RAGE与肝缺血再灌注损伤间的关系

晚期糖化终末产物受体(receptor for advanced glycation end product,RAGE)是一种单穿膜受体,同时也是一种多配体受体,属于免疫球蛋白超家族的成员。其配体包括高速泳动族框1蛋白质(high mobility group box 1,HMGB1)、晚期糖化终末产物(advanced glycation end product,AGE)、S100/钙粒蛋白(calgranulin)及β淀粉样肽等。在肝脏中,RAGE主要表达于巨噬细胞与树突状细胞上。RAGE一旦被激活,就会通过一系列的信号传导,诱导这些细胞释放出多种促炎症的物质,并引起中性粒细胞沉积,产生瀑布式的炎症反应链。肝脏的缺血再灌注(ischemia/reperfusion,I/R)损伤作用机制繁多。其中RAGE作为一个关键的调节点,各种外来和内在的因素都可以通过作用于RAGE从而影响炎症反应。现就肝脏I/R损伤与RAGE之间关系做一综述。     

Cathepsin B inactivation attenuates the apoptotic injury induced by ischemia/reperfusion of mouse liver

Background: A major mechanism underlying warm ischemia/reperfusion (I/R) injury during liver transplantation is the activation of the caspase chain, which leads to apoptosis. Recently, it was demonstrated that the release of cathepsin B, a cysteine protease, from the cytosol in liver injury induces mitochondrial release of cytochrome c and the activation of caspase-3 and -9, thereby leading to apoptosis. The aim of this study was to ascertain if cathepsin B inactivation attenuates the apoptotic injury due to I/R in mouse liver. Methods: A model of segmental (70%) hepatic ischemia was used. Eighteen mice were anesthetized and randomly divided into three groups: (1) Control group: sham operation (laparotomy); (2) Ischemic group: midline laparotomy followed by occlusion of all structures in the portal triad to the left and median lobes for 60 min (ischemic period); (3) Study group: like group 2, but with intraperitoneal administration of a pharmacological inhibitor of cathepsin B (4 mg/100 g) 30 min before induction of ischemia. Serum liver enzyme levels were measured by biochemical analysis, and intrahepatic caspase-3 activity was measured by fluorometric assay; apoptotic cells were identified by morphological criteria, the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) fluorometric assay, and immunohistochemistry for caspase-3. Results: Showed that at 6 h of reperfusion, there was a statistically significant reduction in liver enzyme levels in the animals pretreated with cathepsin B inhibitor (p < 0.05). On fluorometric assay, caspase-3 activity was significantly decreased in group 3 compared to group 2 (p < 0.0001). The reduction in postischemic apoptotic hepatic injury in the cathepsin B inhibitor -treated group was confirmed morphologically, by the significantly fewer apoptotic hepatocyte cells detected (p < 0.05); immunohistochemically, by the significantly weaker activation of caspase-3 compared to the ischemic group (p < 0.05); and by the TUNEL assay (p < 0.05). Conclusion: The administration of cathepsin B inhibitor before induction of ischemia can attenuate postischemic hepatocyte apoptosis and thereby minimize liver damage. Apoptotic hepatic injury seems to be mediated through caspase-3 activity. These findings have important implications for the potential use of cathepsin B inhibitors in I/R injury during liver transplantation.     

Downregulation of tripartite motif protein 11 attenuates cardiomyocyte apoptosis after ischemia/reperfusion injury via DUSP1-JNK1/2

