The tyrosine phosphatase inhibitor bis(maltolato)oxovanadium attenuates myocardial reperfusion injury by opening ATP-sensitive potassium channels

Vanadate has been shown to inhibit tyrosine phosphatase, leading to an increased tyrosine phosphorylation state. The latter has been demonstrated to be involved in the signal transduction pathway of ischemic preconditioning, the most potent endogenous mechanism to limit myocardial infarct size. Furthermore, there is evidence that phosphatase inhibition may be cardioprotective when given late after the onset of ischemia, but the mechanism of protection is unknown. We tested the hypothesis that the organic vanadate compound bis(maltolato)oxovanadium (BMOV) limits myocardial infarct size by attenuating reperfusion injury and investigated the underlying mechanism. Myocardial infarction was produced in 112 anesthetized rats by a 60-min coronary artery occlusion, and infarct size was determined histochemically after 180 min of reperfusion. Intravenous infusion of BMOV in doses of 3.3, 7.5, and 15 mg/kg i.v. decreased infarct size dose-dependently from 70 +/- 2% of the area at risk in vehicle-treated rats down to 41 +/- 5% (P < 0.05 versus control), when administered before occlusion. Administration of the low dose just before reperfusion was ineffective, but administration of the higher doses was equally cardioprotective as compared with administration before occlusion. The cardioprotection by BMOV was abolished by the tyrosine kinase inhibitor genistein and by the ATP-sensitive potassium (K(+)(ATP)) channel blocker glibenclamide but was not affected by the ganglion blocker hexamethonium. We conclude that BMOV afforded significant cardioprotection principally by limiting reperfusion injury. The mode of action appears to be by opening of cardiac K(+)(ATP) channels via increased tyrosine phosphorylation.     

Activated protein C protects against myocardial ischemic/reperfusion injury through AMP‐activated protein kinase signaling

Summary. Background: Activated protein C (APC) is a vitamin K‐dependent plasma serine protease that down‐regulates clotting and inflammatory pathways. It is known that APC exerts a cardioprotective effect by decreasing apoptosis of cardiomyocytes and inhibiting expression of inflammatory mediators after myocardial ischemia. Objectives: The objective of this study was to understand the mechanism of the APC‐mediated cardioprotection against ischemic injury. Methods: Cardioprotective activities of wild‐type APC and two derivatives, having either dramatically reduced anticoagulant activity or lacking signaling activity, were monitored in an acute ischemia/reperfusion injury model in which the left anterior descending coronary artery (LAD) was occluded. Results: APC reduced the myocardial infarct size by a mechanism that was largely independent of its anticoagulant activity. Thus, the non‐anticoagulant APC‐2Cys mutant, but not the non‐signaling APC‐E170A mutant, attenuated myocardial infarct size by EPCR and PAR‐1‐dependent mechanisms. Further studies revealed that APC acts directly on cardiomyocytes to stimulate the AMP‐activated protein kinase (AMPK) signaling pathway. The activation of AMPK by APC ameliorated the post‐ischemic cardiac dysfunction in isolated perfused mouse hearts. Moreover, both APC and APC‐2Cys inhibited production of TNFα and IL‐6 in vivo by attenuating the ischemia/reperfusion‐induced JNK and NF‐κB signaling pathways. Conclusions: APC exerts a cardioprotective function in ischemic/reperfusion injury through modulation of AMPK, NF‐κB and JNK signaling pathways.     

The cardioprotective effects of mineralocorticoid receptor antagonists

Despite state-of-the-art reperfusion therapy, morbidity and mortality remain significant in patients with an acute myocardial infarction. Therefore, novel strategies to limit myocardial ischemia–reperfusion injury are urgently needed. Mineralocorticoid receptor (MR) antagonists are attractive candidates for this purpose, since several clinical trials in patients with heart failure have reported a survival benefit with MR antagonist treatment. MRs are expressed by several cells of the cardiovascular system, including cardiomyocytes, cardiac fibroblasts, vascular smooth muscle cells, and endothelial cells. Experiments in animal models of myocardial infarction have demonstrated that acute administration of MR antagonists, either before ischemia or immediately at the moment of coronary reperfusion, limits infarct size. This action appears to be independent of the presence of aldosterone and cortisol, which are the endogenous ligands for the MR. The cardioprotective effect is mediated by a nongenomic intracellular signaling pathway, including adenosine receptor stimulation, and activation of several components of the Reperfusion Injury Salvage Kinase (RISK) pathway. In addition to limiting infarct size, MR antagonists can improve scar healing when administered shortly after reperfusion and can reduce cardiac remodeling post myocardial infarction. Clinical trials are currently being performed studying whether early administration of MR antagonists can indeed improve prognosis in patients with an acute myocardial infarction, independent of the presence of heart failure.     

