吉非罗齐对高脂血症兔心肌缺血再灌注损伤的影响及机制

目的探讨吉非罗齐对高脂血症兔心肌缺血再灌注损伤的影响。方法24只新西兰大白兔随机分成缺血再灌注组、吉非罗齐 缺血再灌注组(简称吉非罗齐组)和假手术组,所有动物给以高脂饮食9周以建立高脂血症兔模型,吉非罗齐组在喂养8周后同时给予吉非罗齐200mg(kg·d)口服1周。冠状动脉左前降支结扎法复制心肌缺血再灌注损伤模型。9周后观察各组血脂水平的变化及心肌细胞超微结构改变,并测定心肌梗死面积。逆转录聚合酶链反应测定心肌过氧化体增殖物激活型受体α和脂肪酸转位酶CD36 mRNA的表达。结果喂饲高脂饮食后,兔血清总胆固醇、低密度脂蛋白胆固醇水平明显升高(P<0.01),吉非罗齐干预1周未对血脂水平产生影响。吉非罗齐组心肌梗死面积较缺血再灌注组明显减少(P<0.05);且心肌细胞超微结构损伤明显低于缺血再灌注组。缺血再灌注组心肌过氧化体增殖物激活型受体α和CD36 mRNA的表达低于假手术组(P<0.05),而吉非罗齐组与假手术组过氧化体增殖物激活型受体α和CD36 mRNA的表达无明显差异(P>0.05)。结论吉非罗齐短期干预可减少高脂血症兔缺血再灌注后心肌梗死面积,并上调心肌过氧化体增殖物激活型受体α和CD36 mRNA的表达。     

吡格列酮通过p-CREB蛋白对大鼠缺血再灌注损伤心肌保护机制的研究

目的通过检测大鼠心肌缺血再灌注p-CREB蛋白表达的变化,探讨吡格列酮对大鼠缺血再灌注损伤心肌保护机制。方法将55只SD大鼠随机分为假手术组、缺血再灌注组、吡格列酮组、吡格列酮+GW9662组,左前降支结扎的方法建立缺血再灌注损伤模型,伊文思蓝染色测定心肌梗死面积,Western blot法测定心肌组织p-CREB蛋白表达。结果吡格列酮组梗死面积与缺血再灌注组比较明显减少(P0.05),与吡格列酮组比较,吡格列酮+GW9662组梗死面积差异有统计学意义(P0.05)。与假手术组和缺血再灌注组相比,吡格列酮组p-CREB蛋白表达明显增加(P0.05),吡格列酮+GW9662组p-CREB蛋白表达无明显变化(P0.05);与吡格列酮组相比,吡格列酮+GW9662组p-CREB蛋白表达减少,差异有统计学意义(P0.05)。结论吡格列酮可能上调p-CREB蛋白表达进而抑制缺血再灌注诱导的心肌细胞损伤,GW9662可逆转吡格列酮对心肌细胞的保护作用。     

脂联素对大鼠心肌缺血再灌注损伤的保护作用

目的 观察脂联素对大鼠心肌缺血再灌注损伤的保护作用并探讨其机制.方法 32只8周龄雄性大鼠随机分为假手术组、缺血再灌注组、地尔硫革组和脂联素组,每组8只.(1)假手术组:只穿线,旷置90 min.(2)缺血再灌注组:先阻断血流30 min,再灌注60 min.(3)地尔硫(革)组和脂联素组:先阻断血流30 min,于再灌注开始时,从鼠尾静脉分别注射地尔硫(革)(3.5 μg·g~(-1)min~(-1))或脂联素(60 ng·g~(-1)·min~(-1)),注射2 min,再灌注60 min.各模型组于再灌注60 min后处死大鼠.测定心肌组织一氧化氮(NO),心肌组织半胱氨酸蛋白酶3(Caspase 3)活性,心肌组织腺苷酸活化蛋白激酶(AMPK)活性,过氧化物酶体增殖物激活受体γ(PPARγ)的含量,同时用透射电镜观察大鼠心肌线粒体结构.结果 (1)缺血再灌注组心肌组织中Caspase 3活性显著高于假手术组[(168.50±30.08)μmol/L比(53.25±11.41)μmol/L,P<0.01],AMPK活性、PPARγ含量均显著低于假手术组[(0.74±0.59)IU/ml比(25.63±4.61)IU/ml,P<0.01;0.1894比0.7949,P<0.01],心肌组织中NO含量显著低于假手术组[(6.359±1.355)μmol/L比(10.396±1.901)μmol.L,P<0.01].(2)脂联素组心肌组织中Caspase 3活性显著低于缺血再灌注组[(88.75±6.92)μmol/L比(168.50±30.08)μmol/L,P<0.01],AMPK活性、PPARγ含量均显著高于缺血再灌注组[(27.22 ±4.76)IU/ml比(0.74±0.59)IU/ml,P<0.01;0.8613比0.1894,P<0.01],心肌组织中NO含量显著高于缺血再灌注组[(15.755±1.045)μmol/L比(6.359±1.355)μmol/L,P<0.01].脂联素可保护急性心肌缺血再灌注过程中大鼠心肌细胞线粒体结构的完整性,上述作用优于地尔硫(革).结论 脂联素对缺血再灌注造成的心肌损伤有一定的保护作用,机制可能与其增加心肌细胞AMPK、PPARγ表达,以及抗心肌细胞凋亡作用有关.     