Currently, the prevention of ischemic diseases such as myocardial infarction associated with ischemia/reperfusion (I/R) injury remains to be a challenge. Thus, this study was designed to explore the effects of tripartite motif protein 11 (TRIM11) on cardiomyocytes I/R injury and its underlying mechanism. Cardiomyocytes AC16 were used to establish an I/R injury cell model. After TRIM11 downregulation in I/R cells, cell proliferation (0, 12, 24, and 48 h) and apoptosis at 48 h as well as the related molecular changes in oxidative stress-related pathways was detected. Further, after the treatment of TRIM11 overexpression, SP600125, or DUSP1 overexpression, cell proliferation, apoptosis, and related genes were detected again. As per our findings, it was determined that TRIM11 was highly expressed in the cardiomyocytes AC16 after I/R injury. Downregulation of TRIM11 was determined to have significantly reduced I/R-induced proliferation suppression and apoptosis. Besides, I/R-activated c-Jun N-terminal kinase (JNK) signaling and cleaved caspase 3 and Bax expression were significantly inhibited by TRIM11 downregulation. In addition, the overexpression of TRIM11 significantly promoted apoptosis in AC16 cells, and JNK1/2 inhibition and DUSP1 overexpression potently counteracted the induction of TRIM11 overexpression in AC16 cells. These suggested that the downregulation of TRIM11 attenuates apoptosis in AC16 cells after I/R injury probably through the DUSP1-JNK1/2 pathways.     

Ischemic preconditioning attenuates apoptotic cell death associated with ischemia/reperfusion

Apoptosis or programmed cell death is a genetically controlled response for cells to commit suicide and is associated with DNA fragmentation or laddering. The common inducers of apoptosis include oxygen free radicals/oxidative stress and Ca2+ which are also implicated in the pathogenesis of myocardial ischemic reperfusion injury. To examine whether ischemic reperfusion injury is mediated by apoptotic cell death, isolated perfused rat hearts were subjected to 15, 30 or 60 min of ischemia as well as 15 min of ischemia followed by 30, 60, 90 or 120 min of reperfusion. At the end of each experiment, the heart was processed for the evaluation of apoptosis and DNA laddering. Apoptosis was studied by visualizing the apoptotic cardiomyocytes by direct fluorescence detection of digoxigenin-labeled genomic DNA using APOPTAG® in situ apoptosis detection kit. DNA laddering was evaluated by subjecting the DNA obtained from the hearts to 1.8% agarose gel electrophoresis and photographed under UV illumination. The results of our study revealed apoptotic cells only in the 90 and 120 min reperfused hearts as demonstrated by the intense fluorescence of the immunostained digoxigenin-labeled genomic DNA when observed under fluorescence microscopy. None of the ischemic hearts showed any evidence of apoptosis. These results were corroborated with the findings of DNA fragmentation which showed increased ladders of DNA bands in the same reperfused hearts representing integer multiples of the internucleosomal DNA length (about 180 bp). The presence of apoptotic cells and DNA fragmentation in the myocardium were completely abolished by subjecting the myocardium to repeated short-term ischemia and reperfusion which also reduced the ischemic reperfusion injury as evidenced by better recovery of left ventricular performance in the preconditioned myocardium. The results of this study indicate that reperfusion of ischemic heart, but not ischemia, induces apoptotic cell death and DNA fragmentation which can be inhibited by myocardial adaptation to ischemia.     

Inhibition of cathepsin S attenuates myocardial ischemia/reperfusion injury by suppressing inflammation and apoptosis

Myocardial ischemia/reperfusion (I/R) injury leads to high mortality and morbidity due to the incomplete understanding of the underlying mechanism and the consequent lack of effective therapy. The present study revealed and validated key candidate genes in relation to inflammation and apoptosis pathways underlying myocardial I/R injury. Cathepsin S was identified as the top hub protein based on the protein–protein interaction analysis, and, thus, its role during myocardial I/R injury was further investigated. Myocardial I/R in mice resulted in significantly increased levels of myocardial injury biomarkers (cardiac troponin I, lactic dehydrogenase, and creatinine kinase‐MB) and inflammatory cytokines (interleukin‐1β [IL‐1β], IL‐6, and tumor necrosis factor‐α), elevated apoptosis rate, and upregulated protein expression of cleaved caspase‐8, cleaved caspase‐3, and cleaved poly ADP‐ribose polymerase. These abovementioned changes were blocked by two different selective cathepsin S inhibitors, LY3000328 or MIV‐247. Moreover, Kaplan–Meier survival plot showed that cathepsin S inhibition improved 21‐day survival rate following myocardial I/R injury. This study demonstrated that the inhibition of cathepsin S alleviated myocardial I/R‐induced injury by suppressing inflammation and apoptosis, which may be used in clinical applications of cardioprotection.     