Early treatment with hepatocyte growth factor improves cardiac function in experimental heart failure induced by myocardial infarction

Plasma levels of hepatocyte growth factor (HGF) are increased within hours of cardiac ischemia/reperfusion in rats, and HGF has been shown to be cardioprotective toward acute ischemic injury. Myocardial levels of HGF mRNA and protein are increased for several days after myocardial infarction (MI), however, indicating a possible additional protective effect of HGF toward the progression of MI to heart failure. The purpose of this study was to determine whether HGF administration during the time course of endogenous cardiac HGF induction would lead to long-term improvement in cardiac function in rats with MI. MI was induced by 2-h occlusion of the left coronary artery, followed by reperfusion. HGF was given by intravenous infusion at 0.45 mg/kg/day for 6 days beginning on the day after surgery. Cardiac function and hemodynamic parameters were measured by using indwelling catheters and perivascular flow probes in conscious animals 8 weeks post-MI. Myocardial infarcts were approximately 30% of the left ventricle, and there was no difference in infarct size between the vehicle-treated and HGF-treated groups. Compared with untreated sham-operated rats, vehicle-treated MI animals had significantly lower cardiac index and stroke volume index and higher systemic vascular resistance, indicating heart failure developed. Treatment with HGF caused a significant increase in cardiac index and stroke volume index and a reduction in systemic vascular resistance in rats with MI, restoring these parameters close to those observed in sham-operated control animals. These results provide direct evidence that HGF may be of benefit to cardiovascular function in ischemic cardiomyopathy.     

Effect of naloxone on expression of Bcl-2 protein and tumor necrosis factor-alpha in rats with acute myocardial ischemia/reperfusion injury]

OBJECTIVE: To investigate the effect of naloxone on myocardial cell apoptosis and apoptosis-related gene Bcl-2 in rats with acute myocardial ischemia/reperfusion (AMIR) injury, and explore the mechanism of protective effect of naloxone on myocardium. METHODS: Thirty SD rats were randomly divided into three groups (n=10): ischemia/reperfusion group, naloxone preconditioning group (naloxone was injected intraperitoneally 10 minutes before ischemia and 2 hours after reperfusion), and normal control group. The left anterior descending branch (LAD) of rat coronary artery was tied and untied in ischemia/reperfusion group and naloxone preconditioning group to establish the AMIR model in rats. The animals were then sacrificed and hearts were harvested. The expression of Bcl-2 protein was observed by immunohistochemical technique. Radioimmunoassay (RIA) was used to determine tumor necrosis factor-alpha (TNF-alpha) in serum. RESULTS: In the normal control group, there was no Bcl-2 expression and TNF-alpha level was (0.39+/-0.06) mug/L. Higher expression of Bcl-2 and increased TNF-alpha levels were found in ischemia/reperfusion group. The expression of Bcl-2 protein increased significantly [(+++) vs. (+)], and TNF-alpha was significantly lower in naloxone preconditioning group than those in the normal control group [(0.55+/-0.12) microg/L vs. (0.86+/-0.11) microg/L, P<0.01]. CONCLUSION: Naloxone can protect myocardium from AMIR injury by inhibiting the apoptosis of cardiomyocytes induced by TNF-alpha and up-regulating protein expression of bcl-2 gene.     