心肌缺血/再灌注损伤大鼠心肌组织PGC-1α的表达变化及意义

目的观察心肌缺血/再灌注损伤大鼠心肌组织过氧化物酶体增殖物受体γ(PPARγ)辅助激活因子1α(PGC-1α)的表达变化,并探讨其意义。方法将21只Wistar大鼠随机分为缺血/再灌注模型组(I/R组)、GW9662组、假手术组,各7例。I/R组采用在体结扎左前降支方法建立缺血/再灌注大鼠模型,结扎左前降支使其缺血30 min,再灌注120 min;GW9662组建立模型1 d前静脉注射GW9662,剂量0.3 mg/kg;假手术组开胸绕过左前降支不做冠状动脉结扎,剩余步骤同I/R组。RT-PCR法检测各组大鼠心肌组织PGC-1αmRNA,Western blotting法检测各组大鼠心肌组织PGC-1α蛋白,ELLSA法测定各组大鼠血清中肌钙蛋白I。结果 I/R组、GW9662组、假手术组PGC-1αmRNA分别为1.70±0.09、1.00±0.07、0.86±0.03,PGC-1α蛋白分别为2.80±0.21、1.00±0.15、0.65±0.05,I/R组、GW9662组与假手术组比较,I/R组与GW9662组比较,P均<0.05。I/R组、GW9662组PGC-1αmRNA及蛋白表达与其血清中c Tn I水平呈负相关(P均<0.05)。结论心肌缺血/再灌注损伤大鼠心肌组织中PGC-1α表达上调,与血清中c Tn I水平呈负相关,具有心脏保护作用。     

过氧化体增殖物激活型受体β/δ激活剂抑制体外血管紧张素Ⅱ诱导的心肌细胞肥大

目的探讨过氧化体增殖物激活型受体β/δ激活剂GW0742在体外对血管紧张素Ⅱ诱导的肥大心肌细胞的作用,分析过氧化体增殖物激活型受体β/δ在其中的可能作用。方法体外培养新生大鼠的心室肌细胞,用血管紧张素Ⅱ诱导建立心肌肥厚模型,在模型中加入GW0742,用软件分析心肌细胞表面积观察心肌细胞面积,3H-亮氨酸的掺入检测心肌细胞蛋白合成速率及使用逆转录聚合酶链反应半定量测定心房钠尿肽、脑钠尿肽和过氧化体增殖物激活型受体β/δmRNA的表达变化,用免疫荧光方法测定过氧化体增殖物激活型受体β/δ的蛋白表达水平。结果血管紧张素Ⅱ可使体外培养的心肌细胞面积和3H-亮氨酸的掺入增加,升高心房钠尿肽和脑钠尿肽的表达,过氧化体增殖物激活型受体β/δ表达下降;GW0742可逆转上述变化。结论GW0742具有抑制血管紧张素Ⅱ诱导的体外心肌细胞肥大的作用,很可能通过活化过氧化体增殖物激活型受体β/δ途径。     

