二氮嗪在长时程心脏低温保存中的作用

延长心脏的体外有效保存时间对临床心脏移植具有重要意义。本文旨在研究线粒体ATP敏感性钾通道开放剂二氮嗪(diazoxide,DE)在离体大鼠心脏长时程低温保存中的作用。SD大鼠随机分成5组,包括对照组(单纯Celsior保存液),DE组(Celsior液中含15、30或45μmol／L的DE)和DE 5-HD组[Celsior液中含30μmol／L的DE和100μmol／L的5-羟基葵酸盐(5-hydroxydecanoate,5-HD)]。利用Langendorff离体鼠心灌注法,观察心脏在4℃条件下保存10h后,复灌期血流动力学恢复、冠脉流出液中心肌酶漏出量及心肌水含量变化,并做心肌超微结构检查。结果显示：与对照组比较,DE处理后,复灌期的左心室舒张末期压力明显降低,心率、左心室发展压、左心室压力变化率、冠脉流出量等的恢复率在多个复灌时间点上优于对照组,且能显著减少复灌过程中心肌酶(乳酸脱氢酶、磷酸肌酸激酶及谷草转氨酶)的漏出量,降低心肌水含量;其中30和45μmol／LDE组的保护作用优于15μmol／LDE组;电镜结果显示DE对长时程低温保存心脏的超微结构有较好的保护作用。DE的上述作用可被线粒体ATP敏感性钾通道的特异性阻断剂5-HD所取消。以上结果提示：DE可通过激活线粒体ATP敏感性钾通道显著改善离体大鼠心脏长时程低温保存效果。     

二氮嗪对长时程低温保存大鼠心脏Fas/FasL蛋白表达的影响

本文旨在研究线粒体ATP敏感性钾(mitochondrial ATP-sensitive potassium channel,mitoKATP)通道开放剂二氮嗪(diazoxide,DE)对离体长时程低温保存的大鼠心脏促凋亡蛋白Fas和FasL表达的影响.利用Langendorff离体大鼠心脏灌注法,观察心脏在4 oC含或不含(对照组)DE的Celsior保存液保存8 h后,复灌期心脏作功量(rate-pressure product,RPP)变化情况,采用原位末端标记(TdT-mediated dUTP nick end labeling,TUNEL)染色法检测心肌细胞凋亡和免疫组织化学方法检测Fas和FasL蛋白表达情况.结果显示,在Celsior保存液中加入DE(30 pmol/L),复灌期RPP的恢复率在多个复灌时间点上优于对照组;同时可降低长时程低温保存心脏心肌细胞凋亡指数,减少Fas和FasL蛋白的表达.DE的上述作用可被mitoKAxr通道特异性阻断剂5.羟基葵酸盐(5-hydroxydecanoate,5-HD)所取消.以上结果提示,DE可能通过激活mitoKATP通道来减少Fas和FasL蛋白表达,从而减轻大鼠心肌缺血/再灌注损伤后的心肌细胞凋亡.     

低温保存诱导大鼠心肌细胞Smac／DIABLO蛋白表达的动态变化

目的：观察大鼠供心不同时程低温保存后线粒体Smac／DIABLO蛋白表达的差异。方法：根据不同的低温保存时程,SD大鼠随机分5组（n=8）。采用Langendorff离体鼠心灌注法停搏大鼠心脏,检测心脏在4℃条件下celsior保存液中分别保存0、3、6、9、12h后,心肌细胞线粒体内超氧化物岐化酶（SOD）活性和丙二醛（MDA）含量的变化。并采用Westom blotting蛋白印迹分析法观察心肌细胞Smac／DIABLO蛋白表达情况,原位末端标记（TUNEL）染色法检测心肌细胞凋亡。结果：①随着低温保存时间的延长,心肌细胞线粒体内SOD活性随之降低,MDA含量随之升高,心肌细胞凋亡指数也逐渐增高。②随着低温保存时间的延长,Smac／DIABLO蛋白表达逐渐增多,至低温保存6h后最为显著,随后又逐渐减弱。结论：随着低温保存时间的延长,可能由于心肌细胞抗氧自由基的能力逐步减弱,致使诱导细胞凋亡的心肌线粒体Smac／DIABLO蛋白表达逐渐增强,心肌细胞凋亡逐渐增多。     

