糖尿病对大鼠心肌细胞动作电位和瞬时外向钾电流的影响

目的探讨糖尿病对大鼠心室肌细胞动作电位(AP)和瞬时外向钾电流(Ito)的影响。方法通过链脲佐菌素诱导糖尿病大鼠模型,双酶法急性分离出对照组和糖尿病组心室肌细胞,全细胞膜片钳技术分别观察心肌细胞AP和Ito电流密度变化以及Ito动力学改变。结果与对照组比较,糖尿病组心肌细胞AP形态明显增宽,AP复极20%、50%和90%的时程均明显延长(64.3±7.5 ms vs 29.7±9.2 ms;174.3±6.8 ms vs 98.9±4.2 ms;276.7±8.3 ms vs 173.7±7.2 ms,P均<0.01,n=12);在钳制电位为+50mV时,与对照组比较,糖尿病组心肌细胞Ito的电流密度显著降低(11.51±1.37 pA/pF vs 17.43±1.98 pA/pF,P<0.05,n=12);与对照组比较,糖尿病组心肌细胞Ito的I-V曲线明显下移;失活曲线显著左移(P<0.01,n=12);失活恢复曲线明显减慢。结论糖尿病引起了心肌细胞AP时程延长,Ito幅度降低,并使Ito的失活加快以及失活后恢复减慢。     

同种心脏移植急性排斥反应机制研究进展

同种原位心脏移植已成为临床治疗终末期心脏病的有效方法 ,供心保存、外科手术技术、术后感染已不再是阻碍心脏移植成功的最主要因素。影响心脏移植成败 ,术后病人的生存期以及生存质量的主要因素是术后免疫排斥反应。因此 ,对心脏移植急性排斥反应的发生机制的研究便显得尤为重要。本文就其基本理论 ,目前研究现状及进展进行探讨和综述。     

新生大鼠心肌细胞短暂外向钾电流下降与心肌肥大的相关性研究

在某些心力衰竭患者中常观察到心肌细胞短暂外向钾电流 (Ito)下降和动作电位时程 (APD)延长 ,笔者主要探讨Ito下降与心肌肥大的关系及内在机制。用Ito阻断剂 ,4 氨基吡啶 (4 AP) ,处理新生大鼠心室肌细胞 ,观察作为心肌肥大指标的细胞膜电容和3 H 亮氨酸 (3 H Leu)掺入量 ,同时测Ito振幅和APD。结果 :Ito振幅下降近 5 0 %(1 5 0 .3± 1 8.6pA ,n =7vs 74 .0± 1 1 .5pA ,n =1 1 ,P <0 .0 5 )。APD50 (5 0 %复极 )显著的延长 (75 .8± 1 4 .1ms,n =7vs2 0 1 .7± 2 3.5ms,n =1 1 ,P <0 .0 5 )。膜电容和3 H Leu掺入量分别增加 4 7%和 31 % (P均 <0 .0 5 )。L 型钙通道阻断剂维拉帕米 ,能抑制 4 AP诱导的APD延长以及膜电容和3 H 亮氨酸掺入量的增加。环孢素A(CsA)也可抑制 4 AP诱导的膜电容和3 H Leu掺入量的增加 ,但对APD影响不明显。结论 :Ito下降通过延长APD ,致细胞内钙增加 ,激活钙调神经磷酸酶反应途径 ,可能引起心肌肥大     

心肌中穿孔素和颗粒酶B基因表达水平与心脏移植急性排斥反应的关系

目的 研究穿孔素和颗粒酶B基因在移植心的心肌组织中表达水平与心脏移植急性排斥反应的关系。方法 应用大鼠腹腔同种异位心脏移植模型，实验组为同种移植，SD大鼠为受体，Wistar大鼠为供体；对照组为同系移植，供受体均为SD大鼠。观察术后1，3，5，7，9，11d的移植心病理改变同时采用RT－PCR法测定的移植心心肌组织中穿孔素和颗粒酶B基因表达水平。用免疫组化方法观察穿孔素及颗粒酶B的表达情况。结果 术后3d起移植心心肌组织中穿孔素和颗粒酶B基因表达水平即明显升高（术后3，5，7，9，11d与对照组相比均为P＜0.01），其中穿孔素基因表达在7－9d达高峰，而颗粒酶B基因表达在11d达高峰，此两种基因表达与心脏的病理学变化有明显的相关性。免疫组化显示术后5d浸润细胞胞浆中穿孔素和颗粒酶B表达明显增多。结论 移植心心肌组织中穿 纱和颗粒酶B基因表达水平与心脏移植急性排斥反应的经过相平等，可作为判定排斥反应的诊断指标。     

