Targeting mitochondrial fusion and fission proteins for cardioprotection

New treatments are needed to protect the myocardium against the detrimental effects of acute ischaemia/reperfusion (IR) injury following an acute myocardial infarction (AMI), in order to limit myocardial infarct (MI) size, preserve cardiac function and prevent the onset of heart failure (HF). Given the critical role of mitochondria in energy production for cardiac contractile function, prevention of mitochondrial dysfunction during acute myocardial IRI may provide novel cardioprotective strategies. In this regard, the mitochondrial fusion and fissions proteins, which regulate changes in mitochondrial morphology, are known to impact on mitochondrial quality control by modulating mitochondrial biogenesis, mitophagy and the mitochondrial unfolded protein response. In this article, we review how targeting these inter‐related processes may provide novel treatment targets and new therapeutic strategies for reducing MI size, preventing the onset of HF following AMI.     

Mitochondrial ion channels as therapeutic targets

The study of mitochondrial ion channels changed our perception of these double-wrapped organelles from being just the power house of a cell to the guardian of a cell’s fate. Mitochondria communicate with the cell through these special channels. Most of the time, the message is encoded by ion flow across the mitochondrial outer and inner membranes. Potassium, sodium, calcium, protons, nucleotides, and proteins traverse the mitochondrial membranes in an exquisitely regulated manner to control a myriad of processes, from respiration and mitochondrial morphology to cell proliferation and cell death. This review is an update on both well established and putative mitochondrial channels regarding their composition, function, regulation, and therapeutic potential.     

线粒体钙单向转运体参予肿瘤坏死因子α抗心肌缺血/复灌损伤的研究

目的：探讨肿瘤坏死因子α（TNFα）诱导的抗心肌缺血／复灌损伤的保护作用是否与线粒体钙单向转运体以及相关成分有关。方法：采用离体大鼠心脏灌流方法,结扎冠状动脉左前降支30min和复灌120min复制局部缺血／复灌损伤模型,测定心肌梗死面积、冠脉流量和冠脉流出液中乳酸脱氢酶（LDH）含量。提取大鼠心肌线粒体,分光光度法测啶,520nm吸光度。结果：与单纯缺血／复灌组相比,10U／ml TNFα预处理明显降低心脏缺血／复灌后的梗死面积和复灌期冠脉流出液中LDH含量,促进冠脉流量的恢复;复灌开始用线粒体钙单向转运体激动剂精胺（20μmol／L）灌流10min减弱了TNFα降低梗死面积和LDH含量的作用。10u／ml TNFα预处理离体大鼠心脏后分离线粒体,520nm处吸光度的下降明显低于对照组;精胺（50μmol／L）减弱了TNFα对520nm处吸光度的影响。结论：TNFα诱导的抗心肌缺血／复灌损伤的保护作用可能与其抑制线粒体钙单向转运体的开放和抑制线粒体通透性转变孔道开放有关。     

Klotho protein contributes to cardioprotection during ischaemia/reperfusion injury

Restoration of blood flow to ischaemic heart inflicts ischaemia/reperfusion (I/R) injury, which manifests in metabolic and morphological disorders. Klotho is a protein with antioxidative and antiapoptotic activity, and is involved in the regulation of inflammation and fibrosis. The aim of the current research was to determine the role of Klotho in the heart subjected to I/R injury, as well as to study Klotho as a potential cardioprotective agent. Human cardiomyocytes and Wistar rat hearts perfused using Langendorff method subjected to I/R have been used. Hemodynamic parameters of heart function, markers of I/R injury, and gene and protein expression of Klotho were measured. Human cardiomyocytes were also incubated in the presence of recombinant Klotho protein, and the viability of cells was measured. There was a higher expression of Klotho gene and protein synthesis in the cardiomyocytes subjected to I/R injury. The compensatory production and release of Klotho protein from cardiac tissue during I/R were also shown. The treatment of cardiomyocytes subjected to I/R with Klotho protein resulted in increased viability and metabolic activity of cells. Thus, Klotho contributes to compensatory mechanism during I/R, and could be used as a marker of injury and as a potential cardiopreventive/cardioprotective agent.     