葛根素抗心肌细胞过氧化氢损伤的线粒体相关机制

目的:探讨葛根素(puerarin,Pue)预处理抗过氧化氢(H2O2)应激损伤的作用是否与线粒体渗透性转换孔和/或线粒体钙激活钾通道有关。方法:采用酶解分离大鼠心肌细胞模型,台盼蓝拒染法测定心肌细胞存活率;Rhodamine123孵育测定线粒体膜电位值,分离线粒体测定mPTP孔开放程度。结果:与H2O2应激组相比,Pue(0.24mmol/L)预处理5min可明显对抗H2O2应激引起的心肌细胞存活率的降低,线粒体钙激活钾通道阻断剂paxilline(Pax,1μmol/L,预处理30min)、线粒体渗透性转换孔开放剂atractyloside(20μmol/L,预处理20min)或PKC抑制剂chelerythrine(5μmol/L,预处理30min)可拮抗Pue的作用。Pue预处理或钙激活钾通道开放剂NS1619(10μmol/L,10min)都明显减弱H2O2应激引起的线粒体膜电位的去极化,线粒体渗透性转换孔开放剂atractyloside能明显减弱Pue的作用。在分离心肌线粒体模型上,Pue(0.24mmol/L,5min)显著减弱CaCl2诱导的线粒体在A520处吸光度降低,Pax(1μmol/L,5min)可拮抗Pue的作用。结论:在大鼠分离心肌细胞模型或分离线粒体模型上,Pue预处理具有抗过氧化氢应激损伤的作用,这种保护作用可能与其抑制线粒体渗透性转换孔的开放和促进线粒体钙激活钾通道的开放有关。     

多胺通过调节线粒体通透性转换孔在心肌缺血再灌注损伤中发挥双重作用（英文）

多胺(腐胺、亚精胺和精胺)是一类重要的聚阳离子化合物,在哺乳动物各种生理和病理过程中起重要作用。本研究旨在探索多胺(腐胺、亚精胺和精胺)在心肌缺血再灌注(ischemia/reperfusion, i/R)损伤中的作用及其机制。采用langendorff离体心脏灌流装置对大鼠离体心脏进行灌流,全心缺血30 min,再灌注120 min。在复灌前10 min给予不同浓度的多胺(0.1、1、10、15μmol/L腐胺、亚精胺和精胺)、环孢菌素a (0.2μmol/L)或苍术苷(20μmol/L)。记录血流动力学变化;分光光度法检测灌流液中乳酸脱氢酶(lactate dehydrogenase, lDh)含量;TTC染色法测定心肌梗死面积;分离心肌线粒体,Ca~(2+)诱导肿胀,分光光度计测定线粒体通透性转换孔(mitochondrial permeability transition pore, MPTP)的开放程度。结果显示,与单独的i/R相比,0.1和1μmol/L多胺处理改善大鼠心脏功能,降低lDh释放,减少心肌梗死面积,但这些作用被MPTP开放剂苍术苷抑制。在分离自正常大鼠的线粒体,0.1和1μmol/L多胺处理抑制了MPTP的开放。10和15μmol/L多胺处理却出现相反的作用,这些作用被MPTP抑制剂环孢菌素a抑制。以上结果表明,多胺既可通过抑制MPTP减轻心肌i/R损伤,又可通过促进MPTP开放加重心肌i/R损伤。     

