肢体缺血预处理减轻大鼠海马缺血/再灌注损伤

目的:探讨肢体缺血预处理(LIP)对大鼠全脑缺血/再灌注损伤的影响.方法: 36只大鼠椎动脉凝闭后随机分为假手术(Control)组、脑缺血组、肢体缺血组、LIP 0 d组(LIP后即刻行脑缺血)、LIP 1 d组(LIP后1 d行脑缺血)和LIP 2 d组(LIP后2 d行脑缺血).重复夹闭大鼠双侧股动脉3次(每次10 min,间隔10 min)作为LIP,夹闭颈总动脉进行全脑缺血8 min后再灌注.硫堇染色观察海马CA1区组织学分级及锥体神经元密度以判断海马损伤程度.结果:脑缺血组海马CA1区锥体神经元损伤严重,与Control组比较,组织学分级明显升高,神经元密度明显降低(P<0.01).LIP 0 d组海马CA1区神经元损伤较脑缺血组明显减轻,组织学分级明显降低,神经元密度明显升高(P<0.01).而LIP 1 d组和LIP 2 d组大鼠海马CA1区锥体细胞缺失较多,仍有明显的组织损伤.结论:LIP可减轻随后立即发生的脑缺血/再灌注损伤,但对间隔1 d后的脑缺血/再灌注损伤无显著对抗作用.     

肢体缺血预处理减少大鼠全脑缺血再灌注诱导的海马CA1区锥体神经元凋亡

探探讨肢体缺血预处理(limb ischemic preconditioning,LIP)对大鼠全脑缺血再灌注后海马CA1区锥体细胞凋亡的影响。46只大鼠椎动脉凝闭后分为假手术组、肢体缺血组、脑缺血组、LIP组。重复夹闭大鼠双侧股动脉3次(每次10min,间隔10min)作为LIP,之后立即夹闭双侧颈总动脉进行全脑缺血8min后再灌注。DNA凝胶电泳、TUNEL和吖啶橙/溴乙锭(AO/EB)双染技术从生化和形态学方面观察海马神经元凋亡的情况。凝胶电泳显示,脑缺血组出现了凋亡特征性DNA梯状条带,而LIP组无上述条带出现。与脑缺血组比较,LIP可明显减少海马CAI区TUNEL阳性神经元数(17.8±5.8vs 69.8±12,P<0.01)。AO/EB染色也显示LIP可明显减少脑缺血再灌注引起的神经元凋亡。以上结果提示,LIP可抑制脑缺血再灌注后海马神经元的凋亡,进而减轻脑缺血再灌注损伤,提供脑保护作用。     

缺血预处理对肢体缺血/再灌注大鼠胃粘膜损伤的保护效应

目的：观察肢体缺血再灌注（LI／R）对胃粘膜的损伤作用及缺血预处理对其影响,探讨胃粘膜损伤的机制及缺血预处理（IPC）的作用机理。方法：观察并测定肢体缺血4h再灌注4h后以及应用肢体缺血预处理干预后各组胃粘膜损伤指数,胃结合粘液量;检测胃粘膜中髓过氧化物酶（MPO）、超氧化物歧化酶（SOD）、丙二醛（MDA）、黄嘌呤氧化酶（XOD）含量的变化以及血浆中乳酸脱氢酶（LDH）的含量变化。结果：大鼠LI／R后胃粘膜损伤指数增加;胃结合粘液量较对照组显著下降;胃粘膜中MPO、MDA、XOD的值均较对照组增加,血浆中LDH的含量亦较对照组显著增加,胃粘膜组织中SOD的酶活力下降;IPC组与LIR组对比,胃结合粘液量较LIR组显著增加：胃粘膜损伤指数、胃粘膜中MPO的含量、以及胃粘膜中MDA、XOD、LDH均较LI／R组明显降低;胃粘膜中SOD酶活力增强。结论：LI／R作为应激原可引起胃粘膜损伤,导致应激性溃疡的发生;自由基在肢体缺血再／灌注后继发胃粘膜损伤过程中发挥作用。缺血预处理可减轻肢体缺血再灌注后的胃粘膜损伤,其作用机制可能是通过减少自由基的产生而发挥其保护作用。     

