缺血后处理对大鼠局灶性脑缺血再灌注损伤时TLR4信号通路表达的影响

目的：观察缺血后处理对大鼠局灶性脑缺血再灌注损伤后TLR4通路表达的影响。方法：成年健康雄性SD大鼠110只,随机分为假手术组（sham组）（n=10）、缺血再灌注组（I／R组）和后处理组（IP组）,后两组又依据缺血再灌注6h、12h、24h、48h、72h不同的时间点再分五个亚组。对各组行神经行为学评分,脑组织梗死体积测量,TUNEL技术检测神经细胞凋亡的情况,免疫组织化学技术观察各组大鼠脑组织TLR4、NF—KB和TNF—a蛋白的表达,原位杂交方法检测各组大鼠脑组织TLR4mRNA、NF-KBmRNA的表达。结果：缺血后处理可下调TLR4、NF-KB、TNF-a细胞炎性因子的表达,抑制细胞凋亡、减少脑梗死体积,改善神经行为。结论：后处理可通过抑制TLR4信号通路表达,减少脑梗死体积,改善神经功能。     

缺血后处理对大鼠局灶性脑缺血再灌注损伤时TLR4 信号通路表达的影响

目的:观察缺血后处理对大鼠局灶性脑缺血再灌注损伤后TLR4通路表达的影响。方法:成年健康雄性SD大鼠110只,随机分为假手术组(sham组)(n=10)、缺血再灌注组(I/R组)和后处理组(IP组),后两组又依据缺血再灌注6h、12h、24h、48h、72h不同的时间点再分五个亚组。对各组行神经行为学评分,脑组织梗死体积测量,TUNEL技术检测神经细胞凋亡的情况,免疫组织化学技术观察各组大鼠脑组织TLR4、NF-κB和TNF-α蛋白的表达,原位杂交方法检测各组大鼠脑组织TLR4mRNA、NF-κBmRNA的表达。结果:缺血后处理可下调TLR4、NF-κB、TNF-α细胞炎性因子的表达,抑制细胞凋亡、减少脑梗死体积,改善神经行为。结论:后处理可通过抑制TLR4信号通路表达,减少脑梗死体积,改善神经功能。     

Autophagy Is Involved in the Cardioprotection Effect of Remote Limb Ischemic Postconditioning on Myocardial Ischemia/Reperfusion Injury in Normal Mice,but Not Diabetic Mice

Background

Recent animal study and clinical trial data suggested that remote limb ischemic postconditioning (RIPostC) can invoke potent cardioprotection. However, during ischemia reperfusion injury (IR), the effect and mechanism of RIPostC on myocardium in subjects with or without diabetes mellitus (DM) are poorly understood. Autophagy plays a crucial role in alleviating myocardial IR injury. The aim of this study was to determine the effect of RIPostC on mice myocardial IR injury model with or without DM, and investigate the role of autophagy in this process.

Methodology and Results

Streptozocin (STZ) induced DM mice model and myocardial IR model were established. Using a noninvasive technique, RIPostC was induced in normal mice (ND) and DM mice by three cycles of ischemia (5 min) and reperfusion (5 min) in the left hindlimb. In ND group, RIPostC significantly reduced infarct size (32.6±3.0% in ND-RIPostC vs. 50.6±2.4% in ND-IR, p<0.05) and improved cardiac ejection fraction (49.70±3.46% in ND-RIPostC vs. 31.30±3.95% in ND-IR, p<0.05). However, in DM group, no RIPostC mediated cardioprotetion effect was observed. To analyze the role of autophagy, western blot and immunohistochemistry was performed. Our data showed that a decreased sequestosome 1 (SQSTM1/p62) level, an increased Beclin-1 level, and higher ratio of LC3-II/LC3-I were observed in ND RIPostC group, but not DM RIPostC group.

Conclusions

The current study suggested that RIPostC exerts cardioprotection effect on IR in normal mice, but not DM mice, and this difference is via, at least in part, the up-regulation of autophagy.     

