阿片肽与P2Y12受体信号通路的研究进展

糖尿病可增加心血管疾病危险性,因此糖尿病和心血管疾病的密切关系也日益被人们所重视。糖尿病引发的血小板功能亢进以及抗血小板药物抵抗的机制尚不明确。阿片肽类物质能够抑制血小板细胞活性以及凝集作用。本文对2型糖尿病血小板P2Y12信号通路高反应性、阿片肽及阿片受体对抗P2Y12信号通路高反应性的可能机制进行了归纳总结。     

血小板膜P2Y12受体基因T744C多态性对外伤性脑梗死(PTCI)患者血小板聚合率及疗效的影响

目的:外伤性脑梗死(posttraumatic cerebral infarction,PTCI)是颅脑损伤的常见并发症之一,P2Y12受体介导血小板聚集是血栓形成的重要通路,与血小板聚集形成密切相关。本研究探讨外伤性脑梗死发生发展与血小板膜P2Y12受体基因T744C基因多态性的关系。方法:用聚合酶链反应(PCR)和限制性酶切片段长度多态性(RFLP)技术对186例外伤性脑梗死患者P2Y12受体基因T744C多态性进行分析。分别在治疗前和治疗后对所有颅脑外伤患者的伤情GCS评分,并按基因型分组对照分析结果。结果:血小板膜T744C血小板膜T744C基因型基因频率分别为TT基因型59.14%、TC型32.26%、CC型8.60%,T等位基因75.27%、C等位基因24.73%;其中TT基因型对奥扎格雷反应较敏感,GCS评分预后好;而CC型对奥扎格雷反应性低,预后差。结论:T744C基因多态性中CC基因型可能导致外伤性脑梗死临床及预后存在明显的个体差异,与其对抗血小板药物抵抗有关。T744C的C等位基因可能是脑梗死的遗传危险因素,开展相关遗传学风险研究,对于进一步缓解脑梗症状、改善预后具有重要意义。     

血小板衍生生长因子受体结构与功能的研究

血小板衍生生长因子受体(platelet-derived growth factor receptor, PDGFR),包括PDGFRα和PDGFRβ,属于第三类受体酪氨酸激酶家族.它们参与血管再生和创伤修复等重要生理过程,并能够促进肿瘤细胞的增殖、迁移与存活.目前,在多种肿瘤、纤维化以及心血管疾病中均检测到高表达或突变的PDGFR受体以及高表达的血小板衍生生长因子(platelet-derived growth factor, PDGF), PDGF/PDGFR已成为基础生物学与转化医学研究所关注的重要靶点.本文总结了当前关于PDGFR的结构与功能研究,对PDGF/PDGFR信号传导机制以及PDGF/PDGFR信号异常与疾病的关系进行了梳理,论述了针对该信号通路的多种靶向药物的治疗机制,并对今后研究方向进行了展望.     

Rho/Rho激酶信号通路与脉管收缩

Rho/Rho激酶信号通路在正常血管、淋巴管等脉管收缩过程中发挥重要的调节作用,并参与休克后血管反应性和钙敏感性的双相调节以及休克淋巴管低反应性的发生.以Rho/Rho激酶为靶点,对于干预休克脉管系统低反应性的发生具有重要意义.本文综述Rho/Rho激酶信号通路在脉管收缩中的调节机制.     

TGF-β1通过激活Smad信号途径抑制PI3K/AKT信号介导的BMSC成脂分化

转化生长因子β1 (TGF-β1) 是参与骨髓间充质干细胞（BMSCs）脂肪定向分化的重要调节因子,其具体的调节机制尚不清楚. 本研究证明,BMSCs在体外分化为脂肪细胞的过程中, TGF-β1的基因表达显著下调,重组TGF-β1能够抑制BMSCs体外脂肪细胞定向分化,其分化的标志蛋白C/EBPβ和αP2的表达水平显著降低. TGF-β1在激活Smad信号通路的同时,还抑制胰岛素(脂肪分化的主要诱导剂)对PI3K/Akt信号通路的激活.加入Smad特异性阻断剂后,C/EBPβ和αP2的诱导表达恢复正常,同时PI3K/Akt信号通路的活化亦得以恢复. 结果提示,TGF-β1可通过Smad信号通路干扰脂肪细胞分化的核心信号通路-PI3K/Akt的活化,从而实现对BMSCs脂肪分化的抑制.该研究结果为肥胖等导致的心血管疾病或Ⅱ型糖尿病等的临床治疗提供有价值的参考.     

