阿片样物质与心脏缺血预处理

阿片肽和外源性阿片术物质如吗啡除了能缓解心肌梗塞造成的疼痛外,还具有减小梗塞范围和降低心律失常的发生等重要作用。心脏阿片受体参与了缺血预处理（IPC）对心脏的调节作用,阿片样物质激活心脏阿片受体还可模拟IPC对心脏的作用。心脏阿片受体的激活产生的急性即第一窗口期和延迟即第二窗口期的心脏保护作用的信号途径,与IPC相似,其信号通路涉及Gi/Go蛋白、蛋白激酶C、酪氨酸激酶和ATP敏感K^ 通道等途径。     

阿片受体的研究进展

阿片及其衍生物在神经系统中具有很强的镇痛作用,对阿片受体的研究已有20多年的历史。20世纪70年代发现了阿片受体的存在并先后发现了脑啡肽、β-内啡肽和强啡肽等阿片肽,随后发现了孤啡肽。如年代3种阿片受体的基因均已克隆成功,氨基酸序列表明它们均属G蛋白偶联受体,为7螺旋跨膜受体家族的成员,具有很高的同源性,功能包括介导腺苷酸环化酶的抑制作用以及一些离子通道的激活和抑制作用等。阿片受体基因的克隆将有利于新型临床药物的开发以及耐受和药物成瘾性分子基础的研究。目前阿片受体基因敲除、计算机结构模拟分析以及寻找新型阿片受体基因的研究均在深入进行。     

内源性阿片物质参与大鼠缺血预处理的心肌保护作用

实验以离体灌流的ＳＤ大鼠心脏为模型,用ｋ特异性拮抗剂的ＭＲ２２６６研究ｋ阿片受体的阻断与缺血预处理的关系,用放射免疫分析法研究ＩＰ及长时间缺血对心肌强啡肽Ａ１－１３浓度的影响,探索Ｋ阿片物质在ＩＰ过程中的作用和地位。     

δ阿片类物质的抗缺血心脏保护机制和临床应用前景

阿片类物质尤其是δ阿片受体激动剂,在整体动物、离体器官、培养的细胞模型,以及人的心脏组织中能够模拟缺血预适应,对抗心肌缺血-再灌注损伤。本文介绍了近年来δ阿片类物质在心肌缺血-再灌注中的作用,其心脏保护作用涉及的信号调控机制的研究进展,以及阿片类药物治疗缺血性心脏疾病的临床应用前景。     

八肽胆囊收缩素对抗mu和Kappa型受体介导的镇痛作用

以往的资料表明,八肽胆襄收缩素(CCK-8)能对抗阿片镇痛,本实验进一步分析 CCK-8对抗哪一类型阿片受体激动剂的镇痛作用。给大鼠脊髓蛛网膜下腔(I.T.)注射 CCK-8(剂量4ng到1.0μg)既不产生痛敏也不产生镇痛。I.T.注射特异性的μ受体激动剂 PL01710 ng 或 k 受体激动剂 NDA P500 ng 引起的镇痛作用可被注射 CCK-8 4ng 所对抗。而L.T.注射δ受体激动剂 DPDPE(6.5,13.0和26.Oμg)引起的镇痛作用不能被 CCK-8(4ng,40ng I.T.)所对抗。但 CCK-8对抗 PL017和 NDAP 镇痛的作用可被 I.T.CCK 受体拮抗剂 proglumide(3μg)所翻转。以上结果表明,I.T.注射 CCK-8可有效地对抗μ和 k 受体介导的镇痛,并且这种对抗作用是经 CCK 受体介导而实现的。     