大鼠肢体缺血预处理对肝缺血/再灌注损伤的保护作用

目的：研究肢体缺血预处理对大鼠肝缺血/再灌注损伤是否具有保护作用。方法：雄性SD大鼠32只,随机分为对照组（S组）;缺血/再灌注组（I/R组）;经典缺血预处理组（IPC组）;肢体缺血预处理组（远端缺血预处理组,RPC组）。S组仅行开腹,不作其他处理;IPC组以肝缺血5min作预处理;RPC组以双后肢缺血5min,反复3次作预处理,2个预处理组及I/R组均行肝缺血1h再灌注3h。取血用于血清谷丙转氨酶（ALT）与血清谷草转氨酶（AST）检测。切取肝组织用于测定湿干比（W/D）、中性粒细胞（PMN）计数及观察显微、超微结构的变化。结果：与I/R组比较,IPC组,RPC组ALT,AST,W/D值,及PMN计数均明显降低（P〈0.01）,肝脏的显微及超微结构损伤减轻。结论：肢体缺血预处理对大鼠肝脏I/R损伤有明显的保护作用,强度与经典缺血预处理相当,其机制可能与抑制肝脏炎症反应、减轻肝脏水肿、改善肝组织微循环有关。     

吸入一氧化碳抗肢体缺血/再灌注损伤的实验研究

目的：观察吸入适量一氧化碳（CO）对大鼠肢体缺血/再灌注（I/R）损伤的防治作用。方法：SD大鼠44只,随机分为假手术（S）、I/R、I/R吸入CO（RC）组;通过夹闭股动脉4h、再开放48h,复制肢体I/R损伤模型;RC组行再灌注时,使动物吸入含有CO的医用空气（CO的体积分数为0.05%）,其余两组呼吸正常空气;对比观测缺血肢体大体及骨骼肌组织病理学、缺血肢体湿干重比值（W/D）的变化,流式细胞仪检测肌组织中Bax、Bcl-2的表达水平及细胞凋亡百分比,全自动生化分析仪检测血清乳酸脱氢酶（LDH）和肌酸激酶（CK）的变化。结果：与I/R组比较,RC组动物W/D、血清LDH及CK含量、肌组织中Bax表达水平及细胞凋亡百分比均显著降低,肌组织Bcl-2表达水平显著升高,缺血肢体大体观及肌组织病理学明显改善。结论：吸入适量浓度的外源性CO对肢体I/R损伤有防治作用。     

缺血预处理对大鼠肺缺血/再灌注损伤的保护作用

目的 :观察缺血预处理 (IPC)对大鼠肺缺血 /再灌注 (I/R)损伤的保护作用 ,并初步探讨其作用机制。方法 :建立离体大鼠肺灌流模型 ,36只wistar大鼠随机分为对照组、I/R组和IPC组 ,处理完毕后分别测定平均肺动脉压(MPAP)、肺组织湿 /干重比、支气管肺泡灌洗液中肺表面活性物质磷脂及表面张力改变 ,肺组织标本送电镜检查。结果 :①电镜下观察IPC组肺损伤明显减轻。②肺组织湿 /干重比值IPC组为 4.41± 0 .2 4,显著低于I/R组 ,但仍高于缺血前 (P <0 .0 1) ;③IPC组大鼠缺血 1h后MPAP为 ( 1.88± 0 .2 9)kPa ,明显低于I/R组 (P <0 .0 1) ;④IPC组支气管肺泡灌洗液中总磷脂为 ( 2 33 .42± 14.0 5 ) μg/kg ,大聚体为 ( 10 5 .39± 6 .17) μg/kg ,与I/R组相比显著增高 ,但低于对照组 (P <0 .0 1) ,三组之间小聚体含量没有显著差异 ;⑤IPC组表面张力为 ( 36 .88± 3.49)mN/m ,显著低于I/R组 ,与对照组相比则无显著性差异 (P >0 .0 5 )。结论 :缺血预处理对大鼠肺I/R损伤有保护作用 ,保护机制可能与促进肺表面活性物质 (PS)磷脂分泌、改善PS组成 ,从而提高PS功能有关。     