The production of hydrogen sulfide limits myocardial ischemia and reperfusion injury and contributes to the cardioprotective effects of preconditioning with endotoxin, but not ischemia in the rat

We investigated whether (endogenous) hydrogen sulfide (H2S) protects the heart against myocardial ischemia and reperfusion injury. Furthermore, we investigated whether endogenous H2S is involved in the protection afforded by (1) ischemic preconditioning and (2) the second window of protection caused by endotoxin. The involvement of one of the potential (end) effectors of the cardioprotection afforded by H2S was investigated using the mitochondrial KATP channel blocker, 5-hydroxydecanoate (5-HD; 5 mg/kg). Animals were subjected to 25 min regional myocardial ischemia followed by reperfusion (2 h) and were pretreated with the H2S donor, sodium hydrosulfide (3 mg/kg i.v.). Animals were also subjected to shorter periods of myocardial ischemia (15 min) and reperfusion (2 h) and pretreated with an irreversible inhibitor of cystathionine-gamma-lyase, dl-propargylglycine (PAG; 50 mg/kg i.v.). Animals were also pretreated with PAG (50 mg/kg) and subjected to either (1) ischemic preconditioning or (2) endotoxin (1 mg/kg i.p.) 16 h before myocardial ischemia. Myocardial infarct size was determined by p-nitroblue tetrazolium staining. Administration of sodium hydrosulfide significantly reduced myocardial infarct size, and this effect was abolished by 5-HD. Administration of PAG (50 mg/kg) or 5-HD significantly increased infarct size caused by 15 min of myocardial ischemia. The delayed cardioprotection afforded by endotoxin was abolished by 5-HD or PAG. In contrast, PAG (50 mg/kg) did not affect the cardioprotective effects of ischemic preconditioning. These findings suggest that (1) endogenous H2S is produced by myocardial ischemia in sufficient amounts to limit myocardial injury and (2) the synthesis or formation of H2S by cystathionine-gamma-lyase may contribute to the second window of protection caused by endotoxin.     

L-NAME enhances microcirculatory congestion and cardiomyocyte apoptosis during myocardial ischemia-reperfusion in rats

Besides necrosis, apoptosis is the other major mode of cardiomyocyte loss in ischemic cardiovascular disease. In the present study, we examined the hypothesis that nitric oxide (NO) protects myocardial function by improving myocardial microcirculation and attenuating cardiomyocyte apoptosis in a rat model of myocardial ischemia/reperfusion (MI/R). The left main coronary artery of anesthetized male rats was ligated for 40 min, followed by 4 h reperfusion. Four groups of animals were studied: sham operated control + saline; sham operated control + N(W)-nitro-L-arginine methyl ester (L-NAME); MI/R + saline; MI/R + L-NAME (10 mg/kg, iv, 10 min prior to reperfusion). Results show that MI/R caused a decrease in mean arterial blood pressure (MABP), cardiac index (CI), and stroke volume index (SVI). Inhibition of NO synthesis by L-NAME attenuated plasma NO levels, but increased MABP and SVR in sham control rats and rats subjected to MI/R, and further depressed left ventricular function in rats subjected to MI/R as indicated by decreased CI and SVI. Furthermore, administration of L-NAME to rats subjected to MI/R enhanced cardiomyocyte apoptosis as indicated by a significant increase in DNA fragmentation compared to rats with MI/R alone. Histological study revealed that L-NAME caused arterial constriction and congestion of red blood cells in arteries and capillaries in the peri-ischemic areas of the hearts in rats subjected to MI/R and, interestingly, also in the sham control rats. Data suggest that the mechanism of increased reperfusion injury may be attributable to a "no-reflow" phenomenon induced by L-NAME, resulting in increased cardiomyocyte apoptosis secondary to ischemia and enhanced cytochrome-c release from mitochondria. In addition, cardiac injury may be increased due to the augmented oxygen consumption of cardiomyocytes caused by the increased SVR and afterload. These results suggest that endogenous NO may act to improve myocardial microvascular perfusion, reduce SVR, and limit cardiomyocyte apoptosis, thereby, attenuating myocardial dysfunction induced by MI/R.     

Current perspectives on protective roles of erythropoietin in cardiovascular system: erythropoietin receptor as a novel therapeutic target

