胰岛素干预对糖尿病大鼠后肢缺血的作用及意义

目的研究外源性胰岛素对糖尿病大鼠缺血后肢血管内皮生长因子(VEGF)表达的影响及其促血管新生的作用。方法取20只健康雄性SD大鼠,将其右后肢股动、静脉及其分支和属支结扎,制成糖尿病大鼠后肢缺血模型,然后将其用简单随机化方法随机平均分为模型组与治疗组,另取10只正常大鼠作为对照组。14 d后处死大鼠,应用Western blot法检测大鼠后肢肌肉组织中VEGF蛋白表达水平,并采用碱性磷酸酶(AKP)染色法测定大鼠后肢肌肉组织中毛细血管密度。结果对照组大鼠术前和术后7 d体重和血糖水平比较差异无统计学意义(P>0.05);模型组大鼠术后7 d与术前比较,体重明显下降(P<0.05),但血糖水平差异无统计学意义(P>0.05);而治疗组给予皮下注射胰岛素注射液术后7 d较术前体重明显下降,并且血糖水平较术前也明显下降,差异均有统计学意义(P<0.05)。与对照组比较,治疗组及模型组大鼠术后7 d体重明显下降、血糖明显升高(P<0.05,P<0.01);治疗组与模型组比较,体重差异无统计学意义(P>0.05),但治疗组大鼠术后7 d血糖水平较模型组明显降低(P<0.05)。治疗组大鼠缺血肢体肌肉组织中VEGF蛋白相对表达量(155.06±10.26)明显高于模型组(94.30±11.23),P<0.05;对照组大鼠未检测到VEGF蛋白表达。对照组大鼠右后肢肌肉组织中毛细血管密度明显高于模型组和治疗组(P<0.05),而治疗组又明显高于模型组(P<0.05)。3组大鼠左后肢毛细血管密度差异无统计学意义(P>0.05);对照组大鼠左、右后肢毛细血管密度差异无统计学意义(P>0.05);模型组和治疗组大鼠右后肢毛细血管密度均明显低于左后肢(P<0.05)。结论胰岛素可以增强糖尿病大鼠后肢缺血肌肉组织中VEGF蛋白表达,促进毛细血管生成,发挥保护作用。     

bFGF联合骨髓干细胞动员剂促进兔缺血后肢血管新生的研究

目的: 观察局部应用碱性成纤维细胞生长因子（bFGF）联合干细胞动员剂对促进兔缺血后肢血管新生的作用。方法: 40只大耳白兔均切断左侧股动脉及其分支，制作兔后肢缺血模型。成模后随机分4组(每组10只):(1)bFGF组,在缺血后肢肌内多次注射重组人bFGF蛋白;(2)G-CSF组,皮下注射重组人粒细胞集落刺激因子（rhG-CSF）;(3) bFGF+G-CSF组，按bFGF组和G-CSF组的方法给予bFGF和G-CSF;（4）对照组，给予等量生理盐水。术后4周，各组兔行腹主动脉造影，观察侧支血管形成情况。取内收肌和腓肠肌肌组织行病理切片检查;用图像分析系统统计血管密度;用免疫组化检测内收肌和腓肠肌中VEGF阳性表达的血管数。结果: 兔侧支循环血管条数、血管密度及VEGF阳性表达的血管数均依次为：bFGF+G-CSF组 > bFGF组 > G-CSF组 > 对照组 (均P<0.05)。结论: 在缺血下肢肌内注射bFGF蛋白和皮下注射骨髓干细胞动员剂均可促进血管新生，改善肢体缺血状态;但在骨髓干细胞动员的同时，联合应用bFGF蛋白效果更好，缺血肢体改善更明显。     