大鼠急性低氧运动对心肌细胞瞬时外向钾电流的影响

目的 通过建立大鼠急性低氧运动模型,观察大鼠单个心室肌细胞瞬时外向钾电流(Ito)的改变,在细胞水平探究模拟高原低氧条件下力竭运动对心脏电生理的影响.方法 将40只健康雄性清洁级SD大鼠随机分为低氧运动组、低氧安静组、常氧运动组和常氧安静组,每组10只.利用小动物低压氧舱和常氧状态下进行力竭运动试验.取出各组大鼠心脏,...     

甲状腺素诱发大鼠心肌肥厚时瞬时外向钾电流、内向整流钾电流和钙电流的变化

目的 研究甲状腺素诱发大鼠心肌肥厚模型的心肌细瞬时外向钾电流、内向整流钾电流和钙电流的变化。方法 以ipL-甲门面腺素造成大鼠心肌肥厚模型后,用膜片钳技术记录心肌细胞瞬时外向钾电流、内向整流钾电流和L型钙电流。结果 肥厚组心肌细胞瞬时外向钾电流幅度和心坎产增加,激活动力学特性无改变;内向整流钾电流幅度和密度也增加,激活动力学特性也无改变;而钙电流幅度、细胞膜电容增加,电流密度不变,半数激活电压（V1/2）向负电位方向移动,斜率（k)减小。结论 在甲状腺素诱发大鼠心肌肥厚模型中瞬时外向钾电流、内向整流钾电流和钙电流特性均发生了变化,这是造成肥厚心肌电生理异常的离子基础。     

心脏移植排斥反应中心肌细胞动作电位的变化研究

目的利用大鼠异位心脏移植模型,研究在心脏移植物排斥反应时心肌细胞动作电位(AP)的变化,探索心脏移植排斥反应的心电生理学变化机制。方法建立对照组(Brown Norway-Brown Norway)和实验组(Brown Norway–Lewis)大鼠腹部心脏移植模型,每组建立模型20只,将20只模型随机分为4组,于术后第2天、第4天随机选取各组移植大鼠,获取心脏移植物分别进行病理检查,并应用快速酶解法分离单个心室肌细胞,应用全细胞膜片钳技术记录心肌细胞AP。结果两组模型中供心复跳率100%,设定实验时间前对照组术中大鼠死亡2例,实验组死亡1例。组织学见对照组心脏移植物在移植后第2(n=4)、4(n=5)天均无明显排斥反应;实验组在移植后第2(n=4)、4(n=5)天有轻度到中重度排斥反应。在移植后第2、4天,实验组较对照组心肌细胞AP时程(APD)均显著延长[第2天APD90:实验组(n=15)vs对照组(n=12),(88.1±6.5)mV vs(49.3±5.6)mV,P=0.0016;第4天APD90:实验组(n=21)vs对照组(n=15),(104.0±9.5)mV vs(59.3±5.2)mV,P=0.0064];心肌细胞AP最大去极化速率(dv/dt)均显著增加;动作电位幅度(APA)无显著差异。结论在大鼠心脏移植物排斥反应发生时,心肌细胞APD明显延长,AP dv/dt显著增加,APA无显著变化。     

急性胰腺炎时大鼠心室肌细胞瞬间外向钾电流的变化

目的探讨急性胰腺炎后心室肌细胞瞬间外向钾电流（Ito）的变化。方法以开腹胆总管注射牛磺胆酸钠的方法制备大鼠急性胰腺炎实验模型,2448 h后处死动物分离单个心室肌细胞,采用全细胞膜片钳记录技术观察Ito的变化,同时设假手术对照组。结果急性胰腺炎大鼠心室肌细胞的Ito受到抑制,电流密度?电压关系曲线下移,其+70 mV时的峰值电流密度由对照组的（52±13）pA/pF下降为急性胰腺炎组的（12±4）pA/pF（P<0.01）;其失活曲线左移,半数最大失活电位对照组为（-45±8）mV,急性胰腺炎组为（-55±9）mV,与对照组比较显著减小（P<0.01）,失活速度加快;急性胰腺炎组Ito恢复速度明显减慢,恢复时程延长,和对照组比较P<0.01。结论急性胰腺炎大鼠心室肌细胞的Ito受抑制。     