Erythropoietin (EPO) is a principal regulator that promotes proliferation and terminal differentiation of erythroid progenitor cells. EPO receptors are expressed not only in hematopoietic lineage cells but also in the cardiovascular system. We performed animal experiments using transgene-rescued EPO receptor null mutant mice (EpoR-/- rescued) that express the EPO receptor exclusively in the hematopoietic cells. The results of these experiments suggest that endogenous EPO/EPO receptor system in the heart exerts cardioprotective effects against myocardial injury induced by ischemia followed by reperfusion and pressure-overload induced left ventricular dysfunction. Many animal experiments have shown that the administration of recombinant human EPO also elicits cardioprotective effects against myocardial injury induced by ischemia and reperfusion. In contrast to the promising results of these animal experiments, recent clinical trials failed to demonstrate the reduction in infarct size or improvement of cardiac function by the administration of recombinant human EPO in patients with acute myocardial infarction who underwent primary percutaneous coronary intervention. It should be tested in future clinical studies whether a relatively low dose of recombinant human EPO or its derivatives that have no erythropoietic action reduces infarct size and ameliorates cardiac dysfunction in patients with acute myocardial infarction. In this article, we review implications of anemia associated with chronic heart failure, roles of the endogenous EPO/EPO receptor system, and the effects of the administration of erythropoiesis-stimulating agents in pathologic conditions of the heart by focusing on the EPO receptor as a potential candidate of novel therapeutic targets in cardiovascular diseases.     

三羟基异黄酮对兔缺血心肌的保护作用

目的探讨三羟基异黄酮(GST)对缺血/再灌注(I/R)心肌的保护效果及可能机制。方法结扎雄兔冠脉左前降支建立心肌I/R模型:心肌缺血40 min,然后再灌注2 h。分4组:Sham组:冠脉不结扎;I/R组;GST+I/R组:心肌缺血前5 min静脉注入1.0 mg/kg GST;Vehicle+I/R组:心肌缺血前5 min静脉注入1 mL二甲基亚砜。检测血清乳酸脱氢酶及肌酸激酶活性,再灌注结束后通过Evans蓝-TTC染色判断心肌梗死范围,TUNEL法检测心肌细胞凋亡。结果与I/R组及Ve-hicle+I/R组相比,GST+I/R组心肌梗死范围、心肌酶活性及细胞凋亡指数均显著降低(P<0.01),而前两组之间无显著差异。结论心肌缺血前给予GST能有效地减轻心肌I/R损伤,抗凋亡和减少心肌细胞坏死是其发挥效应的两条途径。     

Inhibition of ischemic cardiomyocyte apoptosis through targeted ablation of Bnip3 restrains postinfarction remodeling in mice

Following myocardial infarction, nonischemic myocyte death results in infarct expansion, myocardial loss, and ventricular dysfunction. Here, we demonstrate that a specific proapoptotic gene, Bnip3, minimizes ventricular remodeling in the mouse, despite having no effect on early or late infarct size. We evaluated the effects of ablating Bnip3 on cardiomyocyte death, infarct size, and ventricular remodeling after surgical ischemia/reperfusion (IR) injury in mice. Immediately following IR, no significant differences were observed between Bnip3(-/-) and WT mice. However, at 2 days after IR, apoptosis was diminished in Bnip3(-/-) periinfarct and remote myocardium, and at 3 weeks after IR, Bnip3(-/-) mice exhibited preserved LV systolic performance, diminished LV dilation, and decreased ventricular sphericalization. These results suggest myocardial salvage by inhibition of apoptosis. Forced cardiac expression of Bnip3 increased cardiomyocyte apoptosis in unstressed mice, causing progressive LV dilation and diminished systolic function. Conditional Bnip3 overexpression prior to coronary ligation increased apoptosis and infarct size. These studies identify postischemic apoptosis by myocardial Bnip3 as a major determinant of ventricular remodeling in the infarcted heart, suggesting that Bnip3 may be an attractive therapeutic target.     

Macrophages mediate cardioprotective cellular postconditioning in acute myocardial infarction

Ischemic injury in the heart induces an inflammatory cascade that both repairs damage and exacerbates scar tissue formation. Cardiosphere-derived cells (CDCs) are a stem-like population that is derived ex vivo from cardiac biopsies; they confer both cardioprotection and regeneration in acute myocardial infarction (MI). While the regenerative effects of CDCs in chronic settings have been studied extensively, little is known about how CDCs confer the cardioprotective process known as cellular postconditioning. Here, we used an in vivo rat model of ischemia/reperfusion (IR) injury–induced MI and in vitro coculture assays to investigate how CDCs protect stressed cardiomyocytes. Compared with control animals, animals that received CDCs 20 minutes after IR had reduced infarct size when measured at 48 hours. CDCs modified the myocardial leukocyte population after ischemic injury. Specifically, introduction of CDCs reduced the number of CD68⁺ macrophages, and these CDCs secreted factors that polarized macrophages toward a distinctive cardioprotective phenotype that was not M1 or M2. Systemic depletion of macrophages with clodronate abolished CDC-mediated cardioprotection. Using both in vitro coculture assays and a rat model of adoptive transfer after IR, we determined that CDC-conditioned macrophages attenuated cardiomyocyte apoptosis and reduced infarct size, thereby recapitulating the beneficial effects of CDC therapy. Together, our data indicate that CDCs limit acute injury by polarizing an effector macrophage population within the heart.     

