate an important role of cardiomyocyte polyploidy and of activation of the proliferating cell nuclear antigen in development of myocardial hypertrophy in patients with OHCMP.     

Thrombospondin-4 critically controls transforming growth factor β1 induced hypertrophic scar formation

Transforming growth factor β (TGF-β) is a growth factor presenting important functions during tissue remodeling and hypertrophic scar (HS) formation. However, the underlying molecular mechanisms are largely unknown. In this study, we identified thrombospondin-4 (TSP-4) as a TGF-β1 target that essentially mediates TGF-β1-induced scar formation both in vitro and in vivo. The expression of TSP-4 was compared on both mRNA and protein levels between hypertrophic scar fibroblasts (HSFs) and normal skin fibroblast (NFs) in response to TGF-β1 treatment. Two signaling molecules, Smad3 and p38, were assessed for their importance in regulating TGF-β1-mediated TSP-4 expression. The significance of TSP-4 in controlling TGF-β1-induced proliferation, invasion, migration, and fibrosis in HSFs was analyzed by knocking down endogenous TSP-4 using small hairpin RNA (shRNA) (TSP-4 shRNA). Finally, a skin HS model was established in rats and the scar formation was compared between rats treated with vehicle (saline), TGF-β1, and TGF-β1 + TSP-4 shRNA. The TSP-4 level was significantly higher in HSFs than in NFs and TGF-β1 more potently boosted TSP-4 expression in the former than in the latter. Both Smad3 and p38 essentially mediated TGF-β1-induced TSP-4 expression. TSP-4 shRNA significantly suppressed TGF-β1-stimulated proliferation, invasion, migration, or fibrosis of HSFs in vitro and drastically improved wound healing in vivo. TGF-β1, by activating both Smad3 and p38, induces TSP-4, which in turn not only presents a positive feedback regulation on the activation of Smad3 and p38, but also essentially mediates TGF-β1-induced HS formation. Targeting TSP-4 thus may benefit HS treatment.