二氮嗪对低温保存后大鼠肾脏的GRP78和CREB2表达的影响

为研究二氮嗪(diazoxide,DE)在大鼠肾脏低温保存的作用及其可能的机制,48只大鼠随机分为对照组(单纯Celsior液冷保存)、实验组(Celsior液中含20μmol/L DE),两组均分别冷保存0、24、48 h。观察肾脏在低温条件下分别保存0、24、48 h后,肾组织丙二醛(malonaldehyde,MDA)含量和超氧化物歧化酶(superoxide dismutase,SOD)活性以及葡萄糖调节蛋白78(glucoseregulated protein-78,GRP78)和环磷腺苷反应元件结合蛋白2(cyclic AMP response element bindingprotein-2,CREB2)表达的变化。结果表明,与Celsior组相比,DE组的MDA含量在24 h、48 h这两个时间段明显降低(P0.01,P0.05),SOD的酶活性在48 h时间段里明显升高(P0.05)。免疫组化和Western印迹结果显示,实验组中GRP78和CREB2在24 h、48 h这两个时间段表达都高于对照组(P0.05)。结果表明含DE的Celsior液较单纯Celsior液对低温保存的离体大鼠肾脏有更好的保护作用,其机制可能是启动内质网应激来保护肾脏功能。     

乙酰胆碱对离体大鼠缺血/复灌心脏的保护作用及其机制

目的:探讨乙酰胆碱(ACh)预处理抗心肌缺血复灌(I/R)损伤作用及其与线粒体渗透性转换孔和/或线粒体ATP敏感性钾通道的关系。方法:采用离体大鼠心脏Langendorff灌流方法进行全心停灌30min,复灌120min复制I/R模型。测定心室力学指标和复灌各时间点冠脉流出液中乳酸脱氢酶(LDH)含量。实验结束测定心肌组织formazan含量的变化。结果:与单纯I/R组相比,ACh(0.1μmol/L,5min)预处理明显提高心肌细胞的formazan含量,降低复灌期间冠脉流出液中LDH含量,明显改善I/R所致的左室发展压、左心室内压最大上升和下降速率、心率与发展压乘积和左室舒张末压力的下降,缓解冠脉流量的减少。线粒体渗透性转换孔开放剂苍术苷(20μmol/L,复灌前给药20min)和线粒体ATP敏感性钾通道抑制剂5-羟基癸酸(100μmol/L,缺血前给药20min)能明显减弱ACh的保护作用。结论:在大鼠离体心脏灌流模型上,ACh预处理具有抗心脏缺血/复灌损伤的作用,这种保护作用可能与其抑制线粒体渗透性转换孔的开放和促进线粒体ATP敏感性钾通道的开放有关。     

木犀草素改善低温下离体大鼠心脏保存效果的研究

目的:研究木犀草素是否能改善心脏停搏保存液(UW液)对离体大鼠心脏的低温保存效果。方法:将40只成年SD大鼠随机分成4组(n=10):对照组(UW组)、7.5μmol/L木犀草素小剂量组,15μmol/L木犀草素中剂量组及30μmol/L木犀草素大剂量组。利用Langendorff离体心脏灌流法,观察心脏在4℃含或不含木犀草素的UW液中保存12 h复灌60 min后心脏功能及超微结构变化,比较心脏冠脉流量(CF)、心肌含水量及冠脉流出液中磷酸肌酸激酶(CK)的释放量。结果:与对照组比较,添加木犀草素后,复灌期心脏的收缩功能(LVPSP,+dp/dtmax)与心脏舒张功能(-dp/dtmax)、冠脉流量在多个复灌时间点均优于对照组,心率在复灌60 min时也显著优于对照组;复灌过程中磷酸肌酸激酶的漏出量及低温保存后心脏超微结构的损伤也均明显低于对照组;随灌注时间延长木犀草素组心脏结构和功能的改善有剂量依赖性趋势;木犀草素对心肌含水量没有影响。结论:木犀草素能显著改善UW液对离体大鼠心脏的低温保存效果,对心脏有明显的保护作用,以30μmol/L的木犀草素大剂量组作用最显著。     