Cytoprotective effect of sodium orthovanadate on ischemia/reperfusion-induced injury in the rat heart involves Akt activation and inhibition of fodrin breakdown and apoptosis

In a rat model of myocardial ischemic infarction, sodium orthovanadate rescued cells from ischemia/reperfusion injuries. Rats underwent 30 min of myocardial ischemia by occluding the left coronary artery followed by 24 h of reperfusion. Post-treatment with orthovanadate reduced infarct size in a dose-dependent manner. Orthovanadate treatment also ameliorated contractile dysfunction of the left ventricle 72 h after reperfusion. The cytoprotective action of orthovanadate treatment was closely associated with inhibition of fodrin breakdown. Since orthovanadate is a potent inhibitor for protein tyrosine phosphatases, thereby activating tyrosine kinases and phosphatidylinositol 3-kinase (PI3K) pathways, we investigated activities of protein kinase B (Akt), a downstream target of PI3K in cardiomyocytes. Orthovanadate-induced cytoprotection was associated with partial restoration of reduced Akt activity following myocardial infarction. Restoration of Akt activity by orthovanadate treatment correlated positively with increased phosphorylation of glycogen synthase kinase-3beta and Bad in cardiomyocytes. Furthermore, orthovanadate treatment inhibited caspase-3 activation induced by ischemia. Taken together, orthovanadate post-treatment rescued cardiomyocytes from ischemia/reperfusion injuries via Akt activation and inhibition of fodrin breakdown, thereby inhibiting apoptosis.     

远隔缺血适应渐进模式对大鼠心肌缺血再灌注损伤的研究

目的：分析远隔缺血时不同适应渐进模式对大鼠心肌缺血再灌注损伤的心肌保护作用及其机制。方法：采用大鼠在体心肌缺血-再灌注损伤模型,并应用随机抽签法将60只实验大鼠随机分为假手术组、缺血/再灌注对照组、标准机械后适应组、标准远隔时适应组、正向渐进模式远隔时适应组、负向渐进模式远隔时适应组6组,每组各10只。同时采用称重法检测实验大鼠心肌梗死范围,TUNEL法检测细胞凋亡,分光光度计测MPTP开放程度,并应用蛋白印迹分析检测心肌细胞内p-STAT-3、p-Jak2、p-Akt、p-ERK1/2的蛋白表达情况,比较各组实验结果。结果：与缺血/再灌注对照组相比,标准机械后适应组、标准远隔时适应组、正向渐进模式远隔时适应组、负向渐进模式远隔时适应组的心肌梗死面积、心肌凋亡率以及MPTP开放程度明显更低,且正向渐进模式远隔时适应组显著低于其他组(P<0.05)。蛋白印迹检测显示,正向渐进模式远隔时适应组的p-STAT-3、p-Jak2、p-Akt、p-ERK1/2表达较其他组别显著提高(P<0.05)。结论：正向渐进远隔时适应模式可以发挥较传统标准模式更好的心肌保护作用,其作用机制可能与激活RISK和SAFE途径,抑制MPTP开放有关。     