缺血预处理对肢体缺血/再灌注时肺损伤的保护作用

目的：观察肢体缺血/再灌注（LI/R）时肺损伤的变化并探讨缺血预处理（IPC）对其保护作用。方法：复制家兔LI/R损伤模型,观察肢体缺血4 h再灌注4 h肺损伤的变化以及采用肢体IPC干预后对肺损伤的影响。从右颈外静脉和左颈总动脉采血,分别代表入肺血和出肺血,检测入、出肺血及肺组织超氧化物歧化酶（SOD）的活性、脂质过氧化物的代谢产物丙二醛（MDA）和一氧化氮（NO）的含量;同时测定肺组织总一氧化氮合酶（tNOS）和诱导型一氧化氮合酶（iNOS）的活性以及肢体IPC对上述指标的影响。结果：与对照组和缺血前比较,LI/R组松夹再灌注4 h入、出肺血及肺组织SOD活性明显降低,MDA和NO含量增高（P〈0.05,P〈0.01）;肺组织tNOS和iNOS活性亦升高,与对照组比较,有统计学意义（P〈0.01）。在缺血前给予IPC组,SOD活性升高,而MDA、NO含量降低,tNOS、iNOS活性也降低（P〈0.01）。相关分析显示MDA与SOD间存在明显负相关（P〈0.01）,而MDA与NO及iNOS呈显著正相关（P〈0.01）。结论：LI/R时并发的急性肺损伤与组织氧化代谢紊乱有关,IPC通过改善LI/R时肺组织氧化与抗氧化之间的平衡,进而增强肺组织的抗氧化能力,对LI/R肺损伤具有保护作用。     

肾缺血预处理对心脏缺血／再灌注损伤的保护作用

目的：探讨肾缺血预处理对家兔心脏缺血／再灌注（I／R）损伤的影响及意义。方法：32只大耳白家兔随机分为假手术（SO）、心脏I／R、经典缺血预处理（CIPC）及肾缺血预处理（RIPC）4组。观察各组心肌梗塞面积、左室舒缩功能、心脏超微结构及心律失常发生率的变化。结果：CIPC、RIPC组,心肌梗塞面积、再灌性心律失常发生率较I／R组明显降低,左室舒缩功能明显恢复（P＜0.01）,心脏超微结构损伤明显减轻。结论：RIPC可诱导出与CIPC类似的心脏保护效应。     

后肢远程缺血预处理对小鼠全脑缺血再灌注的保护作用及机理

目的:探讨肢端远程缺血预处理(limb remote ischemic preconditioning)对小鼠全脑缺血再灌注损伤的保护作用及其机制.方法:36只雄性C57小鼠,随机分为3组,即假手术组、对照组和LRPC预处理组,每组12只,假手术组分离双侧颈总动脉不结扎;对照组分离颈总动脉后结扎双侧颈总动脉,20 min后松线;LRPC组首先暴露双侧股动脉,然后结扎1 min,松开5 min,进行3个循环,最后结扎颈总动脉20min后松线.观察和比较各组小鼠海马神经元形态,MPO及炎性因子IL-1β、TNF-α和IL-10含量的变化.结果:再灌注24 h后,LRPC可明显抑制神经元形态的改变(P＜0.05),减少MPO、IL-1β和TNF-α含量,而增加抗炎因子IL-10的含量.结论:LRPC可显著减轻脑缺血再灌注损伤,可能与其降低海马组织TNF-o,IL-1β的含量,增加IL-10的含量有关.     