Hippo信号通路与心血管发育及疾病调控

心血管疾病已成为中国乃至全球首位死亡原因,探索心血管系统发育及调控异常的原因及相关机制可以为心血管疾病的预防和治疗提供重要的科学依据。Hippo信号通路是新近发现的在调节器官大小、细胞增殖及凋亡、干细胞命运等方面具有重要功能的一条信号通路。Hippo信号通路的不同成分参与心脏血管的发育和心血管细胞增殖、分化等功能调控,影响损伤后修复及再生等过程,该通路调节异常可引起心血管疾病,如心梗、心肌肥大、血管内膜增生、动脉硬化等。本文综述了Hippo信号通路对心血管系统发育和疾病调控的相关研究及最新进展,以期为Hippo通路在心血管疾病的发病机制及临床转化研究提供潜在的理论基础。     

microRNAs对脂肪细胞分化相关因子的作用及预测

microRNAs是一类调节靶基因的转录后翻译的小型非编码单链RNA,研究已发现microRNAs在癌症、心血管疾病及糖尿病中显示极为重要的生物学功能。糖尿病目前已成为威胁人类健康的最主要疾病,尤其是II型糖尿病的发病机制成为研究热点。脂肪细胞分化异常是导致II型糖尿病以及胰岛素抵抗的主要因素。进一步阐明microRNAs对脂肪细胞分化过程的作用机制,可能为糖尿病治疗找到新的靶点。本综述将从microRNAs与脂肪细胞分化基因、核激素受体以及相关信号通路相互作用三方面阐述和预测microRNAs对脂肪细胞分化的潜在作用。     

周围神经损伤中P2Y12受体-p38MAPK通路的研究进展

周围神经损伤是临床中常见的神经损伤之一,神经胶质细胞和信号通路转导在周围神经损伤和再生修复中发挥重要作用。小胶质细胞的活化与周围神经损伤导致的神经损伤及疼痛密切相关,小胶质细胞是周围神经损伤与修复的关键场所。脊髓背角的小胶质细胞可被嘌呤信号通路的P2Y_(12)受体活化,进而导致p38MAPK磷酸化,造成相关神经损伤及感觉功能障碍。以脊髓背角的小胶质细胞为靶点,从P2Y_(12)受体-p38MAPK通路的角度可揭示周围神经损伤的部分可能机制。探究从嘌呤信号通路与小胶质细胞活化的新角度,将神经损伤后的P2Y_(12)受体与p38MAPK的磷酸化表达联系为P2Y_(12)受体-p38MAPK通路,可为临床治疗周围神经损伤提供新的思路。本文就周围神经损伤中P2Y_(12)受体-p38MAPK通路的研究进展作一综述。     

葡萄籽原花青素通过Nrf2/ARE信号通路抗高糖诱导的HUVEC-12细胞氧化损伤

研究葡萄籽原花青素提取物(GSPE)对高糖诱导的人脐静脉内皮细胞HUVEC-12氧化应激损伤的保护作用及其相关机制。建立高糖诱导的HUVEC-12细胞模型,测定细胞活力,检测细胞内活性氧(ROS)水平、乳酸脱氢酶(LDH)与超氧化物歧化酶(SOD)活性及Nrf2/ARE信号通路中相关基因mRNA水平和蛋白含量。结果显示GSPE作用后显著提高HUVEC-12细胞活力,抑制高糖诱导的细胞内ROS水平升高,增强SOD活性(P0.05),并呈现剂量依赖效应。GSPE作用能同时提高抗氧化转录因子Nrf2和下游区GSH-Px、HO-1、γ-GCS、NQO1基因的表达量以及HO-1、NQO1蛋白的含量(P0.05)。结果表明GSPE能通过激活Nrf2/ARE通路对抗高糖诱导的HUVEC-12细胞氧化应激损伤。     

P38MAPK信号通路与心血管疾病关系的研究进展

P38MAPK信号通路是细胞内主要的信息传递途径之一,与其他信号通路相互联系,共同调节细胞增殖、分化、凋亡、细胞骨架重构及细胞周期,在多种心血管疾病发生发展和转归中均起着重要作用。通过阻断和调控P38MAPK的表达和活性,探索防治心血管疾病的新的治疗手段具有重大临床意义。本文拟将P38MAPK与心血管疾病的关系的研究进展做一综述。     

The platelet as a model system for the acute actions of nuclear receptors

Platelets are circulating cell fragments which play a critical role in thrombosis, and whose activity is associated with the progress of cardiovascular diseases, diabetes, inflammation, and cancer cell metastasis. Recently, a number of nuclear receptors have been found present in human platelets, including the receptors for sex steroids, and glucocorticoids, along with peroxisome proliferator-activated receptors (PPAR)s and retinoid X receptors (RXR)s. Although the platelet contains no nucleus, selective ligands for these receptors activate their respective platelet nuclear receptors and regulate platelet aggregation and activation. The human platelet, because of its abundance and accessibility therefore represents an excellent model system to study the rapid non-genomic mechanism of nuclear receptors. Moreover, since targeting platelets is a major clinical therapeutic area, analysis of platelet nuclear receptors may provide clues for new drug targets as well as provide important information regarding the physiological roles of nuclear receptors in the circulation.     