醋酸铜诱导家兔排卵前LH峰过程中下丘脑β—阿片受体密度的变化

下丘脑β－内啡肽活动减弱是排卵前ＧｎＲＨ／ＬＨ峰形成的重要因素,为了解下丘脑μ－阿片受体是否参与了这一过程,本文利用放射受体自显影结合计算机图像处理,观察醋酸铜诱导家兔排卵前ＬＨ峰过程中下丘脑μ－受体密度变化。给新西兰雌兔注射１％醋酸铜０．９ｍｌ或生理盐水（对照组）,于注射后不同时间处死,观察下丘脑内侧基底核及视前内侧区的μ－受体密度变化,结果表明：醋酸铜组给药后１ｈＭＰＯ部位μ－受体密度明显增加     

缺血预处理通过β2-肾上腺素受体保护心肌细胞收缩功能

本文旨在探讨缺血预处理(ischemic preconditioning, IP)对缺血/再灌注(ischemia/reperfusion, I/R)损伤心脏的保护机制,从细胞和受体水平研究β2-肾上腺素受体(β2-adrenoreceptor, β2-AR)是否参与了IP对I/R损伤心脏的保护作用.Sprague-Dawley大鼠随机分为单纯I/R组(对照组)、IP组、短暂异丙肾上腺素(isoproterenol, ISO)处理组、IP ICI118551组、ISO ICI118551组和ICI118551组.除对照组外,其它各组大鼠处理后均行缺血30min/复灌30min.记录心脏收缩期左心室内压上升的最大变化速率( dp/dtmax)、舒张期左心室内压下降的最大变化速率(-dp/dtmax)及左心室内压差(difference of left ventricular pressure, ΔLVP,左心室收缩压-左心室舒张压).测定冠状动脉流出液乳酸脱氢酶(1actate dehydrogenase, LDH)含量.进一步酶解分离心脏,获得单个心室肌细胞,测定其存活率和收缩功能.结果显示,IP和ISO组±dp/dtmax、ΔLVP较对照组增高;心肌细胞存活率和收缩幅度也显著升高;收缩时间(time-to-peak contraction, TTP)缩短;冠状动脉流出液LDH含量减少.选择性β2-AR拮抗剂ICl118551阻断IP和ISO的作用.各组间心肌细胞舒张50%时间(time-to-50% relaxation, R50)和舒张100%时间(time-to-100% relaxation, R100)均无明显差异.结果提示,β2-AR可能在IP对I/R损伤心脏的保护作用中发挥重要作用.     

阿片受体激动剂对猪冠状动脉肌条作用的研究

采用螺旋肌条生物检定技术研究阿片受体激动剂对猪冠状动脉肌条的影响。结果显示κ,μ,δ亚型选择性激动剂Ｕ－５０４８８Ｈ,羟甲基芬太尼,吗啡,Ｄ－ａｌａ－ＤＬｅｕ－ｅｎｋｅｐｈａｌｉｎ（ＤＡＤＬＥ）以及广谱激动剂依托啡都可以引起肌条的收缩,收缩强度以Ｕ－５０４８８Ｈ＞吗啡＞依托啡＞ＯＭＦ,ＤＡＤＬＥ。上述作用均呈量效关系,纳洛酮对上述各亚型激动剂的作用不仅不能拮抗,反有增强作用,纳洛酮本射亦有致收缩作     