缺血预处理对肢体缺血／再灌注肾损伤保护作用的机制初探

目的：探讨缺血预处理对肢体缺血／再灌注时肾损伤的保护作用。方法：复制家兔肢体缺血／再灌注（I／R）损伤模型,观察肢体缺血4h再灌注4h后以及应用缺血预处理干预对肾损伤的影响。分别从右颈外静脉、肾动脉和肾静脉取血,代表外周血以及入、出肾血,观察外周血超氧化物歧化酶（SOD）、丙二醛（MDA）及尿素氮（BUN）;同时测定入肾血和出肾血NO、SOD、MDA和肾组织SOD、MDA、诱导型一氧化氮合酶（iNOS）以及缺血预处理对上述指标的影响。结果：与对照组比较,缺血再灌组松夹后4h外周血、入、出肾血及肾组织SOD活性明显降低,MDA含量增高（P〈0．01）;外周血BUN以及入、出肾血NO和肾组织iNOS含量升高（P〈0．01）;在缺血前给予缺血预处理组．SOD活性升高,而MDA、BUN、NO、iNOS含量降低（P〈0．01）。相关分析显示MDA与SOD间存在明显负相关（P〈0．01）．而MDA与NO、BUN间呈显著正相关（P〈0．01）。结论：肢体缺血／再灌注时伴有肾脏氧自由基代谢紊乱,缺血预处理可以增强肾组织的抗氧化能力,对肢体缺血再灌注肾损伤具有保护作用。     

缺血预适应对大鼠肢体缺血/再灌注后小肠细胞凋亡的影响

目的：观察大鼠肢体缺血再灌注后小肠粘膜自由基及钙含量改变与细胞凋亡情况．以及缺血预适应对其变化的影响。方法：将雄性Wistar大鼠18只,随机分为对照（Control）组,缺血／再灌注（I／R）组和缺血预适应（IPC＋I／R）组,分别测定血浆和小肠组织超氧化物歧化酶（SOD）、黄嘌呤氧化酶（XOD）、丙二醛（MDA）的含量,小肠组织钙及线粒体钙含量;小肠组织的Bel-2和Bax蛋白的表达水平;检测小肠细胞凋亡情况。结果：肢体I／R后血浆和小肠粘膜SOD减少而XOD和MDA增加;小肠组织钙及线粒体钙含量增多;Bel-2蛋白表迭和Bax表达增多,但Bel-2／Bax比值降低;凋亡细胞增多。IPC减轻了I／R后引起的XOD、MDA含量的升高,并且增加了SOD的含量;减轻了组织和线粒体钙超载;Bel-2的表达则明显升高而Bax表达较I／R组明显减少,Bel-2／Bax比值升高;凋亡细胞减少。结论：肢体IR引起小肠粘膜自由基的增多,钙超栽,凋亡细胞增多;IPC可能通过减少自由基的产生及钙超载,抑制细胞凋亡而对肢体I／R继发的小肠功能损伤起保护作用。     

缺血预适应对大鼠肢体缺血/再灌注后肺损伤的影响

目的:观察肢体缺血预适应对大鼠肢体缺血/再灌注(I/R)后肺损伤的影响并探讨其机制。方法:将雄性Wistar大鼠随机分为4组(n=8):对照组(C),肢体缺血/再灌注组(LI/R),缺血预适应组(IPC)和L-NAME组。各组大鼠均于肢体缺血4h再灌注4h处死,分别测定其动脉血氧分压(PaO2)和二氧化碳分压(PaCO2),血浆及肺组织丙二醛(MDA)、一氧化氮(NO)、内皮素(ET)含量,计算血浆NO/ET比值;以及肺湿干比(W/D)、肺系数(LI),肺组织髓过氧化物酶(MPO)含量。结果:大鼠LI/R后4h,PaO2明显降低;W/D、LI、血浆及肺组织的MDA、NO、ET和肺组织MPO活性均明显增加,而血浆NO/ET比值明显减小。与LI/R组比较,IPC组各项损伤指标明显减轻,NO水平升高,血浆NO/ET比值明显增大。与对照组和IPC组比较,L-NAME处理组,各项损伤指标数值明显增加,NO水平降低;血浆NO/ET比值明显减小,差异均具有显著性。各组大鼠PaCO2的变化无显著性。结论:缺血预适应对肢体缺血/再灌注后肺损伤具有保护作用,其机制可能与内源性NO合成增加有关。     