神经生长因子基因转染对缺血肢体血管生成和骨骼肌纤维重塑的影响

目的观察神经生长因子(NGF)对缺血肢体血管生成和骨骼肌纤维重塑的影响,探讨NGF与血管内皮生长因子(VEGF)在血管生成中的关系。方法 18只小鼠随机分为正常对照组、空白对照组和NGF治疗组,每组各6只。建立小鼠左后肢缺血模型,术后第7 d对NGF组进行基因转染。术后第21 d时对3组小鼠左后肢缺血进行评估,然后取腓肠肌组织进行HE染色、增殖细胞核抗原(PCNA)和CD34免疫组织化学染色,ELISA法检测腓肠肌组织中NGF、VEGF蛋白表达量,肌球蛋白ATP酶染色分析肌纤维类型。结果术后第21 d时,NGF组的左后肢肌肉萎缩程度弱于空白对照组,左后肢缺血评分明显低于空白对照组(P0.05),内皮细胞增殖指数、毛细血管密度、NGF和VEGF表达量均明显高于空白对照组(P0.05),Ⅰ型肌纤维比例也明显高于空白对照组(P0.05)。结论 NGF基因转染能够促进缺血肢体NGF、VEGF表达和血管生成,诱导肌纤维向Ⅰ型重塑,相关分子调控机制仍需进一步研究。     

糖尿病足动脉缺血患者骨骼肌血管内皮生长因子基因表达

目的　研究糖尿病患者缺血下肢肌肉组织内源性血管内皮生长因子 (VEGF)基因表达及其与糖尿病足发病机理的关系。　方法　将 2 4例患者 ,33条肢体分为 3组 :无下肢动脉缺血的糖尿病 (DM) 5例 ,10条肢体 ;无糖尿病的下肢动脉粥样硬化闭塞症 (ASO) 10例 ,13条肢体 ;糖尿病下肢动脉硬化闭塞症 (DLASO) 9例 ,10条肢体。对照组为正常志愿者 (NOR) 5例 ,10条肢体。通过肌肉穿刺获取小腿骨骼肌组织 ,采用RT PCR法测定肌肉组织中hVEGF16 5mRNA表达。　结果　DM组和NOR组小腿骨骼肌组织中hVEGF16 5mRNA无表达。DLASO组小腿骨骼肌组织有hVEGF16 5mRNA表达 (0 0 2 1± 0 0 13) μg ,但明显低于ASO组 (0 133± 0 0 2 4 ) μg ,(t=13 32P <0 0 1)。　 结论　DLASO组缺血下肢肌组织内源性VEGF基因表达水平明显低于ASO组 ,是糖尿病足部溃疡发生发展的重要内在原因。     

纳米血管内皮生长因子在治疗下肢缺血促进血管再生成中的作用

目的　利用家兔后肢缺血模型 ,观察纳米材料聚乳酸聚乙醇酸共聚物 (poly dl lactic co glycolicacid ,PLGA) ,包载血管内皮生长因子 (VEGF16 5 )基因 ,经局部肌肉注射后 ,外源基因在局部缺血组织中的转染及强度 ,以及缺血部位的血管新生状况。　方法　制备VEGF16 5 真核表达质粒 ,制备包载VEGF16 5 基因的纳米粒子 ,并检测其理化性质和体外释放曲线。建立家兔后肢缺血模型 2 4只 ,其中4只为对照组 ,只行股动脉及其分支结扎切断术 ;2只为空白纳米粒子组 ,局部缺血肌肉注射空白纳米粒子 ;10只应用裸质粒VEGF16 5 转染 ,8只采用纳米技术包载VEGF16 5 转染。直接缺血部位肌肉内多点注射 ,进行局部定位基因转染。术后 14d行血管造影 ,了解缺血部位侧枝形成情况。处死兔子 ,取股二头肌 ,内收大肌 ,做病理切片 ,免疫组化染色 ,观察VEGF16 5 的表达 ,测定毛细血管密度。应用逆转录 聚合酶链反应了解VEGF16 5 在骨骼肌中的表达 ,并对不同的转染技术进行半定量分析。　结果　转基因治疗 14d后 ,转染VEGF基因组血管造影可见明显新生血管和侧枝循环形成 ,免疫组化染色可见VEGF16 5 蛋白表达水平增高 ,缺血肌肉血管数增多 ,纳米VEGF16 5 治疗组与裸质粒VEGF16 5 治疗组的毛细血管密度明显高于对照组 ,有显著性差异 (P     