落新妇甙对小鼠心脏移植排斥反应的抑制作用

目的探讨落新妇甙对小鼠心脏移植排斥反应的抑制作用。方法采用小鼠颈部心脏移植模型。随机将心脏移植后的48只小鼠分为四组：A组心脏移植后每天用生理盐水1ml灌胃,B组心脏移植后每天用环孢素A5mg／kg灌胃,C组心脏移植后每天用落新妇甙1ml／kg灌胃,D组心脏移植后每天用环孢素A2．5mg／kg及落新妇甙1ml／kg灌胃。观察移植心脏的存活时间及心脏跳动情况。结果B组、C组及D组移植心脏存活时间均较A组显著延长（P＜0．01）;D组移植心脏存活时间最长,优于C组（P＜0．05）和B组（P＜0．01）。结论落新妇甙对心脏移植排斥反应有较强的抑制作用,并与环孢素A有协同作用。     

The molecular physiology of the cardiac transient outward potassium current (I(to)) in normal and diseased myocardium

G. Y. Oudit, Z. Kassiri, R. Sah, R. J. Ramirez, C. Zobel and P. H. Backx. The Molecular Physiology of the Cardiac Transient Outward Potassium Current (I(to)) in Normal and Diseased Myocardium. Journal of Molecular and Cellular Cardiology (2001) 33, 851-872. The Ca(2+)-independent transient outward potassium current (I(to)) plays an important role in early repolarization of the cardiac action potential. I(to)has been clearly demonstrated in myocytes from different cardiac regions and species. Two kinetic variants of cardiac I(to)have been identified: fast I(to), called I(to,f), and slow I(to), called I(to,s). Recent findings suggest that I(to,f)is formed by assembly of K(v4.2)and/or K(v4.3)alpha pore-forming voltage-gated subunits while I(to,s)is comprised of K(v1.4)and possibly K(v1.7)subunits. In addition, several regulatory subunits and pathways modulating the level and biophysical properties of cardiac I(to)have been identified. Experimental findings and data from computer modeling of cardiac action potentials have conclusively established an important physiological role of I(to)in rodents, with its role in large mammals being less well defined due to complex interplay between a multitude of cardiac ionic currents. A central and consistent electrophysiological change in cardiac disease is the reduction in I(to)density with a loss of heterogeneity of I(to)expression and associated action potential prolongation. Alterations of I(to)in rodent cardiac disease have been linked to repolarization abnormalities and alterations in intracellular Ca(2+)homeostasis, while in larger mammals the link with functional changes is far less certain. We review the current literature on the molecular basis for cardiac I(to)and the functional consequences of changes in I(to)that occur in cardiovascular disease.     

犬Marshall韧带心肌细胞短暂外向钾电流的特性

目的　探讨Marshall束 (Marshallbundle ,MB)内心肌细胞短暂外向钾电流 (transientout wardpotassiumcurrent,Ito)的离子通道特性。方法　运用组织块酶解法分离犬MB内单个心肌细胞 ,在倒置显微镜下直接比较细胞形态 ;采用全细胞膜片钳技术记录MB内单个心肌细胞Ito电流密度及动力学特性。在细胞外液中加入 1μM异丙肾上腺素 ,比较加药前后Ito电流密度及动力学特性的变化。结果　MB内有两种形态迥异的心肌细胞 :一种为短矩形 ,短而宽 ,呈典型的矩形或略呈锥型 ;另一种为长杆型 ,长而窄。短矩形细胞数量明显多于长杆型细胞。短矩形细胞和长杆型细胞的长宽比分别为2 99± 0 95和 12 0 5± 2 4 1(P <0 0 1)。两种心肌细胞Ito的动力学无明显差别 ,但短矩形细胞的Ito电流密度明显小于长杆型细胞 ,8 77pA/pF (n =8)对 14 95 pA/pF (n =8) ,P <0 0 1。加用异丙肾上腺素后 ,在 70mV ,长杆型细胞Ito峰值减小到 7 96pA/pF (n =8) ;短矩形细胞减小到 3 89pA/pF(n =8) ;两种细胞加药后Ito分别减小 (5 0 4± 0 32 ) pA/pF和 (6 86± 0 4 9) pA/pF (P <0 0 5 ) ;稳态激活曲线均右移 ,短矩形细胞与长杆型细胞的V1/ 2 分别从 (- 7 1± 0 8)mV和 (- 6 8± 0 7)mV变为 (-1 8± 0 2 )mV和 (- 1 6± 0 4 )mV     