Involvement of glutamate in retinal protection against ischemia/reperfusion damage induced by post-conditioning

Retinal ischemia could provoke blindness and there is no effective treatment against retinal ischemic damage. Brief intermittent ischemia applied during the onset of reperfusion (i.e., post-conditioning) protects the retina from ischemia/reperfusion injury. Multiple evidences support that glutamate is implicated in retinal ischemic damage. We investigated the involvement of glutamate clearance in post-conditioning-induced protection. For this purpose, ischemia was induced by increasing intra-ocular pressure for 40 min, and 5 min after reperfusion, animals underwent seven cycles of 1 min/1 min ischemia/reperfusion. One, three, or seven days after ischemia, animals were subjected to electroretinography and histological analysis. The functional and histological protection induced by post-conditioning was evident at 7 (but not 1 or 3) days post-ischemia. An increase in Müller cell glial fibrillary acidic protein (GFAP) levels was observed at 1, 3, and 7 days after ischemia, whereas post-conditioning reduced GFAP levels of Müller cells at 3 and 7 days post-ischemia. Three days after ischemia, a significant decrease in glutamate uptake and glutamine synthetase activity was observed, whereas post-conditioning reversed the effect of ischemia. The intravitreal injection of supraphysiological levels of glutamate mimicked electroretinographic and histological alterations provoked by ischemia, which were abrogated by post-conditioning. These results support the involvement of glutamate in retinal protection against ischemia/reperfusion damage induced by post-conditioning.     

Role of Keap1-Nrf2/ARE signal transduction pathway in protection of dexmedetomidine preconditioning against myocardial ischemia/reperfusion injury

Objective: To explore the role and mechanism of the Kelch sample related protein-1-nuclear factor erythroid-2 related factor 2/antioxidant response element (Keap1-Nrf2/ARE) signaling pathway in protection of dexmedetomidine (DEX) preconditioning against myocardial ischemia/reperfusion injury (MIRI). Methods: A total of 70 male SD rats were randomly divided into seven equal groups (n=10): blank control (S group), ischemia/reperfusion injury (C group), DEX preconditioning (DEX group), tertiary butylhydroquinone (tBHQ) control (tBHQ group), combined tBHQ and DEX preconditioning (tBHQ+DEX group), all-trans retinoic acid (ATRA) control (ATRA group), and combined ATRA and DEX preconditioning (ATRA+DEX group). Serum creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations were measured by ELISA kits, and the infarct size (IS) was assessed by Evan’s blue and 2,3,5-triphenyltetrazolium chloride (TTC) staining. Oxidative stress was assessed through Western blotting for expression of Keap1-Nrf2/ARE pathway members and oxidative stress markers. Results: Cardioprotection of DEX, tBHQ, and tBHQ+DEX preconditioning treatments were shown as lower concentrations of serum CK-MB and cTnI and a smaller IS following MIRI in rats compared with those of MIRI rats without pre-treatment. In addition, tBHQ+DEX preconditioning exhibited stronger myocardial protection compared with DEX preconditioning. Mechanistically, the cardioprotection offered by DEX, tBHQ, and tBHQ+DEX preconditioning treatments was mediated via exerting antioxidant stress through activation of the Keap1-Nrf2/ARE signal transduction pathway. Conversely, the protective effects of DEX were diminished by blocking the Keap1-Nrf2/ARE pathway with inhibitor ATRA. Conclusion: DEX preconditioning protects against MIRI by exerting antioxidant stress through activation of the Keap1-Nrf2/ARE signal transduction pathway, while inhibition of the Keap1-Nrf2/ARE signal transduction pathway reverses the protective effect of DEX preconditioning on MIRI.     