电脱耦联延迟参与κ-阿片受体兴奋引起的心肌保护作用

目的:研究κ-阿片受体兴奋诱导的心肌保护作用是否与其对心肌缺血期间电耦联的影响有关,并探讨这种作用的可能机理。方法:采用雄性SD大鼠心脏Langendorff离体灌流模型。①全心停灌30min,复灌2h,观察不同浓度κ-阿片受体特异激动剂U50,488H(10-7、10-6、3×10-6、和10-5mol/L)及其特异阻断剂nor-BNI(5×10-6mol/L)和线粒体ATP敏感性钾离子通道特异阻断剂5-HD(10-4mol/L)对缺血/复灌心肌的作用。测量指标:以分光光度计在490nm波长下测定氯化三苯基四氯唑(TTC)与活细胞反应的产物formazan含量的方法测定心肌细胞活性、测定冠脉流出液中乳酸脱氢酶(LDH)的含量以及心室内压;②全心停灌70min,应用四电极法观察不同浓度U50,488H、nor-BNI和5-HD对缺血期间心肌整体阻抗和电脱耦联参数(电脱耦联时间、平台时间、电脱耦联最大速率和阻抗倍数)的影响。结果:①U50,488H可诱导心肌保护作用,并呈浓度依从性,与对照组比较,表现为for-mazan含量增加,LDH释放减少,心室功能恢复增强;②经较高浓度U50,488H(10-6、3×10-6、和10-5mol/L)预处理后,电脱耦联时间和平台时间均延迟,电脱耦联最大速率降低;③U50,488H在10-7-10-5mol/L范围内对电脱耦联时间的延迟与其对formazan含量增加和LDH释放减少的作用呈线形相关;④U50,488H对formazan含量增加、LDH释放减少和电脱耦联时间和平台时间延迟的作用均可被nor-BNI或5-HD所阻断。结论:κ-阿片受体兴奋对电脱耦联的延迟作用与其诱导的心肌保护作用有关,这种作用受到线粒体ATP敏感性钾离子通道的调节。     

迷走神经和乙酰胆碱对缺血心肌保护作用的研究新进展

缺血性心脏病是危害人类健康的主要疾病之一。新近研究发现,心肌缺血与迷走神经活性降低及交感神经活性升高密切相关。本文从缺血性心脏病时心脏迷走神经调控的改变、迷走神经及其递质乙酰胆碱对缺血心肌的保护作用和其在缺血预适应、缺血后适应中可能的信号转导途径等方面,对迷走神经及其递质保护缺血心肌的作用机制研究的新进展予以综述,将有助于深入理解缺血性心脏病的发病机制及防治措施,为该疾病的防治开辟新思路。     

雷米普利对糖尿病大鼠心肌缺血／再灌注损伤保护作用的超微结构研究

目的：研究雷米普利对糖尿病大鼠心肌缺血／再灌注损伤的保护作用,并从超微结构的角度初步探讨其作用机制。方法：链脲佐菌素致糖尿病大鼠被随机分为3组（n=16）：缺血／再灌注（I／R）、缺血预适应（IPC）和雷米普利（RAM）组。RAM组每天用雷米普利（1mg／kg）灌胃,I／R和IPC组用等体积生理盐水灌胃。4周后各组动物均经历心肌缺血／再灌注损伤,IPC组于缺血前行心肌缺血预适应。连续监测心电图变化,测定心肌梗死面积,光、电镜下观察心肌形态学改变。结果：与I／R组比较,RAM及IPC组缺血期心脏ST-段抬高幅度降低,室早出现时间推迟,持续时间缩短,室速、室颤发生率降低,心肌梗死面积缩小,形态学观察心肌损伤减轻,心肌纤维及线粒体特征性结构保持清晰,血管通畅,内皮损伤减轻。结论：连续4周使用RAM对实验性糖尿病大鼠具有与IPC相似的心脏保护效应,机制可能与保护心肌细胞及线粒体、改善内皮功能等有关。     

骨骼肌缺血预适应对猪心肌凋亡的影响及阿片受体的作用

目的:确定骨骼肌缺血预适应对猪心肌凋亡及其调控基因Bcl-2/Bax的影响,并探讨阿片受体在此机制中可能的作用。方法:采用非开胸法建立猪心脏缺血/再灌注(I/R)模型,通过球囊堵塞左股动脉造成骨骼肌短暂缺血,分别使用阿片受体拮抗剂纳洛酮以及神经节阻断剂六烃己胺进行干预。采用末端探针标记及流式细胞技术检测心肌凋亡细胞及调控基因Bcl-2/Bax,确定各组对以上指标的影响。结果:①和缺血对照组(CONT组)相比,远端预处理后心肌细胞凋亡率明显降低(4.43%±0.74%vs15.4%±1.15%,P<0.05),提示骨骼肌远端预适应(RP)可减少心肌凋亡。②和CONT组相比,远端预处理后Bcl-2/Bax比值明显增高(1.36±0.09vs0.56±0.08,P<0.05),提示RP对心肌凋亡的影响可能通过影响Bcl-2/Bax进行调控。③预处理前使用阿片受体拮抗剂纳洛酮可使以上保护作用减弱(P<0.05),但纳洛酮对CONT组无影响。④预处理前使用神经节阻断剂六烃己胺,不影响RP对心肌的保护作用。结论:骨骼肌缺血预适应减少心肌细胞凋亡,可能通过影响Bcl-2/Bax进行调控;阿片受体可能参与此保护作用,且不通过神经反射进行。     