应用转血管内皮生长因子基因治疗肢体缺血的研究

目的研究肌肉内转血管内皮生长因子(VEGF)基因治疗肢体缺血的可行性,比较各种治疗方法的疗效. 方法雄性新西兰大白兔50只,完全切除股动脉后随机分为3组.实验组为明胶海绵携载法转基因组(n=18)和肌肉内注射转基因组(n=18);只注射pcDNA3为对照组(n=14).通过直接注射法及明胶海绵携载法将构建的质粒pcDNA3-VEGF121基因转入缺血肌肉内,立即测定各组肢体髂内动脉血流量,在术后2天,1、2、3和4周应用逆转录-聚合酶链反应(RT-PCR)技术测定基因表达,术后30天通过测定缺血肢体髂内动脉血流量、动脉血管造影及组织学观察测定血管密度,评价侧支循环变化. 结果术后2天,转VEGF基因治疗的两实验组均测到基因表达,并均维持2周.术后立即测定的髂内动脉血流量各组间无明显差异.术后30天,缺血肢体髂内动脉血流量、肢体血管造影血管数目和肌肉组织血管密度转VEGF基因的两实验组均比对照组明显增高,差异有统计学意义(P<0.01),明胶海绵携载组较直接注射组亦有明显增高,差异有统计学意义(P＜0.05). 结论肌肉内转VEGF基因治疗可促进急性缺血肢体侧支循环、改善血供,明胶海绵携载法较直接注射法有更好的疗效.     

碱性成纤维细胞生长因子促进兔缺血后肢血管新生的实验研究

目的:了解局部应用碱性成纤维细胞生长因子(bFGF)对促进兔缺血后肢血管新生的作用。方法:25只日本大耳白兔随机分2组,外科结扎切断各兔股动脉及其分支,制作兔后肢缺血模型。试验组各兔在缺血后肢肌肉内多次注射重组人bFGF蛋白(n=15);对照组给予等剂量生理盐水(n=10)。术后4周,各兔行腹主动脉造影观察侧支血管形成情况,取内收肌和腓肠肌肌肉行病理切片HE染色应用图像分析系统统计血管密度,并用免疫组织化学方法检测内收肌和腓肠肌中VEGF阳性表达的血管数。结果:试验组兔侧支循环血管条数、血管密度及VEGF阳性表达的血管数均大于对照组(P<0.01),缺血状态得到改善。结论:在兔缺血后肢肌肉中注射bFGF蛋白可促进血管新生,增加兔缺血后肢血液灌注,改善肢体缺血状态。     

血管内皮生长因子-碱性成纤维细胞生长因子基因治疗家兔肢体缺血的研究

目的　了解血管内皮生长因子 (VEGF)和碱性成纤维细胞生长因子 (bFGF)联合克隆基因 (VEGF bFGF)治疗兔下肢动脉缺血模型后新生血管和侧支形成状况。方法　应用 40只家兔制成下肢缺血模型 ,其中VEGF bFGF组 10只 ,VEGF组 12只 ,空载体组 8只 ,生理盐水 (NS)组 10只。构建pcDNA3 /VEGF和pcDNA3 /VEGF bFGF真核表达载体。转染缺血部位肌组织 ,行下肢血管造影。结果　血管造影计数显示 ,VEGF bFGF组在转染后 14d(1.98± 0 .2 2 ) ,2 8d (1.81± 0 .5 2 ) ,5 6d(2 .2 1± 0 .44 )和 3个月 (2 .10± 0 .2 2 ) ;VEGF组在 2 8d(1.3 8± 0 .2 9) ,5 6d(1.94± 0 .2 5 )和 3个月 (2 .2 4± 0 .3 1) ,新生血管形成较对照组显著增加 (P <0 .0 5 )。结论　VEGF bFGF真核表达载体可以获得局部高效表达 ,刺激新生血管生成 ,建立侧枝循环 ,改善肢体缺血。     