一氧化氮在乙醇后处理心肌保护中的作用

目的:探讨乙醇后处理心肌保护作用是否与一氧化氮生成有关。方法:局部结扎冠状动脉左前降支30min,复灌120 min复制离体大鼠心肌缺血/复灌模型。心肌缺血末5 min,复灌初期10min给予乙醇50mmol/L,共灌流15 min进行乙醇后处理干预。实验随机分为五组,正常组,缺血/复灌组,乙醇后处理组,乙醇后处理+L-NAME组和乙醇后处理+苍术苷组。测定心室动力学指标和复灌期间冠脉流出液中乳酸脱氢酶(LDH)含量,TTC染色法测定心肌梗死面积,硝酸还原法测定心肌组织一氧化氮(NO)含量。RT-PCR检测左心室前壁心尖组织Bc-l2和BaxmRNA的表达。结果:与单纯缺血/复灌相比,乙醇后处理明显促进了左室发展压、左室做功的恢复,降低复灌期冠脉流出液中LDH的释放和心肌梗死面积,心肌组织NO释放减少,Bc-l 2/Bax mRNA比值增高。一氧化氮合酶抑制剂L-NAME和线粒体渗透性转换孔道开放剂苍术苷均抑制了乙醇后处理心室功能的恢复、LDH释放的减少和梗死面积的降低,心肌组织NO释放进一步减少,Bc-l 2/Bax mRNA比值降低。结论:乙醇后处理的心肌保护作用可能与减少NO的释放、抑制线粒体渗透性转换孔道的开放和抑制细胞凋亡的发生有关。     

心肌再灌注损伤保护的机制和策略

局部缺血部位快速再灌注虽然保护了心肌,但也引起再灌注损伤。目前还没有减轻再灌注损伤的特效疗法,但近年来研究显示,G蛋白耦联受体（Gprotein-coupledreceptor,GPCR）的激动剂、胰岛素和缺血后处理可以在各种实验条件和各类动物模型中有效抵抗再灌注损伤。这些干预手段启动的心脏保护机制可能包括激活再灌注损伤补救激酶（reperfus ioninjury salvage kinase,RISK）途径、抑制糖原合酶激酶-3β（glycogen synthase kinase3β,GSK-3β）以及抑制线粒体膜通透性转换孔（mitochondrial permeabili tytransition pore,mPTP）开放等。这些研究成果有利于开发治疗急性心肌梗死的有效临床手段。     

活性氧、线粒体通透性转换与细胞凋亡

线粒体是真核细胞中非常重要的细胞器,细胞中的活性氧等自由基主要来源于此,线粒体膜的通透性转换(mitochondrial permeability transition,MPT)及其孔道(mitochondrialpermeability transition pore,MPTP)更是在内源性细胞凋亡中发挥了关键作用。持续性的线粒体膜通透性转换在凋亡的效应阶段起决定性作用,可介导细胞色素c等促凋亡因子从线粒体释放到胞浆中,进一步激活下游的信号通路,导致细胞不可逆地走向凋亡。瞬时性的线粒体膜通透性转换及其偶联的线粒体局部的活性氧爆发同样具有促凋亡的作用。线粒体通透性孔道的开放释放出大量活性氧,这些活性氧又能够进一步激活该孔道,以正反馈的形式进一步加剧孔道的打开,放大凋亡信号。活性氧、线粒体通透性转换与细胞凋亡之间具有密不可分的联系,本文根据已知的研究结果集中讨论了这三者的关系,并着重论述了该领域中的最新发现和成果。     

环孢菌素A对脂多糖诱导的小鼠急性肺损伤的保护作用

目的：探讨线粒体渗透性转换孔道抑制剂环孢菌素A（CsA）对脂多糖（LPS）诱导的小鼠急性肺损伤可能的保护作用。方法：LPS 4 mg/kg气管内滴入复制小鼠急性肺损伤模型,实验随机分为5组（n=24）：分别为正常对照组、LPS组、地塞米松组、CsA组和CsA＋苍术苷组。6 h后小鼠处死,测定各组支气管肺泡灌洗液乳酸脱氢酶（LDH）的含量,酶联免疫吸附法测定肺组织匀浆液TNF-α浓度,测定肺组织湿/干重比和肺毛细血管通透性指数。结果：气管内滴入LPS 6 h后,CsA组与LPS组相比,肺泡灌洗液中LDH活性降低,肺组织匀浆液TNF-α浓度下降,肺组织湿/干重比、肺毛细血管通透性指数均明显下降,但CsA＋Atr组与LPS组相比无明显区别。结论：环孢菌素A对脂多糖诱导的小鼠急性肺损伤有保护作用,其机制可能与其抑制线粒体渗透性转换孔道的开放有关。     

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。     

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。     

Mitochondrial ROS production and subsequent ERK phosphorylation are necessary for temperature preconditioning of isolated ventricular myocytes