Agonist-induced regulation and trafficking of kappa opioid receptors

Chronic or repeated administration of κ opioid agonists leads to tolerance to the subsequent drug administration. The mechanisms underlying tolerance are complex and changes at the receptor level contribute in part to the development of tolerance. This review focuses on agonist-induced phosphorylation, desensitization, internalization and down-regulation of the κ opioid receptor. In vivo studies on the rat and guinea pig brains are reviewed, followed by in vitro investigations on cells and tissues endogenously expressing the κ opioid receptor. The bulk of the article describes the studies performed after cloning of the opioid receptors on regulation and trafficking of the κ opioid receptors (KORs) expressed in various cell systems. Topics reviewed and discussed include biochemical mechanisms of desensitization, internalization and down-regulation, differences in the regulation of the rat and the human κ opioid receptors (rKOR and hKOR, respectively) and the structural basis for the species variations, differential abilities of agonists in inducing regulation of the hKOR, the relationship (or the lack thereof) of KOR internalization to activation of p42/p44 mitogen-activated kinase and to adenylyl cyclase superactivation, the role of the PDZ domain-containing protein NHERF-1/EBP50 in the trafficking of the hKOR and the relationship between receptor phosphorylation and tolerance development in mice. There are still questions remained to be answered. Among the issues to be resolved are the signals that direct the sorting of internalized hKORs to the recycling and degradation pathways, the recycling pathway(s) of the internalized hKOR, the molecular bases of differential regulation of the KORs by agonists and the occurrence of agonist-induced KOR internalization occur in vivo and, if so, its role in tolerance and dependence.     

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。     

心肌缺血预适应循环血中微囊泡对大鼠心肌I/R损伤的作用

目的：研究心肌缺血预适应（IPC）大鼠循环血中微囊泡（MVs）对大鼠在体心肌缺血/再灌注（I/R）损伤的作用及相关机制。方法：反复短暂结扎/松开大鼠冠状动脉左前降支建立大鼠IPC模型,自腹主动脉取血,超速离心法分离循环血中的IPC-MVs,并对其进行流式鉴定。建立在体大鼠心肌I/R模型,股静脉注射IPC-MVs 7 mg/kg。HE染色观察心肌形态学变化,TTC染色检测心肌梗死范围,TUNEL染色检测心肌细胞凋亡率。比色法测定血清乳酸脱氢酶（LDH）活力,分光光度法测定心肌组织caspase 3活力,Western blot法检测心肌组织Bcl-2、Bax蛋白表达水平。结果：流式细胞术检测IPC-MVs浓度为4380±745个/μl。与I/R组比较,IPC-MVs能够减轻I/R大鼠心肌组织损伤,缩小心肌梗死范围（P<0.01）,减少心肌细胞凋亡数量（P<0.01）,明显降低血清LDH活力（P<0.01）,降低心肌组织caspase 3活力（P<0.01）,升高Bcl-2蛋白表达（P<0.01）,降低Bax蛋白表达（P<0.01）,升高Bcl-2/Bax比值（P<0.01）。结论：IPC-MVs显著减轻大鼠在体心肌I/R损伤,通过上调心肌组织中Bcl-2的蛋白表达,下调Bax的蛋白表达,升高Bcl-2/Bax比值,降低caspase 3活力而发挥心肌保护作用。     

