p38丝裂原活化蛋白激酶介导大鼠心肌缺血再灌注损伤信号传导的研究

目的:探讨p38丝裂原活化蛋白激酶(p38MAPK)在大鼠心肌缺血再灌注损伤中的作用.方法:健康成年雄性SD大鼠随机分为对照组、单纯缺血组、缺血再灌注组、抑制剂组,每组6只.抑制剂组于术前30 min腹腔注射p38MAPK抑制剂SB 203580(5 mg/kg体重).采用夹闭冠状动脉30 min后再灌注2 h的方法建立大鼠心肌缺血再灌注损伤动物模型.采用逆转录多聚合酶链反应(RT-PCR)检测p38MAPK信使核糖核酸(mRNA)表达,免疫组化法检测p-p38MAPK蛋白表达水平及心肌细胞凋亡率.结果:单纯缺血组与对照组比较,大鼠心肌组织中p-p38MAPK的蛋白含量增加,差异有统计学意义(P<0.01),p38MAPK mRNA的表达及细胞凋亡率也增加,但差异无统计学意义(P>0.05).缺血再灌注组与对照组比较,心肌组织中p38MAPK mRNA及p-p38MAPK蛋白水平和心肌细胞凋亡均显著增加,差异均有统计学意义(P<0.05～0.01).与缺血再灌注组比较,抑制剂组大鼠心肌组织p38MAPK mRNA及p-p38MAPK蛋白水平及心肌细胞凋亡均降低,(P<0.05~0.001),差异均有统计学意义.结论:p38MAPK的激活主要发生于再灌注过程;p38MAPK的活化可使缺血再灌注心肌细胞凋亡增加;抑制p38MAPK的活化可以减少缺血再灌注心肌细胞凋亡,减轻缺血再灌注所致的大鼠心肌损伤.     

肥厚心肌缺血再灌注损伤的实验研究

本文采用大鼠离体工作心脏模型，观察肥厚心肌在低温（２２℃）心脏停跳液保护下，缺血停跳２ｈ后再灌注３０ｍｉｎ时，心肌缺血再灌注损伤的情况。与对照组相比，肥厚心肌更易引起心肌缺血再灌注损伤。     

钙超载与心肌缺血再灌注损伤

冠脉供血量不能满足心肌对能量的需要时即发生心肌缺血,缺血一定时间一定程度,会引起组织细胞的损伤,这是众所周知的。血液的重新灌注是防止损伤,使组织细胞存活下来的必要措施。但近年来人们开始意识到,再灌注不一定使缺血损伤的组织细胞得到恢复,在一定条件下反而加重了损伤,由此逐渐形成了缺血-再灌注损伤概念(ischemia-reperfusioninjury,I-RI)。1977年Hearse首次提出再灌注损伤概念以来,有关这方面的报道很多,但关于I-RI的发病机制目前仍未彻底阐明,本文仅从钙超载方面对I-RI的发生机制及防治作一综述。1　研究现状1.1　1972年She…     

腺苷酸活化蛋白激酶与心血管疾病

1973年,Gobson和Carlson分别报道了腺苷酸活化蛋白激酶(adenosine monophosphate-activated protein kinase,AMPK)广泛存在真核细胞生物中,通过影响细胞物质代谢的多个环节来维持细胞能量供求平衡和调节细胞功能.细胞能量不足时会激活AMPK,一方面抑制糖原、脂肪和胆固醇的合成,减少ATP的利用;另一方面,促进脂肪酸氧化、葡萄糖转运等,增加ATP的产生.反之,当细胞内存在高浓度的ATP则可以抑制该效应.……     

