黄芪甲甙改善扩张型心肌病小鼠左室重构与磷酸化p-38MAPK相关性的实验研究

目的：探讨黄芪甲甙对柯萨奇病毒B3（CVB3）扩张型心肌病(DCM)小鼠左室重构的影响及其可能的作用机制。方法:BALB/c小鼠腹腔无菌重复增量接种CVB3建立扩张型心肌病动物模型（n＝30）；感染CVB3 的小鼠以黄芪甲甙（0.6 mg·kg-1·d-1）灌胃作为扩张型心肌病＋黄芪甲甙治疗组（n＝20）；同期腹腔无菌注射等容积不含病毒的EMEM液作为正常对照组（n＝10）。用高频超声心动图测量左室大小及心功能指数，用ELISA技术检测血清I、III型前胶原端肽（PINP、PICP及PIIINP）浓度并计算PICP/PICN比值，苦味酸天狼猩红胶原特异染色和偏光显微镜显像，并辅以图像分析软件计算心肌胶原容积积分（CVF）和I型胶原的含量，分别应用RT-PCR和Western blotting技术检测心肌组织中Ⅰ、Ⅲ型胶原变化和磷酸化p38MAPK的表达。结果:黄芪甲甙显著提高DCM小鼠的生存率、有效地降低扩大的左室内径及增加心脏功能；组织学和血清学显示DCM小鼠心肌组织胶原沉积明显多于正常对照组，而这种增多的趋势可被黄芪甲甙明显抑制 (P<0.01)；DCM小鼠心肌磷酸化p38MAPK表达高于正常对照组，黄芪甲甙治疗后p38MAPK活性明显低于正常对照组（分别为P<0.01和P<0.05）。结论:黄芪甲甙改善CVB3感染后导致的扩张型心肌病左室重构可能与降低磷酸化p38MAPK活动密切相关。     

病毒性心肌炎小鼠心肌中MMP-2和NF-κB的表达

目的:初步探讨基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)和核因子κB(nuclear factor-κB,NF-κB)p65在柯萨奇病毒B3(CVB3)诱导的小鼠病毒性心肌炎心肌中的表达。方法:6周龄近交系雄性BALB/c小鼠随机分为对照组和病毒性心肌炎组,分别给予0.1 m L PBS和10-5.69TCID50/m L CVB3注射,第4天和第10天各随机取8只小鼠处死并取血和心脏标本。Reed-Muench法测定接种病毒滴度;苏木素伊红(hematoxylin and eosin,HE)染色后光镜观察心肌组织病理学改变;应用免疫组化法(immunohistochemistry,IHC)检测MMP-2和NF-κB p65在心肌组织表达的分布和含量;用Western blot法检测MMP-2、NF-κB p65和IκBα在心肌组织的表达,用ELISA检测血清TNF-α含量的变化。结果:与对照组相比,免疫组化和Western blot实验结果提示病毒性心肌炎小鼠心肌中MMP-2和NF-κB p65的表达显著升高(P0.05);感染组IκBα的表达呈下降趋势(P0.05);ELISA结果提示血清TNF-α含量在感染组显著升高,差异有统计学显著性(P0.05)。结论:病毒性心肌炎小鼠心肌组织中TNF-α、NF-κB p65和MMP-2表达显著上调,可能通过相关机制参与疾病的发生。     