PPARγ、脂联素抑制肝星状细胞增殖

目的探讨过氧化物酶体增殖物激活受体γ(PPARγ)对大鼠肝星状细胞(HSC)-T6生物学特性、脂联素表达的影响。方法将大鼠肝星状细胞培养后分成空白对照组;罗格列酮组;GW9662阻断组;罗格列酮+GW9662组。检测各组细胞的增殖情况;同时检测脂联素、PPARγm RNA及其蛋白表达情况。结果 MTT实验结果显示罗格列酮组的肝星状细胞增殖率较其他组明显减弱(P<0.01),脂联素、PPARγm RNA及蛋白表达量较其他组明显升高(P<0.01);且脂联素、PPARγ表达存在显著相关关系(P<0.01)。结论 PPARγ能上调脂联素的表达,抑制HSC增殖,抑制肝纤维化的发展。     

吡格列酮对大鼠缺血再灌注心肌p38丝裂原活化蛋白激酶表达的影响

目的观察临床用于降糖治疗的噻唑烷二酮类药物吡格列酮对大鼠缺血再灌注损伤心肌的保护作用及对p38丝裂原活化蛋白激酶表达的影响。方法将24只健康雄性SD大鼠随机分为4组:假手术组(Sham组)、缺血再灌注组(I/R组)、吡格列酮10mg/(kg·d)组(P组)、吡格列酮10mg/(kg·d)+过氧化物酶体增殖物激活受体γ(PPARγ)特异性阻断剂GW9662组(P+G组),每组6只;利用结扎左前降支的方法建立缺血再灌注损伤模型,脱氧核糖核苷酸末端转移酶介导的缺口原位末端标记法检测心肌细胞凋亡,Western blot方法检测心肌组织磷酸化p38(p-p38)蛋白的变化。结果与I/R组比较,Sham组、P组心肌细胞凋亡指数(AI)显著降低[(8.6±4.3)%、(21.4±8.8)%vs(40.1±12.3)%,P0.05];P+G组心肌细胞AI显著高于P组[(37.0±10.5)%vs(21.4±8.8)%,P0.05]。与I/R组比较,Sham组、P组p-p38蛋白表达下调,差异有统计学意义(P0.05),与P组比较,P+G组p-p38蛋白表达上调,差异有统计学意义(P0.05)。结论吡格列酮抑制缺血再灌注损伤诱导的心肌细胞凋亡,可能与下调p-p38表达有关,这2种作用是由PPARγ介导的。     

比较替米沙坦与缬沙坦对人动脉平滑肌细胞增殖及血管紧张素Ⅱ受体表达的影响

目的 比较缬沙坦与替米沙坦对离体人主动脉平滑肌细胞(HASMCs)增殖及对血管紧张素受体表达的影响.方法 HASMCs 复苏、传代后,分别用不同浓度及条件的血管紧张素Ⅱ(AngⅡ)、缬沙坦(Val)、替米沙坦(Tel)、GW9662 干预HASMCs,采用CCK-8 检测细胞增殖能力,Western blot 方法检测细胞血管紧张素Ⅱ受体(AT)蛋白表达.结果 25 μmol/L Tel 与25 μmol/L Val 相比可更强地抑制1 μmol/L AngⅡ诱导的HASMCs 增殖.Tel 可抑制无AngⅡ刺激的HASMCs 增殖,且呈剂量依赖性,而Val 无此作用.25 μmol/L Tel 及Val 抑制HASMCs 上AT1受体表达相同(8.6%比17.0%,P>0.05),但Tel 促进AT2受体表达作用更强(29.9%比10.5%,P<0.05).氧化物酶体增殖体激活受体-γ(PPAR-γ)抑制剂GW9662 能抑制吡格列酮对HASMCs 抑制增殖的作用,但不能影响Tel 对HASMCs 抑制增殖作用.结论 替米沙坦比缬沙坦具有更强的抑制HASMCs 增殖及促进AT2受体表达上调的作用.     