MicroRNA-214 在心肌缺血/再灌注的研究进展

MicroRNA是一种内源性的小核苷酸片段,已检测出700余种。大约30%的人类基因受miRNAs调节。其中miRNA-214在不同细胞有多种生物学作用,通过调控多种靶基因在诸多疾病中都发挥着重要作用。microRNA-214在心肌损伤及免疫方面也发挥积极的作用,通过抑制心肌缺血/再灌注的细胞凋亡、HIF1AN等机制参与心肌缺血/再灌注,其有可能成为预防和治疗治疗心肌缺血/再灌注损伤性疾病的新型靶向分子,为临床预防和治疗心肌缺血/再灌注损伤性疾病提供思路和方法。     

A Murine Closed-chest Model of Myocardial Ischemia and Reperfusion

Surgical trauma by thoracotomy in open-chest models of coronary ligation induces an immune response which modifies different mechanisms involved in ischemia and reperfusion. Immune response includes cytokine expression and release or secretion of endogenous ligands of innate immune receptors. Activation of innate immunity can potentially modulate infarct size. We have modified an existing murine closed-chest model using hanging weights which could be useful for studying myocardial pre- and postconditioning and the role of innate immunity in myocardial ischemia and reperfusion. This model allows animals to recover from surgical trauma before onset of myocardial ischemia.Volatile anesthetics have been intensely studied and their preconditioning effect for the ischemic heart is well known. However, this protective effect precludes its use in open chest models of coronary artery ligation. Thus, another advantage could be the use of the well controllable volatile anesthetics for instrumentation in a chronic closed-chest model, since their preconditioning effect lasts up to 72 hours. Chronic heart diseases with intermittent ischemia and multiple hit models are other possible applications of this model.For the chronic closed-chest model, intubated and ventilated mice undergo a lateral blunt thoracotomy via the 4th intercostal space. Following identification of the left anterior descending a ligature is passed underneath the vessel and both suture ends are threaded through an occluder. Then, both suture ends are passed through the chest wall, knotted to form a loop and left in the subcutaneous tissue. After chest closure and recovery for 5 days, mice are anesthetized again, chest skin is reopened and hanging weights are hooked up to the loop under ECG control.At the end of the ischemia/reperfusion protocol, hearts can be stained with TTC for infarct size assessment or undergo perfusion fixation to allow morphometric studies in addition to histology and immunohistochemistry.     

紫铆花素通过调节AMPK/GSK-3β信号通路抑制心肌缺血再灌注损伤

目的:研究紫铆花素对心肌缺血再灌注损伤的保护作用及其机制。方法:体外建立H9c2心肌细胞缺血再灌注模型,分为正常组、模型组、紫铆花素低、中和高剂量组(10,20和40μM)。检测细胞存活率,LDH释放水平,试剂盒检测MDA、SOD、IL-1和IL-6水平,蛋白印迹法检测Bax,Bcl-2蛋白的表达以及AMPK和GSK-3β磷酸化水平。结果:与模型组比较,紫铆花素能够提高细胞存活率,减少LDH水平,降低MDA、IL-1和IL-6,增加SOD水平。减少Bax,Caspase-3蛋白的表达,增加Bcl-2蛋白的表达,提高Bcl-2/Bax的比值(P0.05)。同时,紫铆花素能够剂量依赖性的促进AMPK和GSK-3β磷酸化。进一步研究发现,紫铆花素的保护作用以及对GSK-3β的促磷酸化被AMPK抑制剂Compound C抵消。结论:紫铆花素能减轻心肌缺血再灌注损伤,抑制心肌细胞凋亡,其作用机制可能通过激活AMPK/GSK-3β信号通路,减轻氧化应激水平有关。     

后适应缺血时间窗的选择对小鼠心肌再灌注损伤的影响

目的 探讨后适应对小鼠心肌再灌注损伤的影响以及不同缺血时间窗的后适应心脏保护作用的差异 .方法 96只成年C57/BL小鼠随机分为缺血时间30、45 min和60 min的三组,每组又分为后适应和缺血再灌注两种处理.通过开胸结扎左冠状动脉造成急性心肌梗死 ,在完全再灌注早期给予反复短暂再通/闭塞的缺血后适应.采用Evans blue和TTC染色的方法确定缺血心肌和梗死心肌面积,并测定血清的心肌酶含量、心肌超氧化物歧化酶 (SOD) 活性与丙二醛 (MDA) 水平以及血流动力学指标.结果 缺血30 min后适应组、缺血45 min后适应组心肌梗死面积分别比相同缺血时间的再灌注对照组减少53.1%和31.2%,差异均具有统计学意义(P<0.01),缺血后适应可明显降低血清心肌酶、提高心肌SOD的活性以及改善血流动力学的恶化;缺血60 min后适应组梗死心肌面积无明显降低, 差异无统计学意义(P＞0.05).结论 小鼠心肌处于轻中度水平的缺血损伤,在恢复冠脉血流的早期施行缺血后适应可以有效地减少心肌再灌注损伤,但随着缺血时间的延长,心肌保护作用就明显减弱或消失.     