IL-17单克隆抗体对病毒性心肌炎小鼠的保护作用及其机制

目的探讨IL-17单克隆抗体(mAb)对病毒性心肌炎(VMC)小鼠的保护作用及可能机制。方法 90只BALB/c小鼠随机分为正常对照组(n=15)、模型组(n=15)、同型对照组(n=25)及IL-17 mAb组(n=25)。模型组、同型对照组、IL-17mAb组小鼠腹腔接种0.1 mL内含柯萨奇病毒B3(CVB3)的Eagle液建立VMC模型,对照组仅注射Eagle液。接种后第3、5天,同型对照组腹腔注射100μg非特异性IgG,IL-17抗体组腹腔注射100μg IL-17 mAb。第7天,每组处死5只小鼠,取心脏,采用Reed-Muench法测定病毒滴度,实时荧光定量PCR检测CVB3 mRNA拷贝数。第14天称体质量后处死全部小鼠,比较各组死亡率;分离血清,ELISA测定血清心肌肌钙蛋白I(cTnI)浓度;称心脏质量(HM),计算心脏指数(HM/BM);HE染色计算心肌病理积分,Western blot法测定心脏核因子-κB(NF-κB)p65表达,ELISA检测心脏IL-6、TNF-α含量。结果模型组心脏指数、血清cTnI浓度、NF-κB p65表达水平及心脏IL-6、TNF-α含量高于对照组(P0.01)。IL-17 mAb组死亡率、心脏指数、血清cTnI浓度、心肌病理积分、病毒滴度、CVB3 mRNA拷贝数、NF-κB p65表达水平及心肌IL-6、TNF-α含量较模型组及同型对照组减少(P0.05或P0.01)。同型对照组上述指标与模型组比较,无显著性差异(P0.05)。结论 IL-17 mAb能够减轻VMC小鼠心肌损伤,其机制可能与抑制病毒复制及NF-κB激活有关。     

IL-17单克隆抗体对病毒性心肌炎小鼠的保护作用及其机制北大核心CSCD

目的探讨IL-17单克隆抗体(mAb)对病毒性心肌炎(VMC)小鼠的保护作用及可能机制。方法 90只BALB/c小鼠随机分为正常对照组(n=15)、模型组(n=15)、同型对照组(n=25)及IL-17 mAb组(n=25)。模型组、同型对照组、IL-17mAb组小鼠腹腔接种0.1 mL内含柯萨奇病毒B3(CVB3)的Eagle液建立VMC模型,对照组仅注射Eagle液。接种后第3、5天,同型对照组腹腔注射100μg非特异性IgG,IL-17抗体组腹腔注射100μg IL-17 mAb。第7天,每组处死5只小鼠,取心脏,采用Reed-Muench法测定病毒滴度,实时荧光定量PCR检测CVB3 mRNA拷贝数。第14天称体质量后处死全部小鼠,比较各组死亡率;分离血清,ELISA测定血清心肌肌钙蛋白I(cTnI)浓度;称心脏质量(HM),计算心脏指数(HM/BM);HE染色计算心肌病理积分,Western blot法测定心脏核因子-κB(NF-κB)p65表达,ELISA检测心脏IL-6、TNF-α含量。结果模型组心脏指数、血清cTnI浓度、NF-κB p65表达水平及心脏IL-6、TNF-α含量高于对照组(P<0.01)。IL-17 mAb组死亡率、心脏指数、血清cTnI浓度、心肌病理积分、病毒滴度、CVB3 mRNA拷贝数、NF-κB p65表达水平及心肌IL-6、TNF-α含量较模型组及同型对照组减少(P<0.05或P<0.01)。同型对照组上述指标与模型组比较,无显著性差异(P>0.05)。结论 IL-17 mAb能够减轻VMC小鼠心肌损伤,其机制可能与抑制病毒复制及NF-κB激活有关。     

心肌炎小鼠心肌纤维化与心脏上皮/内皮间充质转化的关系

目的: 探讨心脏上皮/内皮间充质转化(EMT/EndMT)与病毒性心肌炎心肌纤维化的关系。方法: 40只BALB/c 小鼠随机分为2组,分别为对照组(n=16)和心肌炎组(n=24)。2组小鼠每周1次分别腹腔注射无病毒培养液或柯萨奇病毒B3(CVB3);于第7 d后随机处死2组小鼠各8只,30 d后处死其余存活小鼠。以苦味酸天狼星红染色检测小鼠心脏胶原容积分数(CVF),ELISA法检测血清胶原前肽的含量变化,以实时RT-PCR法和Western blotting方法检测小鼠心脏中EMT/EndMT蛋白组包括启动因子转化生长因子β₁(TGF-β₁)和Wnt1、转录因子Twist1、上皮细胞标志物上皮细胞钙黏素(E-cadherin)、内皮细胞表面标志血管内皮钙黏素(VE-cadherin)、间充质蛋白如成纤维细胞特异蛋白(FSP-1)和α-平滑肌肌动蛋白(α-SMA)等的基因和蛋白表达情况。结果: 急性病毒性心肌炎时,出现EMT/EndMT现象,其特征为VE-cadherin和E-cadherin丢失,FSP-1和α-SMA表达上调,启动因子TGF-β₁和Wnt1表达增高,转录因子Twist1表达增加,胶原合成增多;慢性期未发现上皮/内皮细胞表型丢失,间充质标志蛋白仍表达上调,胶原合成增多,TGF-β₁、Twist1和Wnt1表达依然增加。结论: EMT/EndMT参与了急性病毒性心肌炎心肌纤维化的形成,慢性期未发现EMT/EndMT参与心肌纤维化。     