替米沙坦对腹主动脉缩窄大鼠内质网应激相关的心肌细胞凋亡的影响

目的 探讨血管紧张素Ⅱ受体拮抗剂替米沙坦对腹主动脉缩窄术后大鼠内质网应激相关的心肌细胞凋亡的影响.方法 30只雄性SD大鼠随机分为假手术组(n=10),腹主动脉缩窄组(n=10),腹主动脉缩窄+替米沙坦组(n=10).术后10周各组大鼠用导管法测量血液动力学指标并留取心肌标本测左心室质量指数,心肌细胞凋亡用TUNEL法检测,心肌内质网应激信号通路分子GRP78、CHOP用免疫印迹法和免疫组化法检测.结果 (1)腹主动脉缩窄组左心室质量指数(3.29±0.19)mg/g明显高于假手术组(2.17±0.22)ms/g(P<0.01),左心室舒张末压(9.71±0.52)mm Hg(1 mm Hg=0.133 kPa)亦明显高于假手术组(2.79±0.13)mm Hg,左心室收缩末压(105.61 ±6.66)mm Hg明显低于假手术组(135.02 ±5.95)mm Hg(P<0.01),而腹主动脉缩窄+替米沙坦组上述指标分别为(2.34 ±0.08)mg/g、(4.70±0.36)mm Hg、(127.62 ±4.99)mm Hg,明显优于腹主动脉缩窄组(P<0.01).(2)腹主动脉缩窄+替米沙坦组心肌细胞凋亡指数(13.42 ±0.74)%显著低于腹主动脉缩窄组(35.51 ±0.65)%(P<0.01).(3)腹主动脉缩窄组内质网应激信号分子GRP78、CHOP蛋白表达RGRP78/β-actin 0.436 ±0.007、RCHOP/β-actin 0.747±0.034显著高于假手术组RGRP78/β-actin 0.144±0.009、RCHOP/β0.316 ±0.007(P<0.01),而腹主动脉缩窄+替米沙坦组GRP78、CHOP(RGP78/β-actin 0.213±0.007、RCHOP/β0.451 ±0.019),明显低于腹主动脉缩窄组(P<0.01).结论 内质网应激参与了腹主动脉缩窄术后大鼠心肌细胞凋亡,替米沙坦对内质网应激相关的心肌细胞凋亡有保护作用.     

替米沙坦通过磷脂酰肌醇-3-激酶/丝苏氨酸蛋白激酶途径改善内皮祖细胞的功能活性

目的 研究替米沙坦对内皮祖细胞增殖、迁移、黏附等生物学活性的影响并探讨其可能机制.方法 利用密度梯度离心法分离、培养人外周血单个核细胞,经FITC-UEA-I和Dil-acLDL双染色鉴定为正在分化的内皮祖细胞.将分离、培养的内皮祖细胞分为对照组、替米沙坦组(0.1 μmol/L、1μmol/L、10μmol/L)、过氧化体增殖物激活型受体γ抑制剂(GW9662)干预组和磷脂酰肌醇-3-羟基激酶抑制剂(Ly294002)干预组.采用MTT比色法、Transwell小室、细胞计数法观察各组内皮祖细胞增殖、迁移、黏附能力的变化情况.同时采用免疫蛋白印迹法观察替米沙坦处理内皮祖细胞后丝苏氨酸蛋白激酶及磷酸化丝苏氨酸蛋白激酶的表达情况.结果 与对照组相比,替米沙坦组内皮祖细胞增殖、迁移、黏附能力显著提高,且在不同浓度组间呈剂量依赖性增强,而在过氧化体增殖物激活型受体γ抑制剂干预组和磷脂酰肌醇-3-羟基激酶抑制剂干预组,内皮祖细胞功能活性的改善受到明显的抑制.免疫蛋白印迹检测显示,相比于对照组,替米沙坦组磷酸化丝苏氨酸蛋白激酶的表达水平明显增高,而在过氧化体增殖物激活型受体γ抑制剂干预组磷酸化丝苏氨酸蛋白激酶的表达相比于对照组未见明显增高.结论 替米沙坦具有促进内皮祖细胞增殖、迁移、黏附等功能的作用,其主要机制可能与过氧化体增殖物激活型受体γ介导的磷脂酰肌醇-3-激酶/丝苏氨酸蛋白激酶信号通路激活有关.     