大鼠缺血后肢骨骼肌血管内皮生长因子及其受体的表达

目的 研究大鼠缺血后肢侧枝代偿和血管内皮生长因子（VEGF）及其受体表达的动态变化。为外源性VEGF治疗下肢缺血性疾病提供理论依据。方法 切除SD大白鼠右后肢全长股动脉，随机分为9个时间组：造模后1、3d、1、2、3、4、6、8及12周，各组5只动物。分别于造模前后和观察期末检测双后肢大、小腿肌肉Fit-1、Flk-1蛋白及mRNA表达，各组观察期末实验动物后肢动脉DSA检查。结果 （1）缺血后3d，5只大鼠右后肢出现溃疡（11．11％）；2周后，4只大鼠后肢溃疡愈合，而1只趾端坏疽（2．22％）。（2）缺血后2周，患肢侧枝形成达到高峰，12周时仍可见侧支血管显影。（3）缺血早期（3周内），VEGF及其受体的表达均较健侧显著增强（P〈0．05）；缺血中期（3～8周）。VEGF和Flt-1表达迅速下降，Flk-1仍表达；缺血后期（8周后），VEGF及其受体的表达均低至极低水平，与对侧差异无统计学意义（P〉0．05）。结论（1）肢体缺血后自身的血管新生不能完全满足缺血组织的需要。（2）缺血早期外源性的VEGF补充是不必要的；缺血中期补充VEGF是适宜的；缺血后期在应用VEGF治疗的同时，也需要干预受体的表达。     

应用VEGF治疗外周血管疾病

血管内皮细胞生长因子（VEGF），又名血管通透因子（VPF），是一高度特异的血管内皮细胞有丝分裂素，其受体KDR、flt具有酪氨酸激酶特性。不论对肢体缺血的动物实验模型还是对外周血管疾病的患者，VEGF均能明显增加缺血肢体的侧支循环，改善缺血。在临床上VEGF为外周血管疾病的治疗开辟了新的途径。     

2型糖尿病大鼠后肢缺血模型的建立及评价

目的建立2型糖尿病大鼠后肢缺血模型并进行评价,为后续的干预实验提供研究平台。方法将15只SD大鼠随机分为正常对照组、糖尿病组及糖尿病后肢缺血组,每组5只。糖尿病组及糖尿病后肢缺血组的10只大鼠均给予高脂饮食喂养4周后,腹腔注射链脲佐菌素（STZ,40mg／kg）以建立2型糖尿病模型。糖尿病后肢缺血组大鼠建模成功后行双侧髂总动脉结扎术以建立后肢缺血模型,正常对照组和糖尿病组大鼠仅分离髂总动脉,不予结扎。2周后对3组大鼠股动脉的起始段行彩色多普勒超声检查,以检测股动脉的血流峰值速度和血流加速时间;取缺血部位的小腿三头肌及大腿股四头肌组织,分别行HE染色及免疫组化SP染色,以观察3组大鼠肌细胞的营养状况及血管再生情况。结果后肢缺血模型建模2周后,正常对照组、糖尿病组和糖尿病后肢缺血组大鼠的血流峰值速度分别为（22．49±3．02）cm／s、（17．36±2．60）cm／s和（11．23±1．26）cm／s,血流加速时间分别为（0．080±0．009）S、（0．120±0．009）S和（0．160±0．020）s,糖尿病后肢缺血组大鼠的股动脉血流峰值速度小于正常对照组和糖尿病组（P〈0．05）,而血流加速时间较长（P〈0．05）。HE染色结果显示：糖尿病后肢缺血组大鼠小腿三头肌的结构破坏,有大量炎症细胞浸润,肌肉损伤程度重于正常对照组和糖尿病组。免疫组化sP染色结果显示：糖尿病后肢缺血组大鼠大腿股四头肌的毛细血管密度[（1．40±0．55）个／HPF]小于正常对照组[（6．80±0．84）个／HPF]及糖尿病组[（4．60±0．55）个／HPF],差异均有统计学意义伊〈O．05）。结论对SD大鼠给予高脂饮食联合小剂量STZ注射可以成功诱导2型糖尿病模型,在此模型基础上结扎髂总动脉可以成功制备糖尿病后肢缺血模型。     