Inhibition of the cardiac inward rectifier potassium currents by KB-R7943

KB-R7943 (2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl]isothiourea) was developed as a specific inhibitor of the sarcolemmal sodium–calcium exchanger (NCX) with potential experimental and therapeutic use. However, KB-R7943 is shown to be a potent blocker of several ion currents including inward and delayed rectifier K⁺ currents of cardiomyocytes. To further characterize KB-R7943 as a blocker of the cardiac inward rectifiers we compared KB-R7943 sensitivity of the background inward rectifier (I_K1) and the carbacholine-induced inward rectifier (I_KACh) currents in mammalian (Rattus norvegicus; rat) and fish (Carassius carassius; crucian carp) cardiac myocytes. The basal I_K1 of ventricular myocytes was blocked with apparent IC50-values of 4.6 × 10^− 6 M and 3.5 × 10^− 6 M for rat and fish, respectively. I_KACh was almost an order of magnitude more sensitive to KB-R7943 than I_K1 with IC₅₀-values of 6.2 × 10^− 7 M for rat and 2.5 × 10^− 7 M for fish. The fish cardiac NCX current was half-maximally blocked at the concentration of 1.9–3 × 10^− 6 M in both forward and reversed mode of operation. Thus, the sensitivity of three cardiac currents to KB-R7943 block increases in the order I_K1 ~ I_NCX < I_KACh. Therefore, the ability of KB-R7943 to block inward rectifier potassium currents, in particular I_KACh, should be taken into account when interpreting the data with this inhibitor from in vivo and in vitro experiments in both mammalian and fish models.     

Phosphomimetic Modulation of eNOS Improves Myocardial Reperfusion and Mimics Cardiac Postconditioning in Mice

Objective

Myocardial infarction resulting from ischemia-reperfusion injury can be reduced by cardiac postconditioning, in which blood flow is restored intermittently prior to full reperfusion. Although key molecular mechanisms and prosurvival pathways involved in postconditioning have been identified, a direct role for eNOS-derived NO in improving regional myocardial perfusion has not been shown. The objective of this study is to measure, with high temporal and spatial resolution, regional myocardial perfusion during ischemia-reperfusion and postconditioning, in order to determine the contribution of regional blood flow effects of NO to infarct size and protection.

Methods and Results

We used myocardial contrast echocardiography to measure regional myocardial blood flow in mice over time. Reperfusion after myocardial ischemia-reperfusion injury is improved by postconditioning, as well as by phosphomimetic eNOS modulation. Knock-in mice expressing a phosphomimetic S1176D form of eNOS showed improved myocardial reperfusion and significantly reduced infarct size. eNOS knock-out mice failed to show cardioprotection from postconditioning. The size of the no-reflow zone following ischemia-reperfusion is substantially reduced by postconditioning and by the phosphomimetic eNOS mutation.

Conclusions and Significance

Using myocardial contrast echocardiography, we show that temporal dynamics of regional myocardial perfusion restoration contribute to reduced infarct size after postconditioning. eNOS has direct effects on myocardial blood flow following ischemia-reperfusion, with reduction in the size of the no-reflow zone. These results have important implications for ongoing clinical trials on cardioprotection, because the degree of protective benefit may be significantly influenced by the regional hemodynamic effects of eNOS-derived NO.     

细胞因子在心肌缺血再灌注损伤中的作用机制

心肌缺血再灌注损伤(Myocardial Ischemic/Reperfusion Injury,MI/RI)已成为临床心肌梗塞病人血管再通后重要的死亡因素之一,对于这一过程中因细胞因子诱导炎症反应的的作用机制仍是目前研究的热点。本文综述了与MI/RI相关的细胞因子的作用及其机制,并就其相互作用进行探讨。     

Effect of Antioxidant Treatment in Global Ischemia and Ischemic Postconditioning in the Rat Hippocampus

Ischemic postconditioning is a very effective way how to prevent delayed neuronal death. Effect of Ginkgo biloba extract (EGb 761; 40 mg/kg) posttreatment was studied on the rat model of transient forebrain ischemia and ischemia/postconditioning. Global ischemia was produced by four-vessel occlusion in Wistar male rats. Two experimental protocols were used: (a) 10 min of ischemia/7 days of reperfusion with or without EGb 761 treatment or (b) 10 min of ischemia/2 days of reperfusion/5 min of ischemia (postconditioning), following 5 days of reperfusion. EGb 761 was applied as follows: 30 min before 10 min of ischemia then 5 h, 1 and 2 days after 10 min of ischemia. Fluoro Jade B, marker for neuronal degeneration, was used for quantitative analysis of the most vulnerable hippocampal CA1 neurons. Cognitive and memory functions were tested by Morris water maze, as well. Administration of EGb 761 30 min before 10 min of ischemia or 5 h after ischemia has rather no protective effect on neuronal survival in CA1 region. Ten minutes of ischemia following ischemic postconditioning after 2 days of reperfusion trigger a significant neuroprotection of CA1 neurons, but it is abolished by EGb 761 posttreatment. Ischemia/postconditioning group showed a significant improvement of learning and memory on the seventh day of reperfusion. Protection of the most vulnerable CA1 neurons after ischemia/postconditioning is abolished by exogenous antioxidant treatment used in different time intervals after initial ischemia. Moreover, combination of EGb 761 administration with repeated stress (5 min ischemia used as postconditioning) causes cumulative injury of CA1 neurons.     