病毒性心脏病小鼠心脏胶原代谢的动态变化

目的：探讨急、慢性病毒性心肌炎和扩张型心肌病小鼠心肌组织中胶原代谢的动态变化和特征。方法：以柯萨奇病毒B3感染BALB/c小鼠分别建立病毒性心脏病动物模型，同期均设正常对照。组织病理学方法和心脏超声确认动物模型后，以酶联免疫吸附法（ELISA）检测各组小鼠胶原前肽（PINP、PICP和PIIINP）的血清浓度；以免疫印迹法（Western blotting）检测间质胶原酶（MMP-1）及其组织抑制物（TIMP-1）在心肌组织中的表达；同时检测MMP-1活性变化结果：各期感染小鼠心脏均出现明显心肌纤维化，急性期为修复性心肌纤维化，胶原合成和降解均增强；慢性期反应性纤维化和修复性纤维化并存，胶原合成增多降解减少；心肌病理主要为反应性纤维化，胶原合成增多；MMP-1表达量和活性随病程进行性减少，TIMP-1的表达无变化，MMP-1/TIMP-1进行性降低。结论：病毒性心脏病不同时期胶原代谢有其各自的特点，对病程和预后的影响不同。     

汉黄芩苷对柯萨奇B3病毒诱导的病毒性心肌炎小鼠炎症反应的影响

目的:探讨汉黄芩苷对柯萨奇B3病毒(CVB3)诱导的病毒性心肌炎小鼠炎症反应的影响及其可能的调控机制。方法:用CVB3感染BALB/c小鼠构建病毒性心肌炎动物模型。取40只BALB/c小鼠将其随机分为4组:正常对照组、CVB3感染的病毒性心肌炎组、CVB3感染后给予汉黄芩苷处理的治疗组以及CVB3感染后同时给予汉黄芩苷和AKT激动剂处理的激动剂组,每组10只。于药物治疗7 d后处死各组小鼠。用HE染色检测前3组小鼠心肌组织内炎症细胞浸润情况。用ELISA检测前3组小鼠血清中白细胞介素1β(IL-1β)和IL-6含量。用Western blot实验检测前3组小鼠心脏组织中炎症因子蛋白表达水平以及AKT/NF-κB通路的活化情况。最后,通过Western blot实验检测全部4组小鼠心肺组织中AKT/NF-κB通路的活化情况。结果:与正常组相比,病毒性心肌炎小鼠心脏组织内存在大量炎症细胞浸润,而汉黄芩苷治疗显著降低CVB3病毒诱导的心脏组织炎症细胞浸润(P<0.05)。CVB3病毒感染后小鼠血清中IL-1β和IL-6含量较正常组显著升高(P<0.05),而给予汉黄芩苷治疗后小鼠...     