Telmisartan, a dual ARB/partial PPAR-γ agonist, protects myocardium from ischaemic reperfusion injury in experimental diabetes

Aim: Apart from its angiotensin receptor blocker (ARB) activity, telmisartan is also a partial agonist of peroxisome proliferator‐activated receptor gamma (PPAR‐γ). Therefore, we assessed whether telmisartan treatment attenuates myocardial ischaemia/reperfusion (I/R) injury in diabetic rats through PPAR‐γ pathway. Methods: Diabetic rats were randomized to receive vehicle (sham and I/R), telmisartan (10 mg/kg/day, orally), PPAR‐γ antagonist GW9662 (1 mg/kg/day, intraperitoneally) or both for 14 days. On 15th day, excluding sham group, left anterior descending coronary artery occlusion was performed for 45 min followed by 1 h of reperfusion. Haemodynamic, biochemical, histopathological, ultrastructural, immunohistochemical (Bax and Bcl‐2 protein), TUNEL positivity, infarct size and western blot studies were performed. Results: Telmisartan treatment significantly improved cardiac function by normalizing mean arterial pressure, left ventricular pressure (±LVdP/dt_max, a marker of myocardial contraction and relaxation), by decreasing left ventricular end‐diastolic pressure (a marker of preload, 3.7 ± 0.41 vs. 7.3 ± 0.89, p < 0.001) and percent infarct area (37.52 ± 5.83 vs. 46.27 ± 3.20, p < 0.01) as compared to diabetic I/R group. Interestingly, GW9662 worsens the I/R injury (percent infarct area, 54.38 ± 6.48 vs. 46.27 ± 3.20, p < 0.01), whereas telmisartan with GW9662 (percent infarct area, 41.16 ± 8.23 vs. 46.27 ± 3.20, p < 0.05) showed lesser significant results as compared to telmisartan alone. Additionally, telmisartan significantly ameliorates activities of endogenous antioxidants, creatine kinase‐MB isoenzyme, lactate dehydrogenase and prevented the increase of tumour necrosis factor‐alpha and malondialdehyde in myocardium. Furthermore, telmisartan also decreased Bax expression (4.45 ± 1.24% vs. 10.25 ± 0.96%, p < 0.01), number of TUNEL‐positive cells (6.2 ± 0.98% vs. 13.0 ± 1.6, p < 0.01), inflammation, myonecrosis and increased Bcl‐2 expression (5.45 ± 0.15% vs. 1.24 ± 0.3%, p < 0.01). On the other hand, GW9662 treatment alone increased the Bax expression, TUNEL positivity and decreased Bcl‐2 expression. Telmisartan protective effects were partially attenuated by a co‐administration with GW9662. Western blot analysis showed that telmisartan treatment enhanced PPAR‐γ expression, whereas GW9662 decreased it in myocardium. Conclusions: In addition to the class effect of ARBs, telmisartan has a beneficial effect in I/R injury in diabetic rats in part because of activation of PPAR‐γ.     

Effects of telmisartan, a unique angiotensin receptor blocker with selective peroxisome proliferator-activated receptor-gamma-modulating activity, on nitric oxide bioavailability and atherosclerotic change

OBJECTIVE: Telmisartan is a unique angiotensin II (Ang II) receptor blocker (ARB) with selective peroxisome proliferator-activated receptor-gamma (PPAR gamma). We therefore investigated the effects of telmisartan on endothelial function and atherosclerotic change in genetically hyperlipidemic rabbits, compared with candesartan, an ARB without PPAR gamma activity. METHODS: A total of 30 Watanabe heritable hyperlipidemic (WHHL) rabbits equally derived (n = 6 each) were treated with (1) vehicle (control), (2) GW9662, a PPAR gamma antagonist (0.5 mg/kg per day), (3) telmisartan (5 mg/kg per day), (4) telmisartan + GW9662, (5) candesartan (5 mg/kg per day) for 8 weeks. After treatment, acetylcholine (ACh)-induced nitric oxide production was measured as a surrogate for endothelium protective function, and vascular nitrotyrosine (a product of superoxide and nitric oxide) was measured for assessing dysfunctional endothelial nitric oxide synthase activity. Plaque area was quantified by histology. RESULTS: Telmisartan increased ACh-induced nitric oxide by 5.5 nmol/l, significantly more than control. Interestingly, cotreatment with GW9662 significantly attenuated telmisartan-induced ACh-induced nitric oxide almost to the levels observed with candesartan. Vascular nitrotyrosine concentration was 1.4 pmol/mg protein in the control group and significantly higher than that in the telmisartan or candesartan group. The lowest nitrotyrosine concentration was observed in the telmisartan group, which was significantly lower than that in the candesartan or telmisartan + GW9662 group. Histology of the thoracic aorta revealed that the plaque area was more significantly decreased in the telmisartan group than in the candesartan or telmisartan + GW9662 group. CONCLUSION: In addition to a class effect of ARBs, telmisartan may have additional effects on nitric oxide bioavailability and atherosclerotic change through its PPAR gamma-mediated effects in genetically hyperlipidemic rabbits.     