锌对缺血／再灌注肝脏自由基含量和细胞凋亡的影响

目的：观察补锌对缺血再灌注（HIR）大鼠肝脏自由基含量及细胞凋亡的影响。探讨补锌保护肝损伤的机制。方法：用荧光分光光度法测定血清MDA含量;用电子自旋共振法测定肝脏自由基浓度;用流式细胞术检测肝细胞凋亡。结果：HIR组大鼠血清MDA水平和肝自由基产生均增加,补锌后降低;肝脏缺血再灌注后肝细胞凋亡率达到57.72%,补锌后降低40.85%。结论：减少自由基产生和抑制细胞凋亡是锌保护肝缺血再灌注损伤的重要机制。     

Inhibition of adenosine kinase attenuates myocardial ischaemia/reperfusion injury

Increased adenosine helps limit infarct size in ischaemia/reperfusion-injured hearts. In cardiomyocytes, 90% of adenosine is catalysed by adenosine kinase (ADK) and ADK inhibition leads to higher concentrations of both intracellular adenosine and extracellular adenosine. However, the role of ADK inhibition in myocardial ischaemia/reperfusion (I/R) injury remains less obvious. We explored the role of ADK inhibition in myocardial I/R injury using mouse left anterior ligation model. To inhibit ADK, the inhibitor ABT-702 was intraperitoneally injected or AAV9 (adeno-associated virus)—ADK—shRNA was introduced via tail vein injection. H9c2 cells were exposed to hypoxia/reoxygenation (H/R) to elucidate the underlying mechanisms. ADK was transiently increased after myocardial I/R injury. Pharmacological or genetic ADK inhibition reduced infarct size, improved cardiac function and prevented cell apoptosis and necroptosis in I/R-injured mouse hearts. In vitro, ADK inhibition also prevented cell apoptosis and cell necroptosis in H/R-treated H9c2 cells. Cleaved caspase-9, cleaved caspase-8, cleaved caspase-3, MLKL and the phosphorylation of MLKL and CaMKII were decreased by ADK inhibition in reperfusion-injured cardiomyocytes. X-linked inhibitor of apoptosis protein (XIAP), which is phosphorylated and stabilized via the adenosine receptors A2B and A1/Akt pathways, should play a central role in the effects of ADK inhibition on cell apoptosis and necroptosis. These data suggest that ADK plays an important role in myocardial I/R injury by regulating cell apoptosis and necroptosis.     

早期跑步运动对大鼠脑缺血/再灌注损伤后神经行为与神经元凋亡的影响

目的: 探讨早期跑步运动对大鼠脑缺血后神经行为与神经元凋亡的影响。方法:雄性SD大鼠随机分为4组:假手术+安静组(Sham-St、假手术+运动组(Sham-Ex)、缺血(大脑中动脉闭塞(MCAO) +运动组((MCAO -Ex)和缺血+安静组(MCAO-St),每组15只。MCAO-Ex 和 MCAO-St 组大鼠行MCAO 60 min,再灌注2 d后,MCAO-Ex 和Sham-Ex大鼠在跑步机上进行5 d的30 min/d跑步运动(15 m/min),之后进行神经行为学评价,最后大鼠断头取脑进行TTC方法染色,评估各组大鼠梗死体积以及缺血半影Caspase-3和TUNEL阳性细胞表达水平。结果:与Sham-St相比,MCAO-St和MCAO-Ex大鼠缺血半影区Caspase-3表达均显著升高 (P＜0.05);与MCAO-St 组大鼠相比,MCAO-Ex组大鼠脑梗死体积明显减少,大鼠神经功能评分明显改善,大鼠缺血半影区Caspase-3和TUNEL阳性细胞表达水平显著降低 (P＜0.05)。结论: 早期运动可能通过抑制大鼠脑缺血后神经元凋亡发挥神经保护作用。     