Nitrite Anion Therapy Protects Against Chronic Ischemic Tissue Injury in db/db Diabetic Mice in a NO/VEGF-Dependent Manner

Nitrite anion has been demonstrated to be a prodrug of nitric oxide (NO) with positive effects on tissue ischemia/reperfusion injury, cytoprotection, and vasodilation. However, effects of nitrite anion therapy for ischemic tissue vascular remodeling during diabetes remain unknown. We examined whether sodium nitrite therapy altered ischemic revascularization in BKS-Lepr^db/db mice subjected to permanent unilateral femoral artery ligation. Sodium nitrite therapy completely restored ischemic hind limb blood flow compared with nitrate or PBS therapy. Importantly, delayed nitrite therapy 5 days after ischemia restored ischemic limb blood flow in aged diabetic mice. Restoration of blood flow was associated with increases in ischemic tissue angiogenesis activity and cell proliferation. Moreover, nitrite but not nitrate therapy significantly prevented ischemia-mediated tissue necrosis in aged mice. Nitrite therapy significantly increased ischemic tissue vascular endothelial growth factor (VEGF) protein expression that was essential for nitrite-mediated reperfusion of ischemic hind limbs. Nitrite significantly increased ischemic tissue NO bioavailability along with concomitant reduction of superoxide formation. Lastly, nitrite treatment also significantly stimulated hypoxic endothelial cell proliferation and migration in the presence of high glucose in an NO/VEGF-dependent manner. These results demonstrate that nitrite therapy effectively stimulates ischemic tissue vascular remodeling in the setting of metabolic dysfunction that may be clinically useful.     

Differential necrosis despite similar perfusion in mouse strains after ischemia

BACKGROUND: Numerous mouse models have been used to study the tissue response to ischemia, but multiple technical differences make comparisons difficult. We have comprehensively characterized the mouse hind limb ischemia model and determined how different genetic backgrounds of mice affect recovery. MATERIALS AND METHODS: Severity of tissue necrosis and restoration of perfusion after femoral artery excision or femoral artery transection, using five different surgical procedures, were evaluated using laser Doppler imaging in a mouse model of hind limb ischemia. Severity of necrosis was concurrently measured using a five-point scale. RESULTS: Significant differences were observed depending upon the surgical procedure used to initiate ischemia as well as the strain of mouse used. First, a progressively delayed and incomplete recovery of vascular perfusion occurred in relation to the anatomical position and extent of the arterial defect. Second, among mouse strains, the severity of tissue necrosis varied despite similar restoration of perfusion. Thus, DBA/1J mice had significantly increased severity and incidence of tissue loss as compared with either C57Bl/6J (P = 0.01) or BALB/c (P = 0.01) mice. Finally, contrary to previous reports, T-cell-mediated immune events did not modify ischemia-induced hind limb perfusion and necrosis as responses in nude mice were not different than controls on either BALB/c or C57Bl/6J backgrounds. CONCLUSIONS: Surgical approach, mouse strain, and measures of hind limb perfusion and tissue injury are crucial considerations in the study of ischemia. Understanding how different genetic backgrounds in mice can affect necrosis may provide insights into the diverse healing responses observed in humans.     