Hypothermia and hypothermic preconditioning are known to be profoundly cardioprotective, but the molecular mechanisms of this protection have not been fully explained. In this study, temperature preconditioning (16 °C) was found to be cardioprotective in isolated adult rat ventricular myocytes, enhancing contractile recovery and preventing calcium dysregulation after oxidative stress. Hypothermic preconditioning preserved mitochondrial function by delaying the pathological opening of the mitochondrial permeability transition pore (mPTP), whereas transient mPTP flickering remained unaltered. For the first time, reactive oxygen species (ROS) from the mitochondria are shown to be released exclusively during the hypothermic episodes of the temperature-preconditioning protocol. Using a mitochondrially targeted ROS biosensor, ROS release was shown during the brief bursts to 16 °C of temperature preconditioning. The ROS scavenger N-(2-mercaptopropionyl) glycine attenuated ROS accumulation during temperature preconditioning, abolishing the protective delay in mPTP opening. Temperature preconditioning induces ROS-dependant phosphorylation of the prosurvival kinase extracellular signal-regulated kinase (ERK)1/2. ERK1/2 activation was shown to be downstream of ROS release, as the presence of a ROS scavenger during temperature preconditioning completely blocked ERK1/2 activation. The cardioprotective effects of temperature preconditioning on mPTP opening were completely lost by inhibiting ERK1/2 activation. Thus, mitochondrial ROS release and ERK1/2 activation are both necessary to signal the cardioprotective effects of temperature preconditioning in cardiac myocytes.     

Obestatin regulates cardiovascular function and promotes cardioprotection through the nitric oxide pathway

Patients with ischaemic heart disease or chronic heart failure show altered levels of obestatin, suggesting a role for this peptide in human heart function. We have previously demonstrated that GH secretagogues and the ghrelin gene‐derived peptides, including obestatin, exert cardiovascular effects by modulating cardiac inotropism and vascular tone, and reducing cell death and contractile dysfunction in hearts subjected to ischaemia/reperfusion (I/R), through the Akt/nitric oxide (NO) pathway. However, the mechanisms underlying the cardiac actions of obestatin remain largely unknown. Thus, we suggested that obestatin‐induced activation of PI3K/Akt/NO and PKG signalling is implicated in protection of the myocardium when challenged by adrenergic, endothelinergic or I/R stress. We show that obestatin exerts an inhibitory tone on the performance of rat papillary muscle in both basal conditions and under β‐adrenergic overstimulation, through endothelial‐dependent NO/cGMP/PKG signalling. This pathway was also involved in the vasodilator effect of the peptide, used both alone and under stress induced by endothelin‐1. Moreover, when infused during early reperfusion, obestatin reduced infarct size in isolated I/R rat hearts, through an NO/PKG pathway, comprising ROS/PKC signalling, and converging on mitochondrial ATP‐sensitive potassium [mitoK(ATP)] channels. Overall, our results suggest that obestatin regulates cardiovascular function in stress conditions and induces cardioprotection by mechanisms dependent on activation of an NO/soluble guanylate cyclase (sGC)/PKG pathway. In fact, obestatin counteracts exaggerated β‐adrenergic and endothelin‐1 activity, relevant factors in heart failure, suggesting multiple positive effects of the peptide, including the lowering of cardiac afterload, thus representing a potential candidate in pharmacological post‐conditioning.     

随年龄增长心肌线粒体PT孔开放改变及其机制

目的:研究心功能自然衰退过程中线拉体通透性转换孔(MPTP)开放改变规律及其相关机制.方法:检测不同月龄(3、6、9、12月龄)SD大鼠左室心功能;分离各月龄大鼠心肌线粒体,检测MPTP开放改变、线粒体Mn-SOD活性.结果:9月龄和12月龄大鼠心功能同3月龄大鼠相比均出现明显减退,表现为左室收缩压LVSP减小(P<0...     

Inactivation of Mitochondrial Permeability Transition Pore by Octylguanidine and Octylamine

Mitochondrial permeability transition occurs through a Ca²⁺-dependent opening of atransmembrane pore, whose identity has been attributed to that of the adenine nucleotide translocase(ANT). In this work, we induced permeability transition by adding 0.5 M carboxyatractyloside.The process was evaluated analyzing Ca²⁺ efflux, a drop in transmembrane electric gradient,and swelling. We found that the amphiphyllic cations octylguanidine and octylamine, at theconcentration of 100 M, inhibited, almost completely, nonspecific membrane permeability.Hexylguanidine, hexylamine, as well as guanidine chloride and hydroxylamine failed to doso. The inhibition was reversed after the addition of 40 mM Li⁺, Na⁺ K⁺,Rb⁺, or Cs⁺; K⁺ wasthe most effective. We propose that the positive charge of the amines interact with negativecharges of membrane proteins, more likely the ADP/ATP carrier, while the alkyl chain penetratesinto the hydrophobic milieu of the inner membrane, fixing the reagent.     