Effects of novel plant antioxidants on platelet superoxide production and aggregation in atherosclerosis.

Superoxide anion is produced in human platelets predominantly by Nox2-dependent NADPH oxidases. In vitro experiments have shown that it might play a role in modulating platelet functions. The relationship between platelet superoxide production and aggregation remains poorly defined. Accordingly, we aimed to study superoxide production and aggregation in platelets from subjects with significant cardiovascular risk factors (hypertension, hypercholesterolemia, smoking and diabetes mellitus) and from control individuals. Moreover, we studied the effects of novel polyphenol-rich extracts of Aronia melanocarpa (chokeberry) berries on platelet function in vitro. Superoxide production was significantly increased in patients with cardiovascular risk profile when compared to controls, while platelet aggregation in response to either collagen or thrombin were borderline higher, and did not reach statistical significance. Interestingly, no relationship was observed between platelet aggregation ex vivo and platelet superoxide production in either of studied groups. No correlation was found between endothelial function (measured by FMD) and platelet aggregation ex vivo either. Polyphenol-rich extracts of A. melanocarpa berries caused a significant concentration dependent decrease in superoxide production only in patients with cardiovascular risk factors, while no effect was observed in the control group. A. melanocarpa extracts abolished the difference in superoxide production between risk factor patients and controls. A. melanocarpa extracts exerted significant concentration dependent anti-aggregatory effects in both studied groups, which indicated that these effects may be independent of it's ability to modulate superoxide production. The anti-aggregatory effects of chokeberry extracts were similar irrespective of aggregation inducing agent (collagen or thrombin). Moreover, they appear to be independent of platelet NO release as NOS inhibition by L-NAME did not lead to their abrogation.     

Platelet factor 4 (PF4) and heparin released platelet factor 4 (HR-PF4) in diabetes mellitus. Effect of the duration of the disease

Several investigators have reported an altered platelet function in diabetes mellitus as measured by elevated levels of platelet specific proteins platelet factor 4 (PF4) and B-thromboglobulin (BTG). We studied 20 insulin dependent (IDD), 20 non insulin dependent (NIDD) diabetic males without overt clinical symptoms of cardiovascular disorders and 30 normal controls. We evaluated PF4, BTG and heparin released platelet factor 4 (HR-PF4) as measured 2.5 minutes after a bolus injection of 5,000 I.U. of a commercial mucous heparin. The patients showed normal levels of both PF4 and BTG. Furthermore HR-PF4 failed to show statistically significant variation between patients and controls. However when the diabetics were divided on the basis of the duration of the disease, the IDD had an increased HR-PF4 mean level and the trend became statistically significant when diabetes existed more than 17 years (patients HR-PF4 149.1 ng/ml, range 17.3-194; controls HR-PF4 110.9 ng/ml range 50-160, less than p less than 0.05). NIDD failed to reveal the same pattern. Although the significance of HR-PF4 is unknown, insulin dependent diabetes mellitus after many years could cause a potentially dangerous, silent vascular damage with enhanced platelet vessel wall interaction as measured by an elevated HR-PF4.     

Insulin Resistance and Thrombogenesis: Recent Insights and Therapeutic Implications

ObjectiveTo review the relationship between insulin resistance and thrombogenesis, especially in the context of obesity, diabetes, and cardiovascular disease, and to discuss therapeutic implications.MethodsThe pertinent peer-reviewed literature was examined for evidence in support of the aforementioned relationship, and the reported efficacy of various therapeutic interventions was assessed.ResultsRobust evidence indicates that insulin resistance and enhanced thrombogenesis are closely related pathophysiologic mechanisms, especially in the presence of obesity. Thus, targeting insulin resistance and thrombogenesis may be of value in the prevention and management of type 2 diabetes and associated cardiovascular morbidity and mortality. Many proven preventive and therapeutic strategies, such as weight loss, exercise, and various pharmaceutical agents, affect both thrombogenesis and insulin resistance.ConclusionBoth insulin resistance and thrombogenesis contribute to the morbidity and mortality associated with obesity, diabetes, and cardiovascular disease. Effective measures for prevention and management of diabetes and cardiovascular disease also tend to improve insulin sensitivity and to ameliorate abnormalities in coagulation, fibrinolysis, and platelet function. (Endocr Pract. 2007;13:679-686)     