Laminar distribution of the multiple opioid receptors in the human cerebral cortex

Quantitative autoradiographic assessment of cerebral cortical laminar distribution of μ, δ and κ opioid receptors was carried out in coronal sections of five post-mortem human brains obtained at autopsy. The cortical areas studied were: cingulate, frontal, insular, parietal, parahippocampal, temporal, occipitotemporal, occipital and striate area. In general, the laminar patterns of distribution for the three types of receptors are distinctive. Peak levels of δ opioid binding are in laminae I, II, and IIa. μ-Receptors are located in lamina III followed by I and II in cingulate, frontal, insular and parietal cortices and lamina IV in temporal and occiptotemporal cortices. κ-Receptors are found concentrated in laminae V and VI. The patterns of opioid binding in cortical laminae showed remarkable consistency in all five brains examined. In contrast to other cortical areas, the parahippocampal gyrus, at the level of the amygdaloid formation, demonstrated peak κ receptor density in laminae I, II and III. μ-Opioid binding was undetectable in the lateral occipital cortex and in the striate area. Special issue dedicated to Dr. Eric J. Simon.     

The timing of propofol administration affects the effectiveness of remote ischemic preconditioning induced cardioprotection in rats

The cardioprotection of remote ischemic preconditioning (RIPC) is abolished under propofol maintained anesthesia. Transient receptor potential vanilloid 1 (TRPV1) channel is present in the heart, and its activation could induce cardioprotection. Therefore, we tested whether the anesthetic propofol administration phase interfered with the RIPC-induced cardioprotection, and RIPC-induced cardioprotection via the cardiac TRPV1 channel. Male Sprague-Dawley rats were subjected to myocardial 30 minutes of ischemia followed by 2 hours of reperfusion. RIPC consisted of three cycles of 5-minute ischemia/reperfusion applied to a hindlimb. Propofol infusion at 12 mg/kg/h was commenced either at 10 minutes before the start of RIPC in the P-pre + RIPC group, or immediately after myocardial ischemia at the onset of reperfusion (P-post + RIPC) while performing RIPC. These two propofol infusion regimes were applied to another two grou bs without RIPC (P-pre and P-post groups). Infarct size (IS) was assessed by triphenyltetrazolium staining. Heart TRPV1 expression was detected by Western blot and immunofluorescence. RIPC significantly reduced myocardial IS compared with the control group (36.7 ± 3% versus 57.2 ± 4%; P < .01). When propofol was started before RIPC, the IS sparing effect of RIPC was completely abolished. However, propofol infusion starting immediately after myocardial ischemia did not affect RIPC-induced cardioprotection. TRPV1 expression significant increase after RIPC, then propofol inhibited the TRPV1 activation of RIPC if given before RIPC but not after. Our results suggest that the timing of propofol administration is critical to preserve the cardioprotection of RIPC. Propofol might cancel RIPC-induced cardioprotection via the cardiac TRPV1 receptor.     

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.     

Differential involvement of the mu and kappa opioid receptors in spatial learning

In order to test the role of mu and kappa opioid receptors (Mu opioid receptor (MOR) and Kappa opioid receptor (KOR)) in hippocampal-dependent spatial learning, we analyzed genetically engineered null mutant mice missing the functional MOR or KOR gene. Compared to wild-type mice, the homozygous MOR null mutants exhibited an impairment in the ultimate level of spatial learning as shown in two distinct tasks, the 8-arm radial-maze and the Morris water-maze. Control behaviors were normal. The learning impairment could be associated with the impairment we found in the maintenance of long-term potentiation in mossy fibers in CA3. In comparison, there was no impairment in spatial learning in our KOR mutants or in mossy fibers (mf) in CA3 region long-term potentiation (LTP). Our work suggests that the MOR may play a positive role in learning and memory by increasing LTP in CA3 neurons.