Biochemistry and physiology of mitochondrial ion channels involved in cardioprotection

Over the past decades there has been considerable progress in understanding the multifunctional roles of mitochondrial ion channels in metabolism, energy transduction, ion transport, signaling, and cell death. Recent data have suggested that some of these channels function under physiological condition, and others may be activated in response to pathological insults and play a key role in cytoprotection. This review outlines our current understanding of the molecular identity and pathophysiological roles of the mitochondrial ion channels in the heart with particular emphasis on cardioprotection against ischemia/reperfusion injury, and future research on mitochondrial ion channels.     

Mitochondrial Calcium in Heart Cells: Beat-to-Beat Oscillations or Slow Integration of Cytosolic Transients?

Mitochondria have been implicated in intracellular Ca²⁺ signaling in many cell types. Theinner mitochondrial membrane contains Ca²⁺-transporting proteins, which catalyze Ca²⁺ uptakeand extrusion. Intramitochondrial (matrix) Ca²⁺, in turn, regulates the activity of Krebs cycledehydrogenases and, ultimately, the rate of ATP synthesis. In the myocardium, controversyremains whether the fast cytosolic Ca²⁺ transients underlying excitation-contraction couplingin beating cells are rapidly transmitted into the matrix compartment or slowly integratedby the mitochondrial Ca²⁺ transporters. This mini-review critically summarizes the recentexperimental work in this field.     

Metformin mediates cardioprotection against aging‐induced ischemic necroptosis

Necroptosis is crucially involved in severe cardiac pathological conditions. However, whether necroptosis contributes to age‐related intolerance to ischemia/reperfusion (I/R) injury remains elusive. In addition, metformin as a potential anti‐aging related injury drug, how it interacts with myocardial necroptosis is not yet clear. Male C57BL/6 mice at 3–4‐ (young) and 22–24 months of age (aged) and RIPK3‐deficient (Ripk3^?/?) mice were used to investigate aging‐related I/R injury in vivo. Metformin (125 μg/kg, i.p.), necrostatin‐1 (3.5 mg/kg), and adenovirus vector encoding p62‐shRNAs (Ad‐sh‐p62) were used to treat aging mice. I/R‐induced myocardial necroptosis was exaggerated in aged mice, which correlated with autophagy defects characterized by p62 accumulation in aged hearts or aged human myocardium. Functionally, blocking autophagic flux promoted H/R‐evoked cardiomyocyte necroptosis in vitro. We further revealed that p62 forms a complex with RIP1‐RIP3 (necrosome) and promotes the binding of RIP1 and RIP3. In mice, necrostatin‐1 treatment (a RIP1 inhibitor), RIP3 deficiency, and cardiac p62 knockdown in vivo demonstrated that p62‐RIP1‐RIP3‐dependent myocardial necroptosis contributes to aging‐related myocardial vulnerability to I/R injury. Notably, metformin treatment disrupted p62‐RIP1‐RIP3 complexes and effectively repressed I/R‐induced necroptosis in aged hearts, ultimately reducing mortality in this model. These findings highlight previously unknown mechanisms of aging‐related myocardial ischemic vulnerability: p62‐necrosome‐dependent necroptosis. Metformin acts as a cardioprotective agent that inhibits this unfavorable chain mechanism of aging‐related I/R susceptibility.     

线粒体移植在治疗线粒体缺陷疾病中的研究进展

线粒体是真核细胞中重要的细胞器,是高等生命体赖以生存的能量来源.线粒体异常可引起细胞甚至器官发生病变,越来越多的疾病被证实与线粒体功能障碍有关.线粒体移植是从患者正常组织分离线粒体然后注入线粒体损伤或缺失的部位,使损伤细胞得到救治、器官功能得以恢复的全新干预技术.线粒体移植作为一种新兴治疗方案在一些疾病干预的基础研究中崭露头角,尤其是在保护心脏缺血再灌注损伤领域已经发展到临床试验阶段.本文从线粒体起源出发,总结了仍处于实验阶段的几种线粒体移植方法,概述了线粒体移植在脑缺血引起神经元损伤保护领域、心肌缺血再灌注损伤保护领域和肿瘤治疗领域的研究进展,从分子层面探讨了线粒体损伤及线粒体移植修复的机理,并提出研发患者专属的"线粒体移植治疗生物制剂"的设想,旨在为线粒体缺陷有关疾病的治疗研究提供新的视角.