环孢素A对大鼠肺缺血/再灌注损伤中细胞凋亡的影响

目的:探讨线粒体膜通透性转换孔(MPTP)抑制剂——环孢素A(CsA)对大鼠肺常温缺血/再灌注后细胞凋亡的影响。方法:健康SD大鼠30只,随机分为3组(n=10):假手术组、缺血/再灌注组(I/R组)和环孢素A干预组(CsA组)。复制在体肺缺血/再灌注损伤模型。采用原位缺口末端标记(TUNEL)法检测肺组织细胞凋亡,免疫组化技术检测肺组织细胞细胞色素C(CytC)的含量,以及分光光度计测定肺组织细胞caspase-3的活性。结果:I/R组肺组织细胞胞浆CytC的含量、caspase-3活性明显高于假手术组(P0.01),并观察到大量肺组织细胞凋亡的发生。CsA组与I/R组相比,CytC释放明显减少(P0.01),caspase-3活性减弱,细胞凋亡的发生率明显下降(P0.01)。结论:环孢素A可能通过抑制MPTP开放,减少缺血/再灌注后线粒体CytC的释放,从而减少肺组织细胞的凋亡。     

牛磺酸对家兔缺血/再灌注心肌细胞凋亡的影响

目的:研究牛磺酸(Tau)对家兔缺血/再灌注损伤心肌细胞凋亡的影响.方法:阻断家兔心脏左冠状动脉前降支45 min,再灌注180 min引起心肌缺血/再灌注损伤,在心肌缺血前5 min耳缘静脉注射牛磺酸(200mg/kg),应用DNA片段原位末端标记法 (TUNEL染色),DNA凝胶电泳和流式细胞仪(FCM)观测心肌细胞凋亡.结果:琼脂糖凝胶电泳显示损伤对照组(I/R) 心肌DNA呈云梯状改变,而Tau I/R组无此改变.与损伤对照组(I/R) 比较,Tau I/R组缺血心肌凋亡细胞明显减少(TUNEL染色).流式细胞仪测定I/R组及Tau I/R组缺血心肌凋亡率分别为17.66%±1.54%和4.86%±1.23%.I/R组的缺血心肌Fas和Bax蛋白表达较非缺血心肌高 (P<0.01),Bcl-2/Bax比例较非缺血心肌低(P<0.01);而在Tau I/R组,Fas和Bax蛋白表达较I/R组的低 (P<0.01),Bcl-2/Bax比例较I/R组高(P<0.01).结论:牛磺酸可减少I/R家兔心肌细胞凋亡,其机制与调控凋亡相关基因 Fas,Bax和Bcl-2的蛋白表达有关.     

Recombinant human erythropoietin attenuates hepatic injury induced by ischemia/reperfusion in an isolated mouse liver model

Introduction Apoptosis is a central mechanism of cell death following reperfusion of the ischemic liver. Recombinant human erythropoietin (rhEPO) have an important role in the treatment of myocardial ischemia/reperfusion (I/R) injury, by preventing apoptosis. The aim of the study was to investigate the effect of different regimens of rhEPO in preventing apoptosis following I/R-induced hepatic injury. Material and methods Isolated mouse livers were randomly divided into five groups: (1) control group, perfused for the whole study period (105 min); (2) 30-min perfusion followed by 90 min of ischemia and 15 min of reperfusion; (3), (4) and (5) like group 2, but with administration of rhEPO 5,000 units/kg i.p. at 30 min, 24 h, or both 30 min and 24 h respectively, before induction of ischemia. Perfusate liver enzyme levels and intrahepatic caspase-3 activity were measured, and apoptotic cells were identified by morphological criteria, TUNEL assay, and immunohistochemistry for caspase-3. Using immunoblot the expression of the proapoptotic JNK and inhibitor of NFκB (IκBα) were also evaluated. von Willebrand factor (vWF) immunohistochemistry was used as a marker of endothelial cells. Results Compared to the I/R livers, all 3 rhEPO pretreated groups showed: a significant reduction in liver enzyme levels (P < 0.05) and intrahepatic caspase-3 activity (P < 0.05), fewer apoptotic hepatocytes (P < 0.05) and positive vWF staining in numerous endothelial cells lining the sinusoids. EPO decreased JNK phosphorylation and the degradation of the inhibitor of NFκB (IκBα) during I/R. There was no added benefit of the multiple- over the single-dose rhEPO regimen. Conclusion Pretreatment with one dose of rhEPO can attenuate post-I/R hepatocyte apoptotic liver damage. NFκB and JNK activation is likely to play a pivotal role in the pathophysiology of I/R hepatic injury and might have a key role in EPO-mediated protective effects. This effect is associated with the increase in sinusoidal vWF immunostaining suggests an additional effect of rhEPO in liver angiogenesis recovery. These findings have important implications for the potential use of rhEPO in I/R injury during liver transplantation. Edith Hochhauser and Orit Pappo are first two coauthors.     