心肌缺血再灌注损伤研究进展

八十年代以来 ,随着冠状动脉溶栓术、经皮冠状动脉成形术 (ＰＴＣＡ)、冠状动脉内扩张术、冠状动脉旁路术等技术的推广应用 ,心肌再灌注损伤 (ｍｙｏｃａｒｄｉａｌｒｅｐｅｒｆｕｓｉｏｎｉｎｊｕｒｙ ;ＭＲＩ)已越来越受到广大基础和临床工作者的重视。心肌缺血再灌注损伤具有多因素复杂的机制 ,概括起来 ,包括以下几点 :1　自由基与心肌缺血再灌注损伤大量研究表明 ,心肌缺血再灌注时 ,氧自由基含量明显增加。1.1　心肌缺血再灌注时 ,氧自由基生成增多 :(1)次黄嘌呤 黄嘌呤氧化酶系统。在心肌缺血时 ,能量消耗 ,细胞内三磷酸腺苷 (ＡＴＰ…     

血管紧张素转换酶抑制剂与心肌缺血再灌注性损伤

１引言八十年代以来,随着急诊溶栓和经皮冠状动脉成形术（ＰＴＣＡ）等技术的推广应用。心肌再灌注损伤（ｍｙｏｃａｒｄｉａｌ　ｒｅｐｅｒｆｕｓｉｏｎ　ｉｎｊｕｒｙ;ＭＲＩ）已越来越受到广大临床医学工作者的重视,有效地防治ＭＲＩ更具有现实意义。卡托普利是１９７７年问世,第一个应用于临床的口服高效血管紧张素转换酶抑制剂（ＡＣＥＩ）,目前它已被广泛应用于治疗高血压病和充血性心力衰竭。近年来的研究进一步发现,卡托普利等ＡＣＥＩ对缺血心肌具有显著的保护作用,诸如缩小心肌梗塞面积、改善缺血心肌功能和抑制再灌注性心…     

内皮素与心肌缺血再灌注损伤

皮内素作为细胞因子之一,在局部通过特异性受体参与调节机体的许多生理活动及炎症反应,其生物特性及作用机理已阐明,临床及实验研究发现内皮素可能参与心肌缺血再灌注损伤,本文着重探讨内皮素在心肌缺血再灌注损伤中的病理作用,可能机制及其针对内皮素升高的治疗进展,为心肌保护提供新的思路。     

蛋白酶活化受体-2与心肌缺血再灌注损伤

蛋白酶活化受体-2是一种G蛋白偶联的细胞膜表面受体，广泛分布于心血管以及富含血管的组织器官，能通过溶蛋白性裂解的方式激活受体自身，启动多种细胞效应。近年诸多研究表明该受体与心肌缺血再灌注损伤的关系密切。本文主要就其在心肌缺血再灌注中的作用作一综述。     

一氧化氮与心肌缺血—再灌注损伤

血管内皮细胞合成和释放的一氧化氮（ＮＯ）在心血管系统中具有重要的舒张血管，抗粒细胞，血小板粘附和聚集作用。在心肌缺血－再灌注过程中，ＮＯ既有减轻再灌注损伤，又有介导灌注损伤的双重作用。调节体内Ｌ－精氨酸，ＮＯ合成途径，可望为心肌缺血－再灌注损伤的预防和治疗提供新的方法。     

The relationship between p38 mitogen-activated protein kinase and AMP-activated protein kinase during myocardial ischemia

OBJECTIVE: p38 mitogen-activated protein kinase (p38 MAPK) and AMP-activated protein kinase (AMPK) are activated by, and influence sensitivity to, myocardial ischemia. Recently a number of studies have suggested that AMPK may participate in the activation of p38 MAPK. We therefore examined whether AMPK may be the principal "ischemia sensor" responsible for p38 MAPK activation during myocardial ischemia. METHODS: We used a variety of approaches to alter AMPK activity during ischemia and studied the repercussions on p38 MAPK activation. RESULTS: The activities of AMPK and p38 MAPK were temporally related in adult rat ventricular myocytes (ARVM) subjected to simulated ischemia and in isolated mouse hearts subjected to no-flow ischemia. However p38 MAPK activation was unaltered in mouse hearts lacking the predominant or minor myocardial isoforms, AMPKalpha2 or AMPKalpha1 respectively. Likewise, in ARVM, adenoviral-driven expression of the minor myocardial isoform AMPKalpha1, in a constitutively active or dominant negative form reducing AMPK activity, did not alter p38 MAPK activation under basal conditions or during simulated ischemia. Finally, pharmacological inhibition of AMPK during ischemia with compound C did not attenuate the coincident activation of p38 MAPK. CONCLUSIONS: Although AMPK and p38 MAPK are both activated during myocardial ischemia, the activation of p38 MAPK occurs independently of AMPK.     