Cardioprotective mechanism of telmisartan via PPAR-gamma-eNOS pathway in dahl salt-sensitive hypertensive rats

BACKGROUND: Recently, some investigators have shown that telmisartan, an angiotensin II (Ang II)-receptor blocker (ARB), is a partial agonist of the peroxisome proliferator-activated receptor-gamma (PPAR-gamma). We investigate whether telmisartan improves cardiovascular remodeling associated with the production of endothelial nitric oxide synthase (eNOS) through PPAR-gamma, inhibits the Rho-kinase pathway, and suppresses oxidative stress in Dahl salt-sensitive (DS) hypertensive rats. METHODS: Telmisartan (1 mg/kg per day) or telmisartan plus PPAR-gamma inhibitor, GW9662 (1 mg/kg per day) was administered from the age of 6-11 weeks. Age-matched male Dahl salt-resistant (DR) rats served as a control group. RESULTS: The levels of eNOS and PPAR-gamma expression, and eNOS phosphorylation were significantly lower in DS rats than in DR rats. Chronic telmisartan treatment in DS rats significantly increased these parameters, but not telmisartan plus GW9662. Telmisartan effectively inhibited the vascular lesion formation such as medial thickness and perivascular fibrosis, but not telmisartan plus GW9662. Moreover, upregulated RhoA protein, Rho-kinase mRNA, and myosin light-chain phosphorylation in DS rats was decreased by telmisartan to a similar degree as observed after treatment with Y-27632, a selective Rho-kinase inhibitor. In addition, NAD(P)H oxidase p22phox, p47phox, gp91phox expression, and mitogen-activated protein kinase and its downstream effector p70 S6 kinase phosphorylation in DS rats was also inhibited by telmisartan. CONCLUSIONS: These results suggest that the cardioprotective mechanism of telmisartan may be partly due to improvement of endothelial function associated with PPAR-gamma-eNOS, oxidative stress, and Rho-kinase pathway.     

Peroxisome proliferator-activated receptor-γ activation with angiotensin II type 1 receptor blockade is pivotal for the prevention of blood-brain barrier impairment and cognitive decline in type 2 diabetic mice

We reported previously that an angiotensin II type 1 receptor blocker, telmisartan, improved cognitive decline with peroxisome proliferator-activated receptor-γ activation; however, the detailed mechanisms are unclear. Enhanced blood-brain barrier (BBB) permeability with alteration of tight junctions is suggested to be related to diabetes mellitus. Therefore, we examined the possibility that telmisartan could attenuate BBB impairment with peroxisome proliferator-activated receptor-γ activation to improve diabetes mellitus-induced cognitive decline. Type 2 diabetic mice KKA(y) exhibited impairment of cognitive function, and telmisartan treatment attenuated this. Cotreatment with GW9662, a peroxisome proliferator-activated receptor-γ antagonist, interfered with these protective effects of telmisartan against cognitive function. BBB permeability was increased in both the cortex and hippocampus in KKA(y) mice. Administration of telmisartan attenuated this increased BBB permeability. Coadministration of GW9662 reduced this effect of telmisartan. Significant decreases in expression of tight junction proteins and increases in matrix metalloproteinase expression, oxidative stress, and proinflammatory cytokine production were observed in the brain, and treatment with telmisartan restored these changes. Swollen astroglial end-feet in BBB were observed in KKA(y) mice, and this change in BBB ultrastructure was decreased in telmisartan. These effects of telmisartan were weakened by cotreatment with GW9662. In contrast, administration of another angiotensin II type 1 receptor blocker, losartan, was less effective compared with telmisartan in terms of preventing BBB permeability and astroglial end-foot swelling, and coadministration of GW9662 did not affect the effects of losartan. These findings are consistent with the possibility that, in type 2 diabetic mice, angiotensin II type 1 receptor blockade with peroxisome proliferator-activated receptor-γ activation by telmisartan may help with protection against cognitive decline by preserving the integrity of the BBB.     