百令胶囊对病毒性心肌炎小鼠心肌纤维化及TGF-β1-MAPK/ERK通路的影响

目的:探讨百令胶囊(BL)对病毒性心肌炎(VMC)小鼠心肌纤维化及TGF-β1-MAPK/ERK通路的影响。方法:200只健康雄性BALB/c小鼠中的180只采用间断多次腹腔注射组织培养半数感染量(TCID50)100 TCID50/0.1 ml的柯萨奇病毒B3(CVB3)病毒稀释液,建立VMC心肌纤维化模型,另外20只注射不含病毒的Eagle's液作为正常对照组。两个月后模型制作成功。存活的小鼠随机分为4组,模型组、BL高、中、低剂量组。分别给予不同剂量BL进行治疗,每日灌胃给药一次,60 d后结束。心脏超声检测左室舒张末期内径(LVEDd)和左室收缩末期内径(LVEDs),并计算左室射血分数缩短率(FS);采用免疫组化法检测心肌组织Ⅰ型胶原、Ⅲ型胶原;Masson染色计算心肌胶原容积分数(CVF);测定采用半定量Western blot法检测心肌TGFβ1及p-ERK1/2蛋白的表达。结果:(1)与对照组比较,模型组小鼠心肌CVF、Ⅰ型、Ⅲ型胶原明显增高,心脏LVEDd,LVEDs升高,FS下降,差异有统计学意义(P0.05)。(2)与对照组比较,模型组心肌TGF-β1及p-ERK1/2蛋白表达升高,差异有统计学意义(P0.05)。(3)与模型组比较,BL大、中剂量组CVF、Ⅰ型、Ⅲ型胶原下降,心脏LVEDd,LVEDs下降,FS升高,差异有统计学意义(P0.05)。(4)与模型组比较,BL大剂量组心肌TGF-β1及p-ERK1/2蛋白表达下降,差异有统计学意义(P0.05)结论:(1)百令胶囊可以改善病毒性心肌炎小鼠减轻心肌纤维化,改善心功能。(2)在病毒性心肌炎中,TGF-β1-MAPK/ERK通路激活可能起促心肌纤维化作用。(3)百令胶囊抗心肌纤维化作用机制可能是通过抑制TGF-β1-MAPK/ERK通路的活化实现的。     

病毒性心肌炎患者血清sIL-2R、IL-6和IL-8水平变化及临床意义

作者观察了50份柯萨基B组病毒（Cox B）性心肌炎患者血清IL-6、 IL-8和sIL-2R的水平变化,及与病毒血症的关系。发现病毒性心肌炎患者血清的IL-8和IL-6水平均显著高于正常对照组,其中血清Cox B抗原和特异性IgM抗体均阳性组（20例）的IL-8和IL-6含量均明显高于仅检出特异性IgM抗体组（30例）,且IL-8含量升高的程度与检测抗原的阳性强度是显著正相关。然而,两组间及与正常对照组间sIL-2R的含量均无明显差异。认为血清IL-8水平升高是病毒性心肌炎急性期的一个重要指标,并间接反映机体处于病毒血症或病毒抗原血症。     

环孢素A对稳定EBV诱发淋巴瘤模型的作用和意义

目的：观察环孢素A（CSA）对hu-PBL/SCID嵌合体小鼠发生移植物和抗宿主反应（GVHR）的抑制作用，建立稳定的EBV诱发淋巴瘤动物模型，方法：从健康成人新鲜外周血中分离出淋巴细胞，将之移植到SCID小鼠腹腔中，实验感染EB病毒，腹腔注射CSA，并采用ELISA检测小鼠血清中人sIL-2R水平。结果：环孢素A组（14只）无1只小鼠因GVHR而死亡，而其余3组共39只小鼠有15只因GVHR而死亡，中位生存时间为17d，死亡率分别为55．56％（5／9例）、30．43％（7／23例）、42．86％（37．7例），与环孢素A组比较差异有显著性意义。环孢素A组在不同时间sIL-2R含量较稳定，而实验感染组sIL-2R水平有逐渐升高趋势，环孢素A组与实验感染组同一时间比较15d和22d时sIL-2R水平有显著性差异。后者明显高于前者，渡过急性GVHR期而存活的38只SCID小鼠中，共有24只形成肿瘤。结论：CSA可显著抑制hu-PBL/SCID嵌合体小鼠GVHR的发生，对稳定建立EWBV诱发淋巴瘤动物模型具有的实际意义。     

Benign human enterovirus becomes virulent in selenium-deficient mice

Coxsackieviruses have been implicated as possible co-factors in the etiology of the selenium (Se)-responsive cardiomyopathy known as Keshan disease. Here we report that a cloned and sequenced amyocarditic coxsackievirus B3 (CVB3/0), which causes no pathology in the hearts of Se-adequate mice, induces extensive cardiac pathology in Se-deficient mice. CVB3/0 recovered from the hearts of Se-deficient mice inoculated into Se-adequate mice induced significant heart damage, suggesting mutation of the virus to a virulent genotype. We demonstrate the important role of host nutritional status in determining the severity of a viral infection. © 1994 Wiley-Liss, Inc.     