血小板功能负性调控机制

在血液循环系统中,血小板在抑制因子的作用下,处于静息状态。当机体出血或外界因素刺激时,血小板活化,产生聚集、黏附和释放反应,释放出二磷酸腺苷(ADP)、花生四烯酸(AA)、血小板活化因子和5-羟色胺等物质,招募更多的血小板黏附于出血处,从而启动凝血过程,发挥止血作用。当止血反应完成后,血小板发生解聚,恢复到静息状态。然而,在病理条件下,血小板的内在解聚能力下降,形成过度活化的血小板,产生病理性血栓,导致急性缺血性心血管疾病的发生。临床使用抗血小板药物控制血小板的活化,治疗急性缺血性心血管疾病。然而,目前临床上常用的抗血小板药物发挥抗血小板活化作用的同时,影响了血小板正常的生理性止血作用,产生出血等副作用。因此,我们需要研发新型抗血小板药物,使其既能发挥抗血小板作用,又能减少出血等副作用。本文将对血小板负性调控机制进行综述,为进一步研究抗血小板药物提供思路。     

Daily prickly pear consumption improves platelet function

Prickly pear is traditionally used by Pima Indians as a dietary nutrient against diabetes mellitus. We examined the effect of daily consumption of 250 g in 8 healthy volunteers and 8 patients with mild familial heterozygous hypercholesterolemia on various parameters of platelet function. Beside its action on lipids and lipoproteins, prickly pear consumption significantly reduced the platelet proteins (platelet factor 4 and beta-thromboglobulin), ADP-induced platelet aggregation and improved platelet sensitivity (against PGI2 and PGE1) in volunteers as well as in patients. Also plasma 11-DH-TXB2 and the WU-test showed a significant improvement in both patients and volunteers. In contrast, collagen-induced platelet aggregation and the number of circulating endothelial cells showed a significant response in patients only. No influence of prickly pear ingestion on peripheral platelet count was monitored. The dietary run-in period did not influence any of the parameters of haemostasis examined. No sex difference was seen. Prickly pear may induce at least part of its beneficial actions on the cardiovascular system via decreasing platelet activity and thereby improving haemostatic balance.     

Oxidative status and oral contraceptive. Its relevance to platelet abnormalities and cardiovascular risk.

Oral contraceptive (OC) use is a risk for thrombogenic events. This paper reviews effects of OC on oxidative status, coagulation, and platelet activity. Complicating effects of cardiovascular risk factors such as smoking, diabetes, hyperpidemia, and hypertension, are discussed. From these data we conclude that: 1. OC use modifies slightly but significantly the oxidative status in women and in animals by decreasing in plasma and blood cells the antioxidant defenses (vitamins and enzymes). 2. The changes in the oxidative status are related to an increase in plasma lipid peroxides apparently responsible for the hyperaggregability and possibly the imbalance in clotting factors associated with the OC-induced prethrombotic state. 3. These effects of OC appear to be increased by a high intake of polyunsaturated fat and counteracted by supplements of vitamin E. 4. The risk factors acting synergistically with OC, have all been shown to increase platelet reactivity. In addition, smoking, diabetes, and, to some extent, dyslipidemia are associated with an increased level of lipid peroxides and concomitant changes in the antioxidant defenses that can be additive to those induced by OC. Thus, free radicals and lipid peroxidation could be the underlying mechanism in the predisposition to thrombosis induced by most risk factors in OC users. 5. Results of epidemiologic and experimental studies in this field will be concordant only when diet and natural antioxidants will be systematically taken into consideration.     

Aggregation and thromboxane B2 formation in platelets and vascular prostacyclin production from genetically obese rats

Obesity, diabetes, hyperlipidaemia and age are conditions predisposing to atheroscleorosis and arterial occlusion. Recently it has been claimed that increased synthesis of thromboxane A₂ by platelets and decreased synthesis of prostacyclin (PGI₂) by blood vessels play an important role. The “Zucker” rat, a genetically obese animal with hyperlipidaemia, hyperinsulinaemia and normoglycaemia was used to study platelet aggregation, thromboxane (TXB₂) production and aortic PGI₂ synthesis. Two age groups (6–8 months and 14–16 months old) and their homozygote lean controls were used. In the obese rats no increased aggregation was found with ADP, arachidonic acid and collagen. On the contrary platelets from young fatty rats were less sensitive to ADP than platelets from lean young animals. An increase in platelet sensitivity to aggregating agents with age was observed, especially in the obese rats. TXB₂ measured in platelet rich plasma after exposure to ADP, arachidonic acid, arachidonic acid plus ADP and collagen was similar in the fatty and lean animals.Production of PGI₂ from incubated aortic rings was lowest in young lean animals. No differences existed between the other groups of rats studied. Insulin added to aortic rings had no influence on PGI₂ production. It is concluded that age rather than obesity, hyperlipidaemia or hyperinsulinaemia may cause platelet hyperresponsiveness to aggregating agents. Thromboxane and plateletaggregation do not closely correlate. PGI₂ production is not reduced by metabolic alterations, thought to predispose to atherosclerosis.