Adiponectin protects against myocardial ischaemia-reperfusion injury via AMP-activated protein kinase, Akt, and nitric oxide

AIMS: Cardiovascular disease and type 2 diabetes mellitus are associated with low plasma concentration of adiponectin. The aim of this study was to investigate whether adiponectin exerts cardioprotective effects during myocardial ischaemia-reperfusion and whether this effect is related to the production of nitric oxide (NO). METHODS AND RESULTS: Isolated rat hearts were subjected to 30 min of either global or local ischaemia followed by 60 min of reperfusion. The hearts received vehicle, adiponectin (3 microg/mL), the NO-synthase inhibitor nitro-l-arginine (L-NNA) (0.1 mM), or a combination of adiponectin and L-NNA at the onset of ischaemia. Haemodynamics, infarct size, and expression of endothelial NO-synthase (eNOS), AMP-activated protein kinase (AMPK), and Akt were determined. Adiponectin significantly increased left ventricular function and coronary flow during reperfusion in comparison with the vehicle group. Co-administration of L-NNA abrogated the improvement in myocardial function induced by adiponectin. Infarct size following local ischaemia-reperfusion was 40 +/- 6% of the area at risk in the vehicle group. Adiponectin reduced infarct size to 19 +/- 2% (P < 0.01). L-NNA did not affect infarct size per se but abolished the protective effect of adiponectin (infarct size 40 +/- 5%). Phosphorylation of eNOS Ser1177, AMPK Thr172, and Akt Ser 473 was increased in the adiponectin group (P < 0.05). CONCLUSION: Adiponectin protects from myocardial contractile dysfunction and limits infarct size following ischaemia and reperfusion by a mechanism involving activation of AMPK and production of NO.     

An expanded role for AMP-activated protein kinase: regulator of myocardial protein degradation

Rudolph Schoenheimer's concept of the "dynamic state of body constituents" has existed since the 1940s, but the idea that heart muscle cells renew themselves from within is relatively new. Many studies have elucidated the interaction of metabolic pathways for energy provision and contraction of the heart, and work in the field has uncovered novel metabolic regulators of enzyme action. However, the impact of myocardial energy metabolism on myocardial protein turnover has received little attention. Here, we review recent findings that identify metabolic signals as regulators of myocardial protein turnover and seek to broaden the role of energy substrate metabolism from a provider of ATP to a regulator of self-renewal of the cardiomyocyte.     

腺苷酸活化蛋白激酶与胰岛素抵抗

腺苷酸活化蛋白激酶（AMP-activated protein kinase, AMPK）是一类重要的蛋白激酶,通过改变细胞代谢和调节基因转录恢复细胞ATP水平。AMPK参与了肌肉收缩介导的葡萄糖转运和脂肪酸氧化,抑制肝脏葡萄糖、胆固醇和甘油三酯产生,并具有调节食物摄取和体重的作用。AMPK信号通路是目前具有吸引力的治疗肥胖、胰岛素抵抗、2型糖尿病和其它代谢病的药理靶点。     

单磷酸腺苷活化蛋白激酶与肾脏疾病

单磷酸腺苷活化蛋白激酶(AMPK)是体内一种重要的蛋白激酶,广泛分布于全身各组织器官,发挥不同的功能.AMPK作为“细胞能量调节器”来调节糖、脂代谢及蛋白质合成,并参与调控机体炎症反应和细胞增生等过程,参与多种疾病(如动脉粥样硬化、肿瘤、糖尿病和其他代谢性疾病)的发生发展.近年来随着研究的深入,AMPK与肾脏疾病的关系逐渐受到关注.     