p38 MAPK反义寡聚脱氧核苷酸阻断肢体缺血预处理诱导的脑缺血耐受

目的:观察p38MAPK反义寡聚脱氧核苷酸(As-ODN)对肢体缺血预处理(LIP)诱导的脑缺血耐受的影响。方法:48只永久凝闭双侧椎动脉的Wistar大鼠分为8组(n=6):sham组、LIP组、脑缺血损伤组、LIP+脑缺血损伤组、双蒸水+LIP+脑缺血损伤组、p38MAPKAs-ODN组和p38MAPKAs-ODN+LIP+脑缺血损伤组,p38MAPKAs-ODN的剂量又分为5nmol/5μl和10nmol/5μl。所有动物均在sham手术后或末次全脑缺血/再灌注后7天断头取脑,硫堇染色观察海马CA1区锥体神经元迟发性死亡情况。结果:sham组和LIP组均未见延迟性神经元死亡(DND)。与sham、LIP组相比,脑缺血损伤组出现了明显的DND,表现为组织学分级(HG)升高和锥体神经元密度(ND)下降(P0.05)。LIP可显著抑制脑缺血损伤引起的DND。与LIP+脑缺血损伤组相比,p38MAPKAs-ODN+LIP+脑缺血损伤组出现了显著的DND,表现为HG升高、ND降低(P0.05),且此种变化与p38MAPKAs-ODN的注射剂量呈明显正相关。结论:p38MAPKAs-ODN可阻断LIP诱导的脑缺血耐受,进一步证实了p38MAPK表达上调参与了LIP诱导的脑缺血耐受。     

Combined preconditioning and postconditioning provides synergistic protection against liver ischemic reperfusion injury

Hepatic Ischemia and Reperfusion Injury (IRI) is a major cause of liver damage during liver surgery and transplantation. Ischemic preconditioning and postconditioning are strategies that can reduce IRI. In this study, different combined types of pre- and postconditioning procedures were tested in a murine warm hepatic IRI model to evaluate their protective effects. Proanthocyanidins derived from grape seed was used before ischemia process as pharmacological preconditioning to combine with technical preconditioning and postconditioning. Three pathways related to IRI, including reactive oxygen species (ROS) generation, pro-inflammatory cytokines release and hypoxia responses were examined in hepatic IRI model. Individual and combined pre- and postconditioning protocols significantly reduce liver injury by decreasing the liver ROS and cytokine levels, as well as enhancing the hypoxia tolerance response. Our data also suggested that in addition to individual preconditioning or postconditioning, the combination of these two treatments could reduce liver ischemia/reperfusion injury more effectively by increasing the activity of ROS scavengers and antioxidants. The utilization of grape seed proanthocyanidins (GSP) could improve the oxidation resistance in combined pre- and postconditioning groups. The combined protocol also further increased the liver HIF-1 alpha protein level, but had no effect on pro-inflammatory cytokines release compared to solo treatment.     

Fibroblast growth factors in myocardial ischemia / reperfusion injury and ischemic preconditioning

Angiogenic growth factors such as fibroblast growth factors (FGFs) are currently in clinical trials for accelerating blood vessel formation in myocardial and limb ischemic conditions. However, recent experimental evidence suggests that FGFs can also participate as endogenous cardioprotective agents. In this report, the current knowledge for FGFs implication in myocardial ischemic tolerance will be summarized. Pharmacologic preconditioning with drugs as FGFs that mimic the beneficial effects of ischemic preconditioning could lead to novel therapeutic approaches for the treatment of ischemic disorders including myocardial infarction and stroke.