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双下肢缺血后处理保护再灌注心肌时效性及对线粒体通路调控的研究OA北大核心CSTPCD

Protective effect of limb remote ischemic postconditioning on reperfused heart at different time points and its mechanism of mediating mitochon-drial-dependent apoptosis and necrosis pathways

中文摘要英文摘要

目的:观察双下肢缺血后处理(即远隔器官缺血后处理,remote ischemic postconditioning,RIpostC)保护缺血再灌注小鼠心肌的时效性及对心肌线粒体依赖性凋亡和坏死通路的调控.方法:成年雄性C57BL/6J野生型小鼠被随机分为假手术(sham)组、心肌缺血再灌注(myocardial ischemia/reperfusion,MI/R)组、缺血后处理组、RIpostC组及RIpostC延迟1、5、10、15、30和60 min组.阻断左冠脉45 min,再灌注24 h,建立MI/R模型;气囊袖带阻断双下肢血流5 min,再灌注5 min,实施RIpostC.再灌注24 h后,Evans blue和TTC染色观察心肌梗死面积与血清心肌钙蛋白I变化.TUNEL和高迁移率族盒蛋白1(high mobility group box protein 1,HMGB1)染色观察心肌凋亡和坏死;线粒体水肿实验观察心肌线粒体膜电位变化;Western blot观察心肌细胞凋亡和线粒体膜通透性转换孔(mito-chondrial permeability transition pore,mPTP)相关蛋白表达.结果:与MI/R组比较,RIpostC及RIpostC延迟1、5、10和15 min组心肌梗死面积明显减少,RIpostC延迟30和60 min组则无明显改变.缺血后处理与RIpostC对缺血再灌注心肌有类似保护效应.RIpostC减少缺血再灌注心肌细胞凋亡和坏死发生.RIpostC降低缺血再灌注心肌亲环蛋白D(cyclophilin D,CypD)、Bax和Bak蛋白表达水平.结论:心肌再灌注后15 min内实施RIpostC能够减少心肌梗死面积,其保护作用与缺血后处理类似;RIpostC通过调控线粒体依赖性凋亡和坏死通路减轻MI/R损伤.

AIM:To investigate the impact of transient limb remote ischemic postconditioning(RIpostC)on mice with myocardial ischemia/reperfusion(MI/R)at various time points,and to elucidate its protective mechanism associ-ated with mitochondrial-dependent apoptosis and necrosis pathways.METHODS:Male C57BL/6J wild-type mice under-went either sham operation or left coronary artery ischemia for 45 min followed by 24 h of reperfusion.The RIpostC,con-sisting of 3 cycles of ischemia(5 min)/reperfusion(5 min),was performed on the double lower limbs at 0,1,5,10,15,30 or 60 min after myocardial reperfusion.The assessment of myocardial infarction size was conducted using Evans blue and TTC staining,while serum cardiac troponin I levels were measured using an ELESA kit.Apoptosis and necrosis were evaluated through TUNEL and high mobility group box protein 1(HMGB1)immunofluorescence staining.Western blot analysis was employed to determine the expression levels of cyclophilin D(CypD),Bak,Bax,mitochondrial calcium uni-porter(MCU),voltage-dependent anion channel(VADC)and ATP synthase β subunit(ATP5B).RESULTS:In wild-type mice subjected to MI/R,significant decreases in myocardial infarct size were observed with the following treatments:PostC,RIpostC,RIpostC-1 min,RIpostC-5 min,RIpostC-10 min,and RIpostC-15 min.The RIpostC resulted in de-creased TUNEL and HMGB1 positive cardiomyocytes in reperfused myocardial paraffin slides.However,RIpostC-30 min and RIpostC-60 min treatments did not show an apparent reduction in myocardial infarct size.The RIpostC induced cardio-myocyte mitochondrial swelling and down-regulated Bax,Bak and CypD levels during MI/R.The protective mechanism was further verified using peptidylprolyl isomerase F(Ppif)gene(encoding CypD)knockout mice and mitochondrial per-meability transition pore(mPTP)inhibitors.CONCLUSION:The RIpostC bestows cardioprotection even when adminis-tered with a significant delay of 15 min after the initiation of myocardial reperfusion.It significantly reduced cardiomyocyte necrosis and apoptosis by inhibiting the expression of Bax,Bak and CypD during MI/R.

邢大一;张涌;李毅;梁法禹;王志斌;郭林静;秦东泽

山西医科大学第一医院心脏外科,山西 太原 030001山西医科大学第二医院,山西 太原 030001

基础医学

心肌缺血再灌注损伤远隔器官缺血后处理细胞凋亡坏死线粒体膜通透性转换孔

myocardial ischemiareperfusion injuryremote ischemic postconditioningapoptosisnecro-sismitochondrial permeability transition pore

《中国病理生理杂志》 2024 (004)

637-645 / 9

2018年山西省应用基础研究计划项目(No.201801D121342);2016年度山西省留学人员科技活动项目(晋人社厅函2017[397号])

10.3969/j.issn.1000-4718.2024.04.008

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