Coxsackievirus myocarditis: interplay between virus and host in the pathogenesis of heart disease

Coxsackievirus (CVB) infection is a significant cause of myocarditis and dilated cardiomyopathy (DCM). Heart disease may be caused by direct cytopathic effects of the virus, a pathologic immune response to persistent virus, or autoimmunity triggered by the viral infection. CVB interacts with its host at multiple stages during disease development. Signaling through viral receptors may alter the intracellular environment in addition to facilitating virus entry. Viral genetic determinants that encode cardiovirulence have been mapped and may change depending on the nutritional status of the host. Virus persistence is directly associated with pathology, and recent work demonstrates that CVB evolves into a slowly replicating form capable of establishing a low-grade infection in the heart. The innate immune response to CVB has taken on increasing importance because of its role in shaping the development of the adaptive immune response that is responsible for cardiac pathology. Studies of T cell responsiveness and the development of autoimmunity at the molecular level are beginning to clarify the mechanisms through which CVB infection causes inflammatory heart disease.     

Ginkgo biloba extract may alleviate viral myocarditis by suppression of S100A4 and MMP-3

Viral myocarditis (VMC) is an inflammatory cardiac disease caused by coxsackievirus B3 (CVB3) that leads to heart failure or sudden death. However, efficient therapeutic strategies for VMC remain lacking. Ginkgo biloba extract was previously demonstrated to have anti-inflammatory activity and had been used in prevention and therapy of some cardiovascular diseases (ie myocardial infarction), indicating Ginkgo biloba extract may be a potential drug for the treatment of VMC. This study was, for the first time, to investigate the intervention effects of Ginkgo biloba extract on VMC model mice and explore its potential mechanisms. As a result, VMC mice model was successfully established by CVB3 infection, exhibiting significantly higher viral titer, serum creatine kinase isoenzyme level, heart weight/body weight ratio, histopathologic scores, collagen volume fraction (CVF), and significantly increased expression of S100A4 and matrix metalloproteinase-3 (MMP-3) at protein and messenger RNA levels compared with the control group. Also, the expression of S100A4 and MMP-3/CVF was positively correlated. Ginkgo biloba extract treatment significantly reversed the trend in all the above parameters. Thus, Ginkgo biloba extract may be a promising therapeutic approach against VMC because it improved myocardial injury and alleviated the degree of myocardial fibrosis through suppression of S100A4 and MMP-3.     

RIP3/CaMKⅡ信号通路对重症病毒性心肌炎小鼠心脏功能及生存曲线的影响

目的:观察RIP3/CaMKⅡ信号通路对柯萨奇病毒B3(CVB3)诱导的重症病毒性心肌炎小鼠心脏功能及生存曲线的影响,并探讨CaMKⅡ特异性抑制剂KN-93对心肌损伤的作用。方法:将60只雄性BALB/c小鼠分为正常对照组、CVB3组、CVB3+KN-93组和CVB3+KN-93+Ti(活性氧簇特异性抑制剂)组,以上小鼠腹腔及尾静脉注射药物连续7 d。采用双抗体夹心免疫法检测小鼠心肌细胞坏死标志物,心脏超声技术检测小鼠心脏结构和功能,绘制Kaplan-Meier生存曲线,观察KN-93对小鼠心肌的保护作用。结果:CVB3+KN-93组小鼠心肌细胞坏死较CVB3组显著减轻,心脏功能和生存曲线改善(P<0.01);CVB3+KN-93组小鼠心肌组织H2O2含量较CVB3组显著下降(P<0.01);加入Ti后,CVB3+KN-93+Ti组H2O2含量较CVB3+KN-93组轻度下降(P<0.05),但无论是心脏功能还是生存曲线均无显著差异。结论:RIP3/CaMKⅡ信号通路在CVB3诱导的急性重症病毒性心肌炎小鼠心肌细胞损伤中起到主导作用;KN-93能阻断这种作用并可能产生新的治疗方式,其效果可能是通过对CaMKⅡ的直接抑制和对活性氧簇的间接抑制而实现的。     

Coxsackievirus B3-associated myocardial pathology and viral load reduced by recombinant soluble human decay-accelerating factor in mice