Neonatal cardiac mitochondria and ischemia/reperfusion injury

Postnatal maturation of the heart is characterized by decreasing tolerance to ischemia/reperfusion (I/R) injury associated with significant changes in mitochondrial function. The aim of this study is to test the hypothesis that the role of the mitochondrial membrane permeability transition pore (MPTP) in the I/R injury differs in the neonatal and in the adult heart. For this purpose, the effect of blockade of MPTP on the degree of I/R injury and the sensitivity of MPTP to swelling-inducing agents was compared in hearts from neonatal (7 days old) and adult (90 days old) Wistar rats. It was found that the release of NAD⁺ from the perfused heart induced by I/R can be prevented by sanglifehrin A (SfA) only in the adult myocardium; SfA had no protective effect in the neonatal heart. Furthermore, the extent of Ca-induced swelling of mitochondria from neonatal rats was significantly lower than that from the adult animals; mitochondria from neonatal rats were more resistant at higher concentrations of calcium. In addition, not only the extent but also the rate of calcium-induced swelling was about twice higher in adult than in neonatal mitochondria. The results support the idea that lower sensitivity of the neonatal MPTP to opening may be involved in the mechanism of the higher tolerance of the neonatal heart to I/R injury.     

Pretreatment with soluble ST2 reduces warm hepatic ischemia/reperfusion injury

The interleukin-1 receptor-like protein ST2 exists in both membrane-bound (ST2L) and soluble form (sST2). ST2L has been found to play an important regulatory role in Th2-type immune response, but the function of soluble form of ST2 remains to be elucidated. In this study, we report the protective effect of soluble ST2 on warm hepatic ischemia/reperfusion injury. We constructed a eukaryotic expression plasmid, psST2-Fc, which expresses functional murine soluble ST2-human IgG1 Fc (sST2-Fc) fusion protein. The liver damage after ischemia/reperfusion was significantly attenuated by the expression of this plasmid in vivo. sST2-Fc remarkably inhibited the activation of Kupffer cells and the production of proinflammatory mediators TNF-alpha and IL-6. Furthermore, the levels of TLR4 mRNA and the nuclear translocation of NF-kappaB were also suppressed by pretreatment with sST2-Fc. These results thus identified soluble ST2 as a negative regulator in hepatic I/R injury, possibly via ST2-TLR4 pathway.     

Targeting autophagy in cardiac ischemia/reperfusion injury: A novel therapeutic strategy

Acute myocardial infarction (AMI) is one of the leading causes of morbidity worldwide. Myocardial reperfusion is known as an effective therapeutic choice against AMI. However, reperfusion of blood flow induces ischemia/reperfusion (I/R) injury through different complex processes including ion accumulation, disruption of mitochondrial membrane potential, the formation of reactive oxygen species, and so forth. One of the processes that gets activated in response to I/R injury is autophagy. Indeed, autophagy acts as a “double-edged sword” in the pathology of myocardial I/R injury and there is a controversy about autophagy being beneficial or detrimental. On the basis of the autophagy effect and regulation on myocardial I/R injury, many studies targeted it as a therapeutic strategy. In this review, we discuss the role of autophagy in I/R injury and its targeting as a therapeutic strategy.     