脉管复康片联合糖痹外洗方对糖尿病血管病变的疗效及其机制

目的：建立糖尿病大鼠下肢缺血模型,研究脉管复康片联合糖痹外洗方对糖尿病大鼠血管内皮损伤的疗效及其作用机制。方法：选取50只大鼠中的8只为正常对照组,余下大鼠采用高脂饮食联合腹腔注射链脲佐菌素法建立大鼠糖尿病模型,结扎大鼠左后肢股动脉,建立下肢缺血模型。取造模成功的32只大鼠,随机分为模型组和高、中、低剂量给药组,每组8只。给药21 d后处死大鼠,取其血样及左后肢腓肠肌组织,检测血清中血栓素A2(TXA2)、内皮素（ET）-1、一氧化氮（NO）、内皮型一氧化氮合成酶(eNOS)、血管内皮生长因子（VEGF）、血管细胞黏附分子-1(s VCAM-1)、C反应蛋白（CRP）含量;HE染色观察缺血后肢肌细胞形态;CD31免疫组织化学染色检测术侧腓肠肌微血管形成数量。结果：经给药治疗后,大鼠腓肠肌组织HE染色未见明显萎缩坏死,血管内皮功能趋于正常。与模型组相比,脉管复康片高、中、低剂量组大鼠血清中TXA2水平均显著降低（P <0.01）;eNOS水平均显著升高（P <0.001）;ET-1水平均有下降,高剂量组最显著（P <0.001）;高剂量组NO水平显著上升（P <0...     

Hepatic ischemia-reperfusion increases circulating bone marrow-derived progenitor cells and tumor growth in a mouse model of colorectal liver metastases

BackgroundHepatic pedicle clamping is often required to reduce blood loss and transfusion during liver resection. However, the question remains whether use of hepatic pedicle clamping promotes tumor growth. Endothelial progenitor cells (EPCs) are mobilized from bone marrow in response to tissue ischemia, which allows neovascularization of ischemic tissue. It has been suggested that EPCs are involved in tumor progression. We hypothesized that hepatic ischemia reperfusion (I/R)-induced mobilization of EPCs could enhance growth of microscopic tumor, therefore promoting liver metastasis in a mouse model of colorectal cancer.Materials and methodsWe used mouse models of hepatic I/R and hind limb ischemia. For comparison, we studied mice that underwent limb ischemia as positive controls of EPC mobilization. At day 0, we divided 40 mice into four groups: hepatic I/R, hind limb ischemia, combined hepatic I/R and hind limb ischemia, and control (sham midline incision laparotomy). At day 2, we induced liver metastasis in all mice by injecting CT-26 cells into the spleen. Time-dependent circulating EPCs were determined by flow cytometry. We evaluated liver metastasis and microvascular density on day 21.ResultsThe number of circulating progenitor cells increased rapidly in the ischemic groups compared with the control group. Hepatic I/R significantly increased tumor outgrowth compared with the control group. Increased tumor growth was associated with enhanced CD31-positive microvascular density in liver tissue.ConclusionsHepatic I/R leads to mobilization of bone marrow–derived EPCs and enhanced intra-hepatic angiogenesis, which is associated with increased tumor burden in an animal model of colorectal liver metastasis.     

An evaluation of resting arterial ischemia models in the rat hind limb

Techniques for using the rat hind limb as a model of pure arterial ischemia at rest have not been well defined. Because the rat has no profunda femoral artery, numerous collateral pathways exist to the hind limb, and femoral artery ligation is not an effective method of inducing arterial ischemia. After several anatomic studies, a two stage operation to produce arterial ischemia in the left hind limb was devised. The first stage involved surgical interruption of collateral and re-entrant vessels, and the second stage involved femoral artery ligation. Using Xenon 133 clearance as an estimate of blood flow, reduction in flow to 14, 24, and 37% of the simultaneously measured value in the right hind limb was obtained at 2 hours, 2 days, and 5 days post ligation. Oxygen extraction in the left hind limb doubled both at 2 hours and at 2 days post ligation. Histological evaluation of the anterior compartment musculature after 5 days demonstrated loss of nuclei, degenerating contractile elements, edema, and inflammatory infiltrate. Evaluation of rats that had undergone isolated femoral artery ligation showed a 66% reduction in flow 2 hours after ligation, but no reduction in flow at 5 days, no increase in oxygen extraction, and only nuclear changes on histological exam at five days.     