KB-R7943 inhibits high glucose-induced endothelial ICAM-1 expression and monocyte-endothelial adhesion

Hyperglycemia is the major cause of diabetic angiopathy. The aim of our study was to evaluate the impact of KB-R7943, an inhibitor of Na⁺/Ca²⁺ exchanger (NCX) on cell growth and function of human “diabetic” endothelial cells (EC). Intercellular adhesion molecule-1 (ICAM-1) expression and NCX activity were determined after EC were exposed to high glucose in the absence and presence of KB-R7943. Coincubation of EC with high glucose for 24 h resulted in a significant increase of monocyte-endothelial cell adhesion and the expression of ICAM-1. These effects were abolished by KB-R7943 and KB-R7943 significantly decreased the activation of NCX induced by high glucose. These findings suggested that KB-R7943 may play a role in inhibiting expression of adhesion molecules by inhibiting the reverse activation of NCX.     

Effects of caffeine, verapamil, lithium, and KB-R7943 on mechanics and energetics of rat myocardial bigeminies

We examined the effects of pharmacological alteration of Ca2+ sources on mechanical and energetic properties of paired-pulse ("bigeminic") contractions. The fraction of heat release that is related to pressure development and pressure-independent heat release were measured during isovolumic contractions in arterially perfused rat ventricles. The heat released by regular and bigeminic contractions showed two brief pressure-independent components (H1 and H2) and a pressure-dependent component (H3). We used the ratio of active heat (Ha') to pressure-time integral (PtI) and the ratio of H3 to PtI to estimate the energetic cost of muscle contraction (overall economy) and pressure maintenance (contractile economy), respectively. Neither of these ratios was affected by stimulation pattern. Caffeine (an inhibitor of sarcoplasmic reticulum function) significantly decreased mechanical responses and increased the energetic cost of contraction (delta = 101 +/- 12.6%). Verapamil (an L-type Ca2+ channel blocker) decreased pressure maintenance of extrasystolic (delta = 43.4 +/- 3.7%) and postextrasystolic (delta = 37.5 +/- 3.5%) contractions without affecting postextrasystolic potentiation, suggesting that a verapamil-insensitive fraction is responsible for potentiation. The verapamil-insensitive fraction was further studied in the presence of lithium (45 mM) and KB-R7943 (5 microM), inhibitors of the Na+/Ca2+ exchanger. Both agents decreased all mechanical responses, including postextrasystolic potentiation (delta = 67.3 +/- 3.3%), without altering overall or contractile economies, suggesting an association of the verapamil-insensitive Ca2+ fraction to the sarcolemmal Na+/Ca2+ exchanger. The effect of the inhibitors of the Na+/Ca2+ exchanger on potentiation suggests an increased participation of extracellular Ca2+ (and, thus, a redistribution of the relative participation of the Ca2+ pools) during bigeminic contractions in rat myocardium.     

楤木皂苷对大鼠心肌缺血/再灌注损伤的保护作用

目的:观察楤木皂苷(total saponins extracted from Aralia taibaiensis,s AT)对大鼠心肌缺血/再灌注(myocardia1 ischemia/reperfusion,MI/R)损伤的影响。方法:可逆性冠脉左前降支结扎缺血30 min再灌注3 h复制MI/R模型,将SD大鼠随机分为假手术组、模型组、s AT低、中、高剂量组,每组10只。采用伊文思蓝(EB)、2,3,5-氯化三苯基四氮唑蓝(TTC)双染法测定心肌梗死面积,苏木精-伊红(HE)染色法观察心肌病理学形态变化,并检测血清中乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、超氧化物歧化酶(SOD)、丙二醛(MDA)、过氧化氢酶(CAT)及谷胱甘肽过氧化物酶(GSH-Px)水平。结果:与模型组比较,s AT中、高剂量组可明显缩小心肌梗死面积(P0.05),并显著降低血清中LDH、CK-MB及MDA的含量,同时使得血清中SOD、CAT和GSH-Px的活性增加。且所有给药组心肌组织的病理损伤也小于模型组。结论:s AT对大鼠MI/R损伤具有保护作用,其机制可能与抗氧化作用相关。     