SP600125对大鼠肺缺血/再灌注损伤的保护作用及机制

目的:探讨SP600125-c-Jun氨基末端激酶(JNK)特异性抑制剂对大鼠肺缺血/再灌注损伤的保护作用及机制。方法:复制在体大鼠原位单肺缺血/再灌注模型,随机分3组(n=10):假手术对照组(Control组)、缺血再灌注组(I/R组)与缺血再灌注+SP600125干预组(SP600125组)。实验结束时取肺组织测湿/干重比(W/D)、肺泡损伤率(IAR);采用蛋白印迹法检测肺组织磷酸化JNK(p-JNK)、JNK蛋白的表达;免疫组化法检测肺组织Bcl-2、Bax、Caspase-3蛋白的表达;原位末端标记法检测肺组织细胞凋亡指数(AI);电镜观察肺组织超微结构的改变。结果:SP600125组肺组织p-JNK、Bax、caspase-3的蛋白表达显著低于I/R组(均P<0.01),Bcl-2的蛋白表达及Bcl-2/Bax的比值显著高于I/R组(均P<0.01),AI、W/D及IAR显著低于I/R组(均P<0.01),肺组织超微结构损伤不同程度减轻。结论:SP600125可能通过抑制JNK信号通路,上调Bcl-2/Bax的比值减少caspase-3依赖性的肺细胞凋亡,从而减轻肺缺血/再灌注损伤。     

Tetramethylpyrazine induces heme oxygenase-1 expression and attenuates myocardial ischemia/reperfusion injury in rats

The accumulation of oxygen free radicals and activation of neutrophils are strongly implicated as pathophysiological mechanisms mediating myocardial ischemia/reperfusion injury. Heme oxygenase-1 (HO-1) has been reported to play a protective role in oxidative tissue injuries. In this study, the cardioprotective activity of tetramethylpyrazine (TMP), an active ingredient of Chinese medicinal herb Ligusticum wallichii Franchat, was evaluated in an open-chest anesthetized rat model of myocardial ischemia/reperfusion injury. Pretreatment with TMP (5 and 10 mg/kg, i.v.) before left coronary artery occlusion significantly suppressed the occurrence of ventricular fibrillation. After 45 min of ischemia and 1 h of reperfusion, TMP (5 and 10 mg/kg) caused a significant reduction in infarct size and induced HO-1 expression in ischemic myocardium. The HO inhibitor ZnPP (50 μg/rat) markedly reversed the anti-infarct action of TMP. Superoxide anion production in ischemic myocardium after 10 min reperfusion was inhibited by TMP. Furthermore, TMP (200 and 500 μM) significantly suppressed fMLP (800 nM)-activated human neutrophil migration and respiratory burst. In conclusion, TMP suppresses ischemia-induced ventricular arrhythmias and reduces the infarct size resulting from ischemia/reperfusion injury in vivo. This cardioprotective activity of TMP may be associated with its antioxidant activity via induction of HO-1 and with its capacity for neutrophil inhibition.     

异丙酚对家兔肝缺血/再灌注后抗氧化能力改变的影响

目的: 探讨氧自由基(OFR)在肝缺血/再灌注损伤(HI/RI)中的作用及异丙酚对其的影响.方法: 实验兔随机分为假手术对照组、肝缺血/再灌注组和肝缺血/再灌注加异丙酚治疗组,分别在肝缺血前、缺血45 min、再灌注45 min共3个时相点,检测血浆及肝组织超氧化物歧化酶(SOD)活性、黄嘌呤氧化酶(XO)活性、丙二醛( MDA)浓度及谷丙转氨酶(ALT)值,并行肝组织电镜观察.结果: 肝缺血/再灌注期间,血浆XO、MDA及ALT显著高于、SOD明显低于假手术对照组(P<0.05和P<0.01);肝组织XO及MDA显著高于、SOD明显低于假手术对照组(P<0.05和P<0.01);肝组织超微结构发生异常改变.异丙酚可逆转上述指标的异常变化,与肝缺血/再灌注组相比有显著性差异(P<0.05和P<0.01).结论: OFR在HI/RI发生发展中起介导作用;异丙酚可通过降低氧自由基水平(增强SOD活性、减弱XO活性),拮抗脂质过氧化反应(降低MDA浓度),从而减轻HIRI.