外周苯二氮(艹卓)受体激动剂Ro5-4864抑制大鼠心肌细胞线粒体通透性转换

线粒体通透性转换（mitochondrial permeability transition,MPT）导致线粒体氧化应激性损伤。近年研究认为,位于线粒体外膜的外周苯二氮节受体（peripheral benzodiazepine receptor,PBR）参与了线粒体的重要生理功能。本研究在心肌细胞线粒体水平探讨激动PBR能否抑制Ca^2＋诱发的MPT。分离Sprague—Dawley大鼠心肌细胞线粒体,将PBR激动剂Ro5-4864（50、100、200μmol／L）和线粒体孵育,利用150μmol／L Ca^2＋诱发MPT,部分线粒体在与100μmol／L Ro5-4864孵育前5min加入MPT孔道开放剂苍术苷（atractyloside,ATR）。采用分光光度法观察线粒体膨胀情况：Westernblot检测线粒体细胞色素C（cytochrome C,CytoC）释放;利用荧光探针JC-1在激光共聚集显微镜下观察线粒体膜电位的变化。50、100、200μmol／L Ro5-4864均显著抑制Ca^2＋诱发的520nm处线粒体吸光度的下降,而且抑制Ca^2＋引起的线粒体CytoC释放和线粒体膜电位下降,但ATR可阻断R05—4864的上述作用。结果提示,PBR激动剂可抑制大鼠心肌MPT,保持线粒体CytoC含量和稳定线粒体膜电位,减轻线粒体损伤。PBR的激活可能成为减轻心肌细胞应激性损伤及心肌保护的新方法。     

葛根素对离体大鼠缺血/复灌心脏的保护作用及其作用机制

目的：探讨葛根素（puerarin,Pue）预处理抗心肌缺血／复灌（ischemia／reperfusion,I／R）损伤是否与线粒体渗透性转换孔和／或线粒体ATP敏感性钾通道有关。方法：采用离体大鼠心脏Leangendorff灌流方法,全心停灌30min,复灌120min复制I／R模型。测定心室力学指标和复灌各时间点冠脉流出液中乳酸脱氢酶（LDH）含量。实验结束测定心肌组织formazan量的变化。结果：与单纯I／R组相比,Pue（0．24mmol／L,5min）预处理明显提高心肌细胞的formazan含量,降低复灌期间冠脉流出液中LDH含量,明显促进左室发展压、左心室内压最大上升和下降速率、心率与发展压乘积和左室舒张末压力的恢复,缓解冠脉流量的减少。线粒体渗透性转换孔开放剂苍术苷（20μmol／L。复灌前给药20min）和线粒体ATP敏感性钾通道抑制剂5-羟基癸酸（100μmol／L,缺血前给药20min）能明显减弱Pue的保护作用。结论：在大鼠离体心脏灌流模型上,Pue预处理具有抗心脏缺血／复灌损伤的作用,这种保护作用可能与其抑制线粒体渗透性转换孔的开放和促进线粒体ATP敏感性钾通道的开放有关。     

丙泊酚预处理对大鼠离体心肌浅低温缺血／再灌注损伤后线粒体细胞色素C释放的影响

目的：探讨丙泊酚预处理对大鼠离体心肌浅低温缺血／再灌注（I／R）损伤后心肌细胞凋亡及线粒体细胞色素C释放的影响。方法：应用Langendorff离体心脏灌注模型,取50只SD大鼠随机分为5组：对照组（C组）,二甲基亚砜（DMSO）预处理组（D组）,25、50、100μmol·L^-1丙泊酚预处理纽（P1、P2、P3组）。各组均浅低温缺血55min,再常温灌注60min。D组、P1、P2、P3组在缺血前分别以含DMSO、相应浓度丙泊酚的K-H液灌注10min,再冲洗5min,重复2次。记录平衡灌注末、缺血前即刻、再灌注30、60min时的心功能指标。再灌注60min时测定凋亡细胞,提取心肌线粒体,测定线粒体和胞浆的细胞色素C水平。结果：与C组相比,P3组再灌注30min、60min时左室舒张末压（LVEDP）降低、左室发展压（LVDP）升高（P〈0．05或P〈0．01）;P2、P3组再灌注末心肌细胞凋亡率降低（P〈0．05或P〈0．01）,线粒体细胞色素c释放减少,胞浆细胞色素C的量明显降低（P〈0．05或P〈0．01）。结论：丙泊酚预处理能够通过抑制心肌线粒体细胞色素C释放到胞浆,降低浅低温I／R损伤心肌细胞凋亡率,减轻心肌桶伤．     