AMP-activated protein kinase pathway and bone metabolism

There is increasing evidence that osteoporosis, similarly to obesity and diabetes, could be another disorder of energy metabolism. AMP-activated protein kinase (AMPK) has emerged over the last decade as a key sensing mechanism in the regulation of cellular energy homeostasis and is an essential mediator of the central and peripheral effects of many hormones on the metabolism of appetite, fat and glucose. Novel work demonstrates that the AMPK signaling pathway also plays a role in bone physiology. Activation of AMPK promotes bone formation in vitro and the deletion of α or β subunit of AMPK decreases bone mass in mice. Furthermore, AMPK activity in bone cells is regulated by the same hormones that regulate food intake and energy expenditure through AMPK activation in the brain and peripheral tissues. AMPK is also activated by antidiabetic drugs such as metformin and thiazolidinediones (TZDs), which also impact on skeletal metabolism. Interestingly, TZDs have detrimental skeletal side effects, causing bone loss and increasing the risk of fractures, although the role of AMPK mediation is still unclear. These data are presented in this review that also discusses the potential roles of AMPK in bone as well as the possibility for AMPK to be a future therapeutic target for intervention in osteoporosis.     

AMPK-能量代谢感受器与可激活AMPK相关的药物研究进展

单磷酸腺苷活化蛋白激酶（AMPK）可以感受细胞能量代谢变化,调节细胞的葡萄糖、脂肪酸的代谢过程。AMPK与细胞生长、生存和多种代谢信号途径关系密切,研究发现AMPK信号途径涉及炎症、肿瘤和代谢疾病。本文综述AMPK的功能与炎症、肿瘤、代谢类疾病的关系和诸如水杨酸、二甲双胍等药物激活AMPK的研究进展。     

AMP活化蛋白激酶的抗氧化作用

AMP活化蛋白激酶(AMPK)广泛参与细胞代谢,在调节细胞能量代谢过程中起重要作用.另外,AMPK还可以调节机体抗氧化能力,通过调节机体抗氧化防御系统蛋白的表达,如硫氧化还原蛋白(TRX)、NAD(P)H氧化酶、二氧化锰超氧化物歧化酶(MnSOD)、过氧化物酶体增殖物活化受体协同刺激因子(PGC)-1α等,减少机体活性...     

AMP-activated protein kinase in the brain

Since its discovery as an important regulator of fuel utilization in the periphery, AMP-activated protein kinase (AMPK) has become a contender for many important cell-intrinsic and organismal roles regarding energy balance in the central nervous system. The challenge will be to delineate the mechanisms by which neuronal AMPK can respond to cellular energy requirements as well as whole body energy demands. Thus, under physiological conditions in the brain, hypothalamic AMPK responds to changes in energy balance/food intake, whereas under pathological conditions, AMPK responds globally in the brain to energy challenge. Modulation of fatty acid metabolism affects energy balance in a context-specific manner and may provide an insight into other mechanisms for selective activation or inhibition of AMPK activity for therapeutic applications.     

AMP-活化蛋白激酶与缺血性脑血管病

作为细胞内的能量感受器，AMP-活化蛋白激酶(AMP-activated protein kinase,AMPK)在维持细胞和机体能量平衡中发挥着重要作用。最初，AMPK在糖尿病、肥胖等代谢性疾病的病理生理学过程中的作用研究较多；近年来，AMPK在脑组织中的分布以及酸中毒、氧化应激损伤和细胞凋亡等病理生理学过程中的作用日益受到重视。同时发现，卒中后人为调节AMPK活性可改变神经细胞结局。因此，AMPK有望成为治疗缺血性脑血管病的新靶点。