长链非编码RNA、焦亡和心肌缺血-再灌注损伤

急性心肌梗死后的再灌注是挽救缺血心肌的唯一方法,但是血流的恢复可能导致心肌缺血-再灌注损伤. 长链非编码RNA(lncRNA)和焦亡都参与了心肌缺血-再灌注损伤的病理过程并发挥重要作用. lncRNA能直接或者间接作用于焦亡信号通路相关蛋白质,对包括心肌缺血-再灌注损伤在内的多种病理过程进行调控. 本文就lncRNA和焦亡在心肌缺血-再灌注损伤中的作用做一综述,以进一步探索两者关系,为防治心肌缺血-再灌注损伤提供新思路.     

大鼠心肌缺血再灌注模型构建的改良

目的改良大鼠心肌缺血再灌注模型的构建方法,增强实用性。方法32只SD雄性大鼠随机分为四组（A组：伪手术组;B组：缺血组;C组：缺血30 min再灌注组;D组：缺血60 min再灌注组）。缺血过程在人工机械通气条件下完成,术前术中监测心电图变化,模型成功72 h后抽血进行心肌酶谱分析,并观察左室压变化。结果造模成功率为91%。B、C、D组各心肌酶含量明显高于A组（P〈0.05）,C、D组低于B组（P〈0.05）。B、C、D组左室压值低于A组（P〈0.05）,C、D组高于B组（P〈0.05）。结论改进后的模型制备方法简便易行,成功率高,评价指标符合临床应用。     

Glutathione and Ascorbate During Ischemia and Postischemic Reperfusion in Rat Brain

Thirty minutes of total cerebral ischemia (decapitation) decreased total glutathione (GSH + GSSG) by 7% but had no detectable effect on the concentration of oxidized glutathione (GSSG), reduced ascorbate, or total ascorbate. In a model of reversible, bilateral hemispheric ischemia (four-vessel occlusion) no changes in glutathione or ascorbate were detected after 30 min of ischemia. During 24 h of reperfusion following such an insult no detectable change in total ascorbate, reduced ascorbate, or oxidized glutathione was noted; however, total brain glutathione declined by 25%. The findings are discussed in relation to the hypothesis that the deleterious effects of ischemia are due to an increase in free radical production which in turn leads to increased lipid peroxidation.     

七氟烷对糖尿病心肌缺血/再灌注损伤的影响

糖尿病是一种常见病、多发病,严重威胁着人类的健康。现已明确,糖尿病是冠心病发病的一个重要因素。心肌缺血/再灌注(ischemia/reperfusion,I/R)损伤是临床常见的病理过程,同时是冠心病发病及心肌血运重建治疗过程中的核心环节,如何减轻I/R损伤一直是国际研究热点之一。糖尿病与I/R损伤对心肌都有损害作用,相关研究证明糖尿病能够进一步恶化I/R损伤对心肌的损伤作用。研究表明,缺血预处理(ischemia preconditioning,IPC)可以延缓或减轻心肌I/R损伤,同时,麻醉药预处理(anesthetic induced preconditioning,APC)也具有IPC样的心肌保护作用。其中,七氟烷作为现阶段临床较常用的吸入麻醉药,同样对心肌I/R损伤具有保护作用。本文就七氟烷对糖尿病心肌I/R损伤的影响及其机制做一综述。     

肠缺血再灌注时肠内给予不同营养物对肠粘膜ATP含量的影响

将SD大鼠分组 ,先制作空肠袋 ,分别向袋内注射不同营养物 :10mmol/L丙氨酸 ,10mmol/L葡萄糖 ,10mmol/L甘露醇或 5mmol/L丙氨酸 +5mmol/L葡萄糖的混合液 ,用动脉夹阻断肠系膜上动脉血流 6 0min后 ,再恢复灌流 6 0min。分别于阻断血流 6 0min和恢复灌注 6 0min测定肠粘膜ATP含量。研究结果显示 ,缺血再灌注能显著降低肠粘膜ATP含量 ,给予丙氨酸或葡萄糖 /丙氨酸混合液使肠粘膜ATP含量进一步降低 (P <0 .0 1) ,而给予葡萄糖能显著增加肠粘膜ATP含量 (P <0 .0 1)。结论 :缺血再灌注过程中 ,肠内给予葡萄糖能改善肠粘膜ATP含量 ,对缺血再灌注损伤的肠道提供保护作用