Negative regulation of vascular smooth muscle cell migration by blood shear stress

Urocortin (UCN) protects hearts against ischemia and reperfusion injury whether given before ischemia or at reperfusion. Here we investigate the roles of PKC, reactive oxygen species, and the mitochondrial permeability transition pore (MPTP) in mediating these effects. In Langendorff-perfused rat hearts, acute UCN treatment improved hemodynamic recovery during reperfusion after 30 min of global ischemia; this was accompanied by less necrosis (lactate dehydrogenase release) and MPTP opening (mitochondrial entrapment of 2-[(3)H]deoxyglucose). UCN pretreatment protected mitochondria against calcium-induced MPTP opening, but only if the mitochondria had been isolated from hearts after reperfusion. These mitochondria also exhibited less protein carbonylation, suggesting that UCN decreases levels of oxidative stress. In isolated adult and neonatal rat cardiac myocytes, both acute (60 min) and chronic (16 h) treatment with UCN reduced cell death following simulated ischemia and re-oxygenation. This was accompanied by less MPTP opening as measured using tetramethylrhodamine methyl ester. The level of oxidative stress during reperfusion was reduced in cells that had been pretreated with UCN, suggesting that this is the mechanism by which UCN desensitizes the MPTP to reperfusion injury. Despite the fact that we could find no evidence that either PKC-epsilon or PKC-alpha translocate to the mitochondria following acute UCN treatment, inhibition of PKC with chelerythrine eliminated the effect of UCN on oxidative stress. Our data suggest that acute UCN treatment protects the heart by inhibiting MPTP opening. However, the mechanism appears to be indirect, involving a PKC-mediated reduction in oxidative stress.     

异氟烷预处理对大鼠肝缺血再灌注时脑线粒体钙及线粒体转运通道的影响

目的：通过观察在体大鼠肝部分缺血再灌注损伤后脑线粒体游离钙、线粒体转运通道（ mitochondrial permeability transition pore ,MPTP）及外周血中S-100β蛋白含量的变化,明确异氟烷预处理对大鼠肝部分缺血再灌注时脑损伤是否具有保护作用及可能的机制。方法 SD大鼠75只随机分成假手术组（ S组）;缺血再灌注组（ I/R组）：肝缺血60 min,再灌注120 min;异氟烷预处理组（ ISO组）：肝I/R前60 min ISO预处理30 min,后用空气洗脱30 min：CsA＋ISO组,CsA50 mg/kg静脉内注射,30 min后同ISO组;CsA组,I/R前30 min CsA50 mg/kg静脉内注射。再灌注24 h迅速断头取前脑,分离线粒体进行线粒体游离钙、MPTP含量检测,各组分别于缺血前及再灌注120 min后抽取静脉血采用双抗体夹心-ELAISA 法测定 S-100β蛋白含量。结果 I/R组（287.32±26.17）线粒体游离Ca2＋浓度明显增加,高于S组（198.54±21.02）和ISO组（209.74±29.49）（P ＜0.05）;CsA＋ISO（267.31±37.52）明显高于ISO组（ P ＜0.05）;CsA（288.63±23.15）组与I/R组间比较差异无显著意义（ P ＜0.05）;I/R组（1.73±0.24）的ΔS与S组（2.36±0.35）和ISO 组（2.11±0.32）相比明显减少（P ＜0.05）,既MPTP大量开放,而后两组的差异无统计学意义（P ＜0.05）;I/R组与CsA＋ISO组（1.72±0.34）和CsA组（1.77±0.35）△S之间差异无统计学意义（P ＜0.05）;CsA＋ISO组的ΔS值与ISO组相比明显降低（P ＜0.05）。外周血液S-100β蛋白I/R组明显高于S组和ISO组（P ＜0.05）;CsA＋ISO组与ISO组比较显著升高（P ＜0.05）,I/R组,CsA＋ISO组和CsA组与缺血前比较明显升高（ P ＜0.05）,缺血前S-100β蛋白含量五组无显著性差异（ P ＜0.05）。结论大鼠肝部分缺血再灌注后对脑组织造成了一定程度损伤,而异氟烷预处理对此损伤具有一定保护作用;其作用的机制可能与异氟烷抑制MPTP开放,降低线粒体游离Ca2＋浓度,防止了线粒体Ca2＋超载有关。     