NF-kB在大鼠肝缺血再灌注损伤中的活化及意义

目的探讨NFkB在肝缺血再灌注损伤过程中的作用。方法选择健康雌性Wistar大鼠24只,随机分为手术对照组,肝缺血90min组,肝缺血90min/再灌注120min组,每组8只。常规方法观察肝脏组织学改变,检测血清酶学水平和肝组织中髓过氧化物酶(MPO)含量,采用sABC免疫组织化学方法测定肝组织中NFkB的活化程度。结果手术对照组肝组织形态正常,无NFkB活化,肝功能酶学和MPO正常水平;缺血组动物肝细胞索排列紊乱,肝小叶变形,肝细胞和内皮细胞普遍水肿变性,NFkB呈中重度活化,血清酶学和MPO水平升高(P<0.01);肝缺血/再灌注组肝组织在缺血组改变基础上合并中央区局灶性肝细胞坏死,血窦内微血栓形成,汇管区中性粒细胞浸润,NFkB活化最为明显,血清酶学和MPO升高最为显著(P<0.01)。结论肝缺血再灌注时,NFkB被活化,使中性粒细胞组织浸润,对肝脏缺血再灌注损伤病理过程起到重要的作用。     

大白兔肝缺血再灌注损伤时血浆内毒素的变化及对肝肾功能的影响

目的探讨肝缺血再灌注损伤过程中,肠源性内毒素的动态变化和继发性肝肾功能损害。方法取27只健康成年新西兰大白兔,体重1.4~2.3?,随机分为对照组7只,另外20只作为实验组。以缺血10min(I10min)、缺血20min(I20min)、缺血30min(I30min)和分别再灌注30min(R30min)随机分为3组。对照组取门、腔静脉血测肝肾功能及血浆内毒素,实验组阻断第一肝门造成不同的缺血时段,松开血管夹再灌注30min,其余实验同对照组。结果实验组中血浆谷草转氨酶、谷丙转氨酶、尿素氮、肌苷含量及内毒素浓度均有升高,在I10min/R30min组即有升高,但与对照组相比差异无显著性(P>0.05);而后随着缺血时间的延长这些指标继续明显升高,至I30min/R30min组达最高值,与对照组比差异有显著性(P<0.05~0.01)。肾组织电镜观察发现I10min/R30min组肾脏超微结构无明显改变,而I20min/R30min组和I30min/R30min组肾脏超微结构损害明显。结论肝门阻断后门静脉系统淤血,致肠源性内毒素产生和移位;肝门再开放造成肝缺血再灌注损伤,且随着缺血时间的延长,门、腔静脉血中内毒素水平进行性升高,肝功能进一步损害,最终引起肝肾综合征。     

Effect of telmisartan on nitric oxide--asymmetrical dimethylarginine system: role of angiotensin II type 1 receptor gamma and peroxisome proliferator activated receptor gamma signaling during endothelial aging

Telmisartan, in addition to blocking angiotensin (Ang) II type 1 receptor (AT(1)R), activates peroxisome proliferator activated receptor gamma (PPARgamma) signaling that interferes with nitric oxide (NO) system. Because aging of endothelial cells (ECs) is hallmarked by a reduction in NO synthesis, we hypothesized that telmisartan increases NO formation by regulated asymmetrical dimethylarginine (ADMA)-dimethylarginine dimethylaminohydrolase (DDAH)-system through blocking AT(1)R and activating PPARgamma signaling. To test this hypothesis, ECs were cultured with telmisartan, eprosartan, Ang II, and GW9662 (PPARgamma antagonist) until the twelfth passage. During the process of aging, PPARgamma protein expression decreased significantly, whereas the expression of AT(1)R increased. Telmisartan reversed these effects and dose-dependently decreased reactive oxygen species and 8-iso-prostaglandin (PG) F(2alpha) formation. This effect was associated with an upregulated activity and protein expression of DDAH, accompanied by a decrease in ADMA concentration, an increase in NO metabolites, and delayed senescence. Blockade of PPARgamma signaling by GW9662 or PPARgamma small-interference RNA prevented the effect of telmisartan on ADMA-DDAH-NO system. Coincubation with Ang II did not affect the effect of telmisartan-delayed senescence, whereas Ang II itself accelerated endothelial aging. Moreover, AT(1)R blocker eprosartan that did not influence PPARgamma protein expression had no effect on ADMA system and senescence. We have demonstrated that telmisartan mainly by activating PPARgamma signaling can alter the catabolism and release of ADMA as an important cardiovascular risk factor. We therefore propose that telmisartan translationally and posttranslationally upregulated DDAH expression via activation of PPARgamma signaling, causing ADMA to diminish and increase NO synthesis sufficient to delay senescence.     