钙拮抗剂硝苯吡啶对大鼠心肌缺血再灌注损伤的作用

目的研究钙拮抗剂(Calcium antagonists)硝苯吡啶(Nifedipine)对离体大鼠心肌缺血再灌注损伤的作用。方法 30只体重在260-300g的Wistar雄性大鼠随机分为三组:对照组、模型组、Nifedipine组(1μmmol/L)。大鼠麻醉后取出心脏,悬挂于Langendorff灌流装置上行主动脉逆行灌流,制备大鼠离体心脏缺血30min、再灌注120min模型;对照组行150min正常灌流。测定心肌梗死面积,检测SOD(Superoxidedismutas超氧化物歧化酶)及MDA(mal-onaldehyde丙二醛)的含量,免疫组化方法行PKCδ(The protein kinase C蛋白激酶C)的测定,用RT-PCR法测定NCX(Na+/Ca2+exchanger钠钙交换体)及SERCA2α(Sareoplasmie reticulum calcium adenodine triphosphatase肌浆网钙泵)的表达。结果硝苯吡啶组心肌梗死面积较模型组明显缩小(P<0.01);冠脉灌流液中SOD活性明显升高(P<0.01);MDA含量显著下降(P<0.01);药物组的PKC含量水平较模型组增多(P<0.05),药物组NCX mRNA的表达水平较模型组降低,存在显著差异(P<0.05)。结论钙拮抗剂Nifedipine对大鼠心肌缺血再灌注损伤有保护作用。     

Antiarrhythmic effect of caffeic acid phenethyl ester (CAPE) on myocardial ischemia/reperfusion injury in rats

OBJECTIVES: The present study was designed to determine the antiarrhythmic effect of caffeic acid phenethyl ester (CAPE), an active component of propolis, which exhibits antioxidant properties, in rats subjected to myocardial ischemia and ischemia-reperfusion (I/R) injury. DESIGN AND METHODS: Rats were subjected to 30 min coronary artery occlusion for evaluating the effect of CAPE on the myocardial ischemia injury. While in the myocardial I/R injury study, the coronary artery was ligated for a 5-min period of ischemia followed by a 30-min period of reperfusion. Animals were pretreated with or without CAPE before coronary artery ligation and the severity of myocardial ischemia- and I/R-induced arrhythmias and mortality were compared. RESULTS: Pretreatment of CAPE (0.1 and 1 microg/kg) not only reduced both the incidence and duration of ventricular tachycardia (VT) and ventricular fibrillation (VF) but also decreased the mortality during the myocardial ischemia and I/R injury period. CONCLUSIONS: Our results suggest that CAPE is a potent antiarrhythmic agent with cardioprotective effects in myocardial ischemia and I/R injury rats.     

Aldehyde dehydrogenase 2 preserves mitochondrial morphology and attenuates hypoxia/reoxygenation-induced cardiomyocyte injury

BACKGROUND: Disturbance of mitochondrial fission and fusion (termed mitochondrial dynamics) is one of the leading causes of ischemia/reperfusion (I/R)-induced myocardial injury. Previous studies showed that mitochondrial aldehyde dehydrogenase 2 (ALDH2) conferred cardioprotective effect against myocardial I/R injury and suppressed I/R-induced excessive mitophagy in cardiomyocytes. However, whether ALDH2 participates in the regulation of mitochondrial dynamics during myocardial I/R injury remains unknown.     

心肌缺血再灌注损伤模型大鼠心肌组织及血清肌钙蛋白Ⅰ表达和心肌肿瘤坏死因子α与重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白的干预

背景:心肌缺血再灌注时生成大量的肿瘤坏死因子α直接造成心肌的收缩功能下降。目的:观察药物重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对大鼠缺血再灌注心肌损伤的影响。方法:成年雄性Wistar大鼠建立心肌缺血再灌注模型。药物干预组在再灌注前注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白,模型组给予生理盐水,并设立不造模的假手术组。再灌注后立即测量心肌梗死面积,ELISA检测再灌注后的心肌肿瘤坏死因子α及血清肌钙蛋白Ⅰ的含量,实时PCR检测心肌肿瘤坏死因子αmRNA的表达。结果与结论:与假手术组相比,模型组与药物干预组大鼠心肌肿瘤坏死因子α及其mRNA和肌钙蛋白的水平明显升高(P<0.05);与模型组相比,药物干预组心肌肿瘤坏死因子α及血清肌钙蛋白Ⅰ水平明显升高(P<0.05),心肌梗死体积与肿瘤坏死因子αmRNA的表达减少(P<0.05)。提示重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白能够减轻心肌缺血/再灌注损伤作用,改善大鼠的心功能。     

心肌缺血再灌注损伤模型大鼠心肌组织及血清肌钙蛋白Ⅰ表达和心肌肿瘤坏死因子α与重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白的干预