大豆磷脂脂质体对再灌注心肌线粒体的影响

利用Ｌａｎｇｅｎｄｏｒｆｆ离体心脏灌流装置,研究在缺血－再灌注时补充大豆磷脂脂质体对心肌线粒体膜脂质特性和超微结构的影响。结果：在缺血－再灌注时补充大豆磷脂脂质体可提高线粒体膜磷脂含量,抑制胆固醇－磷脂摩尔比和膜脂质微粘度的增加,改善线粒体的超微结构。结果表明,补充大豆磷脂脂质体对再灌注心肌线粒体的脂质特性和超微结构的损伤性变化具有保护作用。     

In vivo hyperoxic preconditioning protects against rat-heart ischemia/reperfusion injury by inhibiting mitochondrial permeability transition pore opening and cytochrome c release

In vivo hyperoxic preconditioning (PC) has been shown to protect against ischemia/reperfusion (I/R) myocardial damage. Mitochondrial permeability transition pore (MPTP) opening is an important event in cardiomyocyte cell death occurring during I/R and therefore a possible target for cardioprotection. We tested the hypothesis that in vivo hyperoxic PC, obtained by mechanical ventilation of animals, could protect heart against I/R injury by inhibiting MPTP opening and cytochrome c release from mitochondria. Mechanically ventilated rats were first exposed to a short period of hyperoxia and isolated hearts were subsequently subjected to I/R in a Langendorff apparatus. Hyperoxic PC significantly improved the functional recovery of hearts on reperfusion, reduced the infarct size, and decreased necrotic damage as shown by the reduced release of lactate dehydrogenase. Mitochondria from hyperoxic PC hearts were less sensitive than mitochondria from reperfused heart to MPTP opening. In addition, hyperoxic PC prevented mitochondrial NAD(+) depletion, an indicator of MPTP opening, and cytochrome c release as well as cardiolipin oxidation/depletion associated with I/R. Together, these results demonstrate that hyperoxic PC protects against heart I/R injury by inhibiting MPTP opening and cytochrome c release. Thus, in vivo hyperoxic PC may represent a useful strategy for the treatment of cardiac I/R injury and could have potential applications in clinical practice.     

Controlled reperfusion after hypothermic heart preservation inhibits mitochondrial permeability transition-pore opening and enhances functional recovery

We investigated whether low-pressure reperfusion may attenuate postischemic contractile dysfunction, limits necrosis and apoptosis after a prolonged hypothermic ischemia, and inhibits mitochondrial permeability transition-pore (MPTP) opening. Isolated rats hearts (n = 72) were exposed to 8 h of cold ischemia and assigned to the following groups: 1) reperfusion with low pressure (LP = 70 cmH(2)O) and 2) reperfusion with normal pressure (NP = 100 cmH(2)O). Cardiac function was assessed during reperfusion using the Langendorff model. Mitochondria were isolated, and the Ca(2+) resistance capacity (CRC) of the MPTP was determined. Malondialdehyde (MDA) production, caspase-3 activity, and cytochrome c were also assessed. We found that functional recovery was significantly improved in LP hearts with rate-pressure product averaging 30,380 +/- 1,757 vs. 18,000 +/- 1,599 mmHg/min in NP hearts (P < 0.01). Necrosis, measured by triphenyltetrazolium chloride staining and creatine kinase leakage, was significantly reduced in LP hearts (P < 0.01). The CRC was increased in LP heart mitochondria (P < 0.01). Caspase-3 activity, cytochrome c release, and MDA production were reduced in LP hearts (P < 0.001 and P < 0.01). This study demonstrated that low-pressure reperfusion after hypothermic heart ischemia improves postischemic contractile dysfunction and attenuates necrosis and apoptosis. This protection could be related to an inhibition of mitochondrial permeability transition.