Coxsackievirus B3 (CVB3) infection can result in myocarditis, which in turn may lead to a protracted immune response and subsequent dilated cardiomyopathy. Human decay-accelerating factor (DAF), a binding receptor for CVB3, was synthesized as a soluble IgG1-Fc fusion protein (DAF-Fc). In vitro, DAF-Fc was able to inhibit complement activity and block infection by CVB3, although blockade of infection varied widely among strains of CVB3. To determine the effects of DAF-Fc in vivo, 40 adolescent A/J mice were infected with a myopathic strain of CVB3 and given DAF-Fc treatment 3 days before infection, during infection, or 3 days after infection; the mice were compared with virus alone and sham-infected animals. Sections of heart, spleen, kidney, pancreas, and liver were stained with hematoxylin and eosin and submitted to in situ hybridization for both positive-strand and negative-strand viral RNA to determine the extent of myocarditis and viral infection, respectively. Salient histopathologic features, including myocardial lesion area, cell death, calcification and inflammatory cell infiltration, pancreatitis, and hepatitis were scored without knowledge of the experimental groups. DAF-Fc treatment of mice either preceding or concurrent with CVB3 infection resulted in a significant decrease in myocardial lesion area and cell death and a reduction in the presence of viral RNA. All DAF-Fc treatment groups had reduced infectious CVB3 recoverable from the heart after infection. DAF-Fc may be a novel therapeutic agent for active myocarditis and acute dilated cardiomyopathy if given early in the infectious period, although more studies are needed to determine its mechanism and efficacy.     

NF-κB蛋白在柯萨奇病毒B3诱导的病毒性心肌炎小鼠心肌细胞焦亡过程中的调控作用

目的:探讨NF-κB蛋白对柯萨奇病毒B3(CVB3)诱导的病毒性心肌炎小鼠心肌细胞焦亡的调控作用.方法:将编号后的45只雄性BALB/c小鼠根据随机数表法平均分为3组,分别为对照组(normal组)、病毒性心肌炎组(CVB3组)和NF-κB蛋白抑制剂吡咯烷二硫代氨基甲酸(PDTC)处理组(CVB3+PDTC组),每组各...     

Neutralizing anti-4-1BBL treatment improves cardiac function in viral myocarditis

Coxsackievirus B3 (CVB3) is the most common causative agent of infectious myocarditis. Chronic inflammation, loss of contractile tissue, and maladaptive remodeling all contribute to dilated cardiomyopathy and heart failure. The 4-1BB receptor is a costimulatory molecule expressed by T cells and cardiomyocytes. We infected mice with CVB3 to examine if virus infection triggers 4-1BB activation and whether inhibition of this pathway will reduce inflammation and improve heart function. Echocardiography was performed on days 3, 9, 30 and at 10 weeks post-infection (pi) and ejection fraction (EF), left ventricular (LV) wall thickness, contractility, and internal cardiac dimensions were measured. At day 9, reduced rate of wall thickening (30+/-17 vs 70+/-19%), increased LV wall thickness (0.15+/-0.04 vs 0.09+/-0.01 cm in diastole and 0.19+/-0.04 vs 0.15+/-0.02 cm in systole), and reduced cardiac volume (0.013+/-0.004 vs 0.023+/-0.003 ml in diastole and 0.004+/-0.002 ml vs 0.007+/-0.001 ml in systole) were observed in infected hearts as compared with shams. At 14 days pi, CVB3-infected mice were randomly assigned to receive either anti-4-1BBL neutralizing (M522) or control antibodies (Ab) for 8 weeks. Cardiac damage, fibrosis, and inflammation were assessed by histological stains and immunohistochemistry. Polymerase chain reaction (PCR) was utilized to detect matrix metalloproteinase (MMP)-2, MMP-9, and MMP-12 expressions. At 10 weeks pi, M522 treatment improved LV wall thickening rate (-10+/-13 vs -49+/-16%, expressed as percentage change from baseline) and reduced diastolic LV posterior wall thickness (17+/-10 vs 57+/-47%, expressed as percentage change from baseline), cardiac damage as assessed by histological scores (0 vs 1.3+/-1.5), fibrosis by collagen volume fraction (3.2+/-0.6 vs 4.9+/-2.2%), overall inflammation (5.9+/-1.3 vs 8.5+/-4.1%), and T-cell infiltration (1.3+/-0.9 vs 4.3+/-3.8%) as compared to control. MMP-12 was highly increased during acute and chronic myocarditis, but was significantly decreased by M522 treatment. Thus, long-term inhibition of the 4-1BB pathway reduces cardiac damage, remodeling, and inflammation during viral myocarditis.