大鼠心肌缺血再灌注心功能变化与JAK-STAT信号通路相关性研究

目的观察JAK-STAT信号通路在离体大鼠心肌缺血再灌注(I/R)损伤过程中激活的时程及意义。方法采用Langendorff离体灌流模型,将42只雄性Wistar大鼠随机分为7组:对照组:用改良的KH液持续灌流180min;I/R组:按再灌注时间分为R0、R5、R15、R30、R60、R120 6组,用改良的KH液灌流平衡30 min后,全心停灌30 min,分别再灌注0、5、15、30、601、20 min。连续监测左室舒张压(LVDP)、左室压力最大升降速率(+dp/dtmax)以评价心功能,免疫印记法检测再灌注不同时程磷酸化的信号转导与转录激活子-1(STAT1)、STAT3蛋白表达的变化。结果与对照组相比,再灌注120 min时,LVDP从(96.0±7.4)mm Hg降至(46.2±3.8)mm Hg,+dp/dtmax从(2002±215)mm Hg降至(642±124)mm Hg(P<0.01)。再灌注各时程STAT1、STAT3均处于激活状态,与对照组相比差异有统计学意义(P<0.01),但二者表达存在时间差异,p-STAT1在缺血30 min增高不明显,再灌注过程中处于显著激活状态(P<0.01);p-STAT3在缺血30 min即明显升高(P<0.01),而再灌注期未见进一步升高(P>0.05),p-STAT1/p-STAT3与LVDP及+dp/dtmax呈明显的相关性(r=-0.894,r=-0.886,P<0.001)。结论JAK-STAT信号通路参与了心肌I/R损伤,磷酸化的STAT1与STAT3的比值可能决定了再灌注损伤的严重程度。     

An Absolute Requirement for P-Selectin in Ischemia/Reperfusion-Induced Leukocyte Recruitment in Cremaster Muscle

Objective : To systematically examine a role for P-selectin in a model of striated muscle ischemia/reperfusion (I/R). Methods : Ischemia was induced in the cremaster muscle of mice by occluding the main feeding arteriole for 30 minutes. Blood flow was then restored to allow for 60 minutes of reperfusion and leukocyte kinetics were assessed during the control period (before I/R) and at 5, 30, and 60 minutes of reperfusion. To study a role for P-selectin in this model, three different approaches were used: Wildtype animals received fucoidin (10 mg/kg, iv), an anti-P-selectin antibody (RB40.34; 20 mg/animal, iv) at 25 minutes of ischemia, or I/R was induced in P-selectin-deficient mice. Results : Ischemia/reperfusion induced a rapid and significant increase in leukocyte rolling, adhesion, and emigration in wild-type mice. The I/R-induced increase in leukocyte rolling was transient, inasmuch as it was reduced by approximately 50% at 30 minutes of reperfusion, and returned to control levels by 60 minutes. Both fucoidin and an anti-P-selectin antibody completely prevented the I/R-induced increase in leukocyte rolling. The P-selectin-deficient animals exhibited absolutely no baseline leukocyte rolling, adhesion, or emigration. Furthermore, I/R did not induce any increase in leukocyte recruitment in the Pselectin-deficient animals over the first 60 minutes of reperfusion. Conclusion : The results from this study clearly illustrate that P-selectin is absolutely critical in both baseline and I/R-induced leukocyte infiltration in the murine-striated muscle.