背景：心肌缺血再灌注时生成大量的肿瘤坏死因子α直接造成心肌的收缩功能下降。目的：观察药物重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对大鼠缺血再灌注心肌损伤的影响。方法：成年雄性Wistar大鼠建立心肌缺血再灌注模型。药物干预组在再灌注前注射重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白,模型组给予生理盐水,并设立不造模的假手术组。再灌注后立即测量心肌梗死面积,ELISA检测再灌注后的心肌肿瘤坏死因子α及血清肌钙蛋白Ⅰ的含量,实时PCR检测心肌肿瘤坏死因子αmRNA的表达。结果与结论：与假手术组相比,模型组与药物干预组大鼠心肌肿瘤坏死因子α及其mRNA和肌钙蛋白的水平明显升高（P〈0.05）;与模型组相比,药物干预组心肌肿瘤坏死因子α及血清肌钙蛋白Ⅰ水平明显升高（P〈0.05）,心肌梗死体积与肿瘤坏死因子αmRNA的表达减少（P〈0.05）。提示重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白能够减轻心肌缺血/再灌注损伤作用,改善大鼠的心功能。     

大鼠心肌缺血再灌注中细胞凋亡及Bcl-2、C-myc的表达研究

目的观察心肌缺血再灌注时心肌细胞凋亡现象,研究Bcl-2、C-myc蛋白的表达情况。方法采用末端标记技术(TUNEL)标记凋亡细胞,免疫组织化学法检测Bcl-2、C-myc蛋白的表达。结果在持续缺血和缺血再灌注大鼠心肌中,TUNEL法检测到大量的阳性细胞。随着再灌注时间的延长,大鼠心肌细胞凋亡数逐渐增多。持续缺血4.5 h组的心肌细胞凋亡数明显高于缺血30min再灌注4 h组的凋亡心肌细胞数。免疫组织化学法检测发现,与假手术组比较,持续缺血4.5 h组和缺血30min再灌注4 h组Bcl-2、C-myc蛋白的表达都增加,缺血再灌注组中Bcl-2蛋白表达明显上调,C-myc蛋白表达明显下调。结论心肌缺血再灌注中存在细胞凋亡现象,且心肌细胞凋亡与Bcl-2、C-myc蛋白的表达密切相关。     

Reduction of infarct size in a rat model of regional myocardial ischemia and reperfusion by the synthetic peptide DAHK

OBJECTIVE: The increased mobilization of iron and copper during ischemia is reported to contribute to postischemic injury. DMI-4983 is a small synthetic peptide, Asp-Ala-His-Lys (DAHK), that mimics the high-affinity copper-binding site of the N-terminus of human albumin. This peptide was reported to inhibit copper-induced formation of reactive oxygen species in vitro, reduce interleukin-8 formation in cultured endothelial cells, and improve left ventricular function after global ischemia and reperfusion in the isolated blood-perfused heart of the rat. The aim of this study was to investigate the effects of DMI-4983 on myocardial infarct size caused by regional ischemia and reperfusion in vivo. DESIGN: Rats were subjected to regional myocardial ischemia (25 mins) followed by reperfusion (2 hrs). Randomized groups received either vehicle or DMI-4983 administered as a 5, 10, or 20 mg/kg intravenous bolus along with a 10 mg/kg/hr continuous infusion starting just before reperfusion and continuing throughout the experiment. Infarct size was determined at the end of the experiment. SETTING: Basic research institute and trauma research laboratory. SUBJECTS: Anesthetized male Wistar rats. MEASUREMENTS AND MAIN RESULTS: The area at risk of infarction and hemodynamic variables were similar in all groups. Rats treated with vehicle resulted in an infarct size of 64% +/- 3% of the area at risk of infarction. Intravenous administration of DMI-4983 reduced infarct size to 52% +/- 3%, 50% +/- 2%, and 45% +/- 3% of the area at risk of infarction for 5, 10, and 20 mg/kg, respectively (p < .05 compared with vehicle for each dosage). CONCLUSIONS: Intravenous DMI-4983 administered before the onset of reperfusion and continuously throughout the reperfusion period caused a significant reduction in tissue necrosis in this in vivo model of regional myocardial ischemia and reperfusion, suggesting that DMI-4983 may represent a novel approach for the treatment of myocardial ischemia and reperfusion injury.