COX-2和mito-KATP通道在舒芬太尼预处理对心肌缺血再灌注大鼠延迟性心肌保护中的作用

目的 探讨环氧合酶-2(COX-2)和线粒体ATP敏感性钾通道(mito-KATP通道)在舒芬太尼预处理对心肌缺血再灌注大鼠产生延迟性心肌保护中的作用.方法 健康成年雄性Wistar大鼠72只,体重250～300 g,随机分为6组(n=12),Ⅰ组～Ⅲ组心肌缺血前24 h腹腔注射生理盐水1 ml/kg;Ⅳ组～Ⅵ组心肌缺血前24 h腹腔注射舒芬太尼20μg/kg;Ⅱ组和Ⅴ组心肌缺血前30 min腹腔注射选择性COX-2抑制剂NS-398 5 mg/kg;Ⅲ组和Ⅵ组心肌缺血前10 min经右侧股静脉注射选择性mito-KATP通道阻断剂5-羟葵酸(5-HD)10 mg/ks.各组随机取6只大鼠,于心肌缺血前即刻处死,采用Western blot法检测心肌组织COX-2表达,ELISA法测定心肌组织PGE2及PGF1α含量.各组其余6只大鼠采用结扎左冠状动脉前降支45 min再灌注120 min的方法制备心肌缺血再灌注模型,记录缺血前即刻、缺血15、30、45 rain、再灌注30、60、90、120 min时的HR及MAP,计算二者乘积(RPP);于缺血前即刻、缺血45 nfin及再灌注120 rain时取右颈内动脉血样0.5 ml,测定血浆肌酸激酶同工酶(CK-MB)活性;于再灌注120min时取心脏,测定左心室面积(LV)、缺血危险区面积(AAR)和梗死区面积(LA),计算AAR/LV及IMAAR.结果 各组缺血再灌注期间HR、MAP和RPP逐渐降低,再灌注期间HR、MAP和RPP明显低于基础值(P<0.05),各组间HR、MAP、RPP及AAR/LV比较差异无统计学意义(P>0.05).与Ⅰ组比较,Ⅳ组血浆CK-MB活性降低,LA/AAR降低,心肌COX-2表达上调,PGE2及PGF1α含量升高(P<0.05),Ⅱ组和Ⅲ组血浆CK-MB活性、IA/AAR、心肌COX-2表达、PGE2及PGF1α含量差异无统计学意义(P>0.05);与Ⅳ组比较,Ⅴ组和Ⅵ组血浆CK-MB活性升高,IMAAR升高,Ⅴ组心肌PGE2和PGF1α含量降低(P<0.05),Ⅴ组心肌COX-2表达、Ⅵ组心肌COX-2表达、PGE2及PGF1α含量差异无统计学意义(P>0.05).结论 COX-2和mito-KATP通道共同介导舒芬太尼预处理对心肌缺血再灌注大鼠的延迟性心肌保护作用.

Role of cyclooxygenase-2 and mitochondrial KATP channels in sufentanil preconditioning-induced delayed cardioprotection against myocardial ischemia-reperfusion injury in rats

Objective To investigate the role of cyclooxygenase-2(COX-2)and mitochondrial adenosine tuiphosphate sensitive potassium channels (mito-KATP channels) in sufentanil preconditioning-induced delayed cardiopreteetion against myocardial ischemia-reperfnsion (I/R) injury in rats. Methods Seventy-two adult male Wistsr rats weighing 250-300 g were randomly divided into 6 groups ( n =12 each). Group Ⅰ,Ⅱ,Ⅲ were preconditioned with intraperitoneal (IP) normal saline (NS) 1 ml/kg while group Ⅳ,Ⅴ,Ⅵ with IP sufentanil 20 μg/kg at 24 h before myocardial ischemia. Group Ⅱ and Ⅴ were given IP NS-398 ( COX-2 inhibitor) 5 mg/kg at 30 rain before myocardial ischemla while group Ⅲ and Ⅵ were given intravenous 5-HD (mito-KATP channelblocker) 10 mg/kg at 10 min before ischemia or before being killed. Six animals in each group underwent 45 min myocardial ischemia followed by 120 min reperfusion, while the other six animals in each group were killed immediately before ischemia for determination of myocardial COX-2 expression and myocardial PGF2 and PGF1α content. Myocardial ischemia was induced by occlusion of left anterior descending branch (LAD) of coronary artety for 45 rain followed by 120 min reperfusion. MAP and HR were recorded immediately before ischemia (T0), at 15, 30, 45 rain of ischemia (T1-3) and at 30, 60, 90, 120 vain of reperfusion (T4-7). Heart rate-blood pressure product (RPP) was calculated. Arterial blood samples were obtained at T0.3 and T7 for measurement of plasma CK-MB activity. The animals were killed at the end of 120 nan reperfusion. The hearts were removed for determination of myocardial infarct area (IA) and area at risk (AAR). LA/AAR was calculated. Results There was no significant difference in HR, MAP and RPP at all time points among the 6 groups. Preconditioning with sufentanil significantly decreased plasma CK-MB activity at T3 and T7 and IA/AAR in group Ⅳ as compared with group Ⅰ.Myocardial COX-2 expression was up-regulated and PGE2 and PGF1α, contents were elevated by sufentanil preconditioning in group Ⅳ as eomared with control group (Ⅰ). In group Ⅴ and Ⅳ preconditioning with NS-398/5-HD significantly increased plasma CK-MB concentration and IS/AAB as compared with group Ⅳ, indicating involvement of COX-2 and mito-KATP channels in the sufentanil-induced delayed cardioprotection.The myocardial PGE2 and PGF1α contents were significantly reduced in group Ⅴ as compared with group Ⅳ. There was no significant difference in the myocardial COX-2 expression among group Ⅳ, Ⅴ and Ⅵ. Conclusion Both COX-2 and mito-KATP channels are involved in sufentanil preconditioning-induced delayed cardiopmtection.