替米沙坦对牵张刺激乳大鼠心房肌细胞短暂外向钾电流和动作电位的影响

目的探讨替米沙坦对牵张刺激乳大鼠心房肌细胞瞬时外向钾电流（Ito）和动作电位（AP）的影响。方法利用胰酶与Ⅱ型胶原酶混合酶解,并结合差速贴壁和5-溴脱氧尿嘧啶核苷处理得到纯化的乳大鼠心房肌细胞。实验分对照组、牵张组、替米沙坦（1μmol/L）组。采用全细胞膜片钳技术分别记录三组Ito和AP。结果在＋20~＋60 mV刺激电压水平,Ito电流密度（pA/pF）：牵张组低于对照组[＋20 mV和＋60 mV分别为（0.8±0.3）vs（2.1±0.8）和（1.6±0.4）vs（12.1±3.0）;P均〈0.01],替米沙坦组[＋20 mV和＋60 mV分别为（1.4±0.3）和（6.7±1.3）较牵张组增大,P均〈0.01]。牵张组AP复极50%、90%时程（APD50、APD90）较对照组明显缩短[（9.6±1.3 ms）vs（15.5±2.4）ms,（29.9±2.9）ms vs（56.3±3.6）ms,P均〈0.01,n=9],替米沙坦组[APD50、APD90分别为（11.7±2.0）和（41.4±4.6）ms]较牵张组APD延长（P均〈0.05）。结论牵张刺激可降低乳大鼠心房肌细胞Ito电流密度、缩短APD;替米沙坦干预可抑制牵张刺激的此作用。     

二十二碳六烯酸对Sprague-Dawley大鼠心室肌细胞动作电位和瞬时外向钾离子流的作用

目的 探讨二十二碳六烯酸(DHA)对Sprague-Dawley大鼠心窜肌细胞动作电位(AP)和瞬时外向钾离子流(Ito)的作用.方法 采用酶消化法获得大鼠耐钙心室肌细胞,以全细胞膜片钳技术分别记录加入 DHA 10、20、40、60、80、100、120 和200 μmol/L 后大鼠心室肌细胞AP和Ito的变化.结果 (1)当 DHA 浓度大于30 μmol/L时,动作电位时程(APD)逐渐延长,且呈浓度依赖性(P<0.05);当 DHA 浓度在0～30 μmoL/ L 时,随着 DHA 浓度增加,APD 延长不明显(P>0.05);加入不同浓度DHA后,在5 min内 APD 随时间延长而逐渐延长,5 min后 APD 基本固定.(2)加入不同浓度DHA 后,随着 DHA 浓度增加,Ito逐渐降低,DHA对Ito呈浓度依赖性阻滞(P<0.05).DHA 对Ito半效抑制浓度为58.3 μmoL/ L.结论 当加入不同浓度 DHA 后,APD 随着 DHA 浓度增加而逐渐延长,Ito逐渐降低,DHA 对 AP 和Ito的影响可能足其抗心律失常作用的机制之一.     

Role of the calcium-independent transient outward current I(to1) in shaping action potential morphology and duration

The Kv4.3-encoded current (I:(Kv4.3)) has been identified as the major component of the voltage-dependent Ca(2+)-independent transient outward current (I:(to1)) in human and canine ventricular cells. Experimental evidence supports a correlation between I:(to1) density and prominence of the phase 1 notch; however, the role of I:(to1) in modulating action potential duration (APD) remains unclear. To help resolve this role, Markov state models of the human and canine Kv4.3- and Kv1.4-encoded currents at 35 degrees C are developed on the basis of experimental measurements. A model of canine I:(to1) is formulated as the combination of these Kv4.3 and Kv1.4 currents and is incorporated into an existing canine ventricular myocyte model. Simulations demonstrate strong coupling between L-type Ca(2+) current and I:(Kv4.3) and predict a bimodal relationship between I:(Kv4.3) density and APD whereby perturbations in I:(Kv4.3) density may produce either prolongation or shortening of APD, depending on baseline I:(to1) current level.     

