PI3K-Akt信号通路在二氮嗪后处理减轻大鼠心肌缺血再灌注损伤中的作用

目的 评价磷脂酰肌醇-3-激酶-蛋白质丝氨酸苏氨酸激酶(PI3K-Akt)信号通路在二氮嗪后处理减轻大鼠心肌缺血再灌注损伤中的作用.方法 成年雄性SD大鼠36只,体重250～300 g,采用随机数字表法,将其随机分为4组(n=9):心肌缺血再灌注组(I/R组)、二氮嗪组(D组)、PI3K抑制剂渥蔓青霉素组(W组)和二氮嗪复合渥蔓青霉素组(DW组).采用结扎大鼠左冠状动脉前降支30min再开放120 min的方法制备心肌缺血再灌注模型.缺血25 min时,4组分别经股静脉输注0.1％二甲基亚砜、二氮嗪0.47 mg·kg-1·min-、渥蔓青霉素1 μg·kg-1 ·min-1和二氮嗪0.47 mg·kg-1·min-1,其中DW组于给予二氮嗪前5min静脉输注渥蔓青霉素1μg·kg-·min -,药物输注时间均为15 min.再灌注120 min时经左心室采集血样,测定血浆乳酸脱氢酶(LDH)活性；取心肌组织,测定心肌梗死面积、细胞凋亡率、Bcl-2和Bax的表达,并计算Bcl-2与Bax的比值(Bcl-2/Bax比).结果 与I/R组比较,D组和DW组血浆LDH活性、心肌梗死面积及细胞凋亡率降低,心肌组织Bcl-2表达上调,Bax表达下调,BcL2/Bax比升高(P＜0.05或0.01),W组上述指标差异无统计学意义(P＞0.05)；与D组比较,DW组血浆LDH活性、心肌梗死面积以及细胞凋亡率降低,心肌组织Bcl-2表达下调,Bax表达上调,Bcl-2/Bax比降低(P＜0.05或0.01).结论 PI3K-Akt信号通路参与了二氮嗪后处理减轻大鼠心肌缺血再灌注损伤.

The role of PI3K-Akt signal pathway in protection of myocardium agalnst ischemia-reperfusion injury by diazoxide postconditioning in rats

Objective To investigate the role of phosphatidylinositol 3-kinase/protein-serine-threonine kinases (PI3K-Akt) signal pathway in the protection of myocardium against ischemia-reperfusion (I/R) injury by diasoxide postconditioning in rats.Methods Thirty-six male SD rats weighing 250-300 g were randomly divided into 4 groups using random number table (n =9 each):group I/R; group diazoxide (group D); group wortmannin (PI3K inhibitor) (group W) and group wortmannin + diazoxide (group WD).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 4 ml/kg,intubated and mechanically ventilated.Myocardial I/R was produced by 30 min occlusion of left anterior descending coronary artery followed by 120 min reperfusion.0.1％ dimethyl sulfoxide (the vehicle for diazoxide and wortmannin)/diazoxide at 0.47 mg· kg-1 · min-1/wortmannin at 1 μg·kg-1 ·min-1 was infused for 15 min starting from 25 min of ischemia in groups I/R,D and W respectively.In group DW wortmannin was infused at 5 min before diazoxide infusion.Blood samples were collected from left ventricle at the end of 120 min reperfusion for measurement of lactate dehydrogenase (LDH) activity.Myocardial infarct size was measured.Myocardial specimens were obtained for determination of apoptosis index (the number of apoptotic cells/the total number of cells examined) and expression of Bcl-2 and Bax.Bcl-2/Bax ratio was calculated.Results Diazoxide postconditioning significantly decreased plasma LDH activity,myocardial infarct size,apoptosis index and Bax expression in myocardium and increased myocardial Bcl-2 expression and Bcl-2/Bax ratio in group D compared with group I/R.Wortmannin partly counteracted the protective effects of diazoxide postconditioning against myocardial infarct.There was no significant difference in the above variables between groups I/R and W.Conclusion PI3K-Akt signal pathway is involved in the protective effects of diazoxide postconditioning on myocardium against I/R injury.