Overexpression of endothelial nitric oxide synthase increases skeletal muscle blood flow and oxygenation in severe rat hind limb ischemia

OBJECTIVE: Although nitric oxide (NO) has a critical role in angiogenesis, the therapeutic potential of NO synthase overexpression in severe ischemia remains undefined. We tested the hypothesis that overexpression of endothelial NO synthase (eNOS) would improve tissue perfusion in severe hind limb ischemia. METHODS: Severe hind limb ischemia was induced in 122 adult male Sprague-Dawley rats. Ten days after the induction of hind limb ischemia, vascular isolation and intraarterial delivery of an adenoviral vector encoding eNOS (AdeNOS), a control adenoviral vector (AdE1), or phosphate-buffered saline solution (PBS) was performed. Skeletal muscle blood flow, muscle oxygen tension, angiography, and immunohistochemistry for capillary counts were measured. RESULTS: Gene transfer of AdeNOS increased eNOS protein expression and enzyme activity. Two weeks after gene transfer, skeletal muscle blood flow was fourfold higher in eNOS-transduced than in AdE1-transduced or PBS treated rats and was similar to exercise-induced maximal flow in nonischemic muscle. eNOS overexpression increased muscle oxygen tension in a titer-dependent fashion. This increase persisted 1 month after transduction, even though eNOS enzyme activity had declined to normal levels. Angiography and capillary counts showed that eNOS overexpression increased the size and number of collateral arteries, but did not significantly increase the capillary-muscle fiber ratio. CONCLUSIONS: eNOS overexpression in an ischemic rat hind limb significantly increased skeletal muscle blood flow, muscle oxygen tension, and collateral arteries (arteriogenesis). Furthermore, eNOS overexpression did not result in capillary angiogenesis above control levels. These studies demonstrate the potential for eNOS overexpression as treatment for severe limb ischemia in human beings.     

12-脂氧化酶对糖尿病肾病鼠肾小球p27kip1表达的影响

目的 探讨12-脂氧化酶(12-LO)对糖尿病肾病肾小球内p27kip1表达的影响。方法 在有或无p38 MAPK（p38）抑制剂（SB203580,1 μmol/L）的条件下,用12-LO作用产物12羟二十烷四烯酸[ 12(S)-HETE,10－7 mmol/L]刺激系膜细胞24 h。雄性SD大鼠分为普通饮食对照组、普通饮食+12-LO抑制剂（CDC,8 mg/kg,3次/周,皮下注射）处理组、高脂饮食结合小剂量链脲菌素（STZ,35 mg/kg,腹腔注射）诱导2型糖尿病组、高脂饮食结合小剂量STZ诱导2型糖尿病+CDC处理组,连续皮下注射CDC 1个月。野生型和12-LO基因敲除C57BL/6小鼠随机分成野生型对照组、12-LO基因敲除组、野生型STZ（200 mg/kg,腹腔注射）诱导1型糖尿病组、12-LO基因敲除STZ诱导1型糖尿病组,饲养16周。实验结束后收集尿、血液、提取肾脏,用系列过筛方法分离肾小球。Western印迹和免疫组织化学方法检测p38 活性和p27kip1蛋白表达的变化。 结果 抑制p38 活性可有效阻断12(S)-HETE诱导的系膜细胞内p27kip1的表达（P < 0.01）。CDC可抑制2型糖尿病大鼠肾小球体积增大,降低尿白蛋白量（24 h）,阻止肾小球内p38 活性和p27kip1蛋白表达增加,与CDC未处理2型糖尿病大鼠比较差异均有统计学意义（均P < 0.01）。与野生型糖尿病小鼠比较,12-LO基因敲除糖尿病小鼠p38活性、p27kip1蛋白表达及细胞外基质积聚显著减少,差异有统计学意义（均P < 0.01）。 结论 12-LO可通过p38通路上调糖尿病肾小球内p27kip1的表达。