短暂外向钾电流参与T波电交替的实验研究

目的：观察短暂外向钾电流（Ito）是否参与T波交替（T wave alternans，TWA）现象的发生或维持。方法：成熟雄性SD大鼠离体灌流心脏，分为对照组和4-氨基吡啶（AP）灌流组（2mM4-AP持续灌流），在右室外膜给予200ms的方波刺激，并逐渐缩短刺激周长至不应期或出现TWA，同步记录灌流心脏的心电图及三层心肌的动作电位，观察TWA的发生情况。结果：大鼠离体灌流心脏心电图QRS与T波之间没有明显的等电位线，心外膜最早完成复极，复极终点与心电图T波顶点一致，中层及心内膜较晚完成复极，复极终点与心电图T波终点一致。快频率刺激未诱发对照组TWA，4-AP组在刺激周长为92±6ms时可诱发TWA，刺激周长缩短至78±8ms时引起持续TWA。结论：Ito是动作电位复极1期的主要外向电流，Ito阻断可通过影响动作电位复极，细胞内钙稳态，引起T波电交替。     

Calcium-activated transient outward chloride current and phase 1 repolarization of swine ventricular action potential

OBJECTIVE: It is unknown whether 4-aminopyridine- (4-AP-) sensitive transient outward K(+) current (I(to1)) and/or Ca(2+)-activated transient outward Cl(-) current (I(Ca.Cl) or I(to2)) contribute(s) to phase 1 repolarization of pig ventricular action potential (AP). The purpose of the present study was to determine ionic contribution of the phase 1 repolarization of AP in pig ventricle. METHODS: We used whole-cell patch techniques to record APs and membrane currents, and Western immunoblotting analysis to detect expression of I(to1) protein (Kv4.2 or Kv4.3) in pig ventricular myocytes. RESULTS: A transient outward current (I(to)) was activated upon depolarization voltage steps to between -10 and +60 mV from -50 mV in pig ventricular cells, and the I(to) was resistant to 4-AP application, but sensitive to the inhibition by ryanodine (10 micromol/l) and the Ca(2+) channel blockade, and the Cl(-) channel blocker 4,4'-diisothiocyanostilben-2,2'disulfonic acid (DIDS, 150 micromol/l). The current was diminished by external Cl(-) (Cl(-)(o)) replacement and showed a 'bell-shaped' I-V relationship at room temperature, typical of I(to2). No difference in I(to2) was observed in the regional cells from epicardium, midmyocardium, and endocardium of left ventricle. APs showed significant phase 1 and 'spike and dome' in pig ventricular myocytes. The phase 1 and 'spike and dome' of APs were not affected by 4-AP (3 mmol/l), but abolished by replacing Cl(-)(o) and by application of 100 micromol/l DIDS, suggesting I(to2) contribution. Western immunoblotting analysis showed no evidence for the expression of 4-AP-sensitive I(to1) channel protein (Kv4.2 or Kv4.3) in pig ventricular cells. CONCLUSION: The results indicate that 4-AP-sensitive I(to1) is not expressed, and only Ca(2+)-activated I(to2) is present in pig cardiac cells, which contributes importantly to the phase 1 repolarization of ventricular APs in this species.     

Mechanism for action potential alternans: the interplay between L-type calcium current and transient outward current.

BACKGROUND: The ionic mechanisms underlying action potential duration alternans are not established. OBJECTIVES: The purpose of this study was to explore the mechanisms underlying action potential alternans. METHODS: Computer simulations were performed using a model of a single ischemic myocyte. To emulate ischemia, extracellular potassium was raised to 10 mM, L-type calcium channel conductance was decreased, and the conductivity of the transient outward current I(to)was varied. RESULTS: Alternans occurred at basic cycle lengths between 350 and 1,800 ms. The alternans resulted from the interplay of the recovery kinetics of the calcium and transient outward current inactivation gates. Depending on the diastolic interval, the transient outward current was sufficiently strong and calcium current sufficiently weak to result in the abolition of the action potential plateau and thus in an abbreviated action potential. The inactivation and recovery kinetics of the inactivation gates were such that calcium current was relatively stronger than transient outward current after an abbreviated action potential. The subsequent action potential was long because calcium current was sufficiently large to restore the action potential plateau dome after the partial repolarization caused by the transient outward current. The long-short pattern repeated indefinitely. This alternans mechanism explains how 2:1 patterns can evolve into 3:1 patterns, as observed in at least one experiment, as ischemia progresses and calcium current diminishes. CONCLUSION: Computer simulations and basic theory suggest that the interplay between L-type calcium and transient outward currents causes at least one type of alternans.