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医药导报, 2019, 38(3): 317-320
doi: 10.3870/j.issn.1004-0781.2019.03.007
右美托咪定预处理对大鼠肺缺血-再灌注损伤时氧化应激反应及细胞凋亡的影响*
Effect of Dexmedetomidine Pretreatment on Oxidative Stress Response and Apoptosis During Lung Ischemia-reperfusion in Rats
孔岚1,, 白玉1, 韩圣娜2

摘要:

目的 观察右美托咪定预处理对大鼠肺缺血-再灌注损伤时氧化应激反应及细胞凋亡的影响。方法 将48只雄性SD大鼠随机分为3组(n=16),假手术组(S组)开左胸不夹闭肺门,缺血-再灌注(IR)组夹闭左肺门使左肺缺血45 min,再恢复灌注2 h;右美托咪定预处理+缺血-再灌注组(D组) 夹闭左肺门前20 min经股静脉注射右美托咪定20 μg·kg-1。再灌注2 h后处死大鼠,留取左肺组织,称湿重(W)和干重(D),测定W/D及总肺水含量(TLW),光镜观察肺组织形态学改变。黄嘌呤氧化酶法测定超氧化物歧化酶(SOD)活性,硫代巴比妥酸法测定丙二醛(MDA)含量,Western blotting检测肺组织B细胞淋巴瘤/白血病-2(bcl-2)、B细胞淋巴瘤/白血病-2相关x蛋白(bax)、半胱氨酸天冬氨酸蛋白酶-3(caspase-3)蛋白表达情况。结果 与S组比较,其他两组W/D、TLW均升高(P<0.01);与IR组比较,D组W/D、TLW明显降低(P<0.01) ;与S组比较,其他两组肺组织MDA含量升高,SOD活性降低(P<0.01),肺组织bax、caspase-3蛋白表达升高(P<0.01),bcl-2蛋白表达降低(P<0.01);与IR组比较,D组MDA含量降低,SOD活性升高更明显(P<0.01),肺组织bax、caspase-3蛋白表达降低及bcl-2蛋白表达升高更显著(P<0.01)。结论 右美托咪定通过抑制氧化应激反应及细胞凋亡减轻大鼠肺缺血-再灌注损伤。

关键词: 右美托咪定 ; 预处理 ; 缺血-再灌注损伤/肺

Abstract:

Objective To evaluate the effects of dexmedetomidine on oxidative stress response and apoptosis during lung ischemia-reperfusion (IR) in rats. Methods Forty-eight adult male Sprague-Dawley rats were randomly divided into 3 groups (n=16 each) using a random number table: sham operation group (group S), group IR, and dexmedetomidine pretreatment+IR group(group D).Dex medetomidine was injected at 25 μg·kg-1 20 min before ischemia in Dex group.The equal volume of 0.9% sodium chloride soution was injected into group S and group IR, respectively.Rats were euthanized 2 h after reperfusion.The left lung tissue was extracted.Wet lung weight and dry lung weight (W/D) and total lung water content (TLW) were tested.Morphology of lung tissue was observed.The left lung tissues were removed for determination of malondialdehyde (MDA) content (by thiobarbituric acid method) and superoxide dismutase (SOD) activity (using xan-thine oxidase method).The bcl-2, bax and Caspase-3 protein expression was detected by Western blotting. Results Compared with group S, W/D and TLW of the lung tissue in the other two groups were all significantly increased (P<0.01).Compared with group IR, W/D and TLW of the lung tissues in group D were all significantly reduced (P<0.01).As compared with group S, MDA was increased and SOD decreased, bax and Caspase-3 protein expression increased, bcl-2 protein expression decreased in the lung tissue of the other two groups (P<0.01).As compared with group IR, MDA decreased and SOD increased more significantly in group D (P<0.01), bax and Caspase-3 protein expression decreased and bcl-2 increased more significantly (P<0.01). Conclusion Dexmedetomidine can alleviate lung IR injury in rats, and the mechanism is related to inhibition of oxidative stress response and apoptosis.

Key words: Dexmedetomidine ; Pretreatment ; Ischemia-reperfusion injury/lung

肺缺血-再灌注损伤是造成急性肺损伤的常见原因,多见于失血性休克、肺移植、体外循环手术、心脏骤停复苏等。研究表明,肺组织氧化应激反应和细胞凋亡与肺缺血-再灌注损伤的发生发展密切相关[1],右美托咪定是高选择性α2肾上腺素能受体激动剂,有研究显示该药可减轻大鼠肺缺血-再灌注损伤[2,3],但机制尚不明确。笔者在本实验研究右美托咪定预处理对大鼠肺缺血-再灌注损伤的影响,并探讨其作用机制。

1 材料与方法
1.1 材料

清洁级SD大鼠,2个月龄,雄性,体质量240~300 g,由郑州大学动物实验中心提供,实验动物生产许可证号:SCXK(豫) 2017- 0009,实验动物合格证号: HG0016。 饲养环境:屏障环境,相对湿度 40%~70%,温度20~26 ℃,人工光照,昼夜明暗交替,空气洁净度10 000级,落下细菌数≤每皿3个,噪声≤60 db,自由摄食、饮水,建模前12 h禁食,本研究已获得郑州大学附属肿瘤医院动物伦理委员会批准同意。

1.2 药品与试剂

右美托咪定(江苏恩华药业股份有限公司,批号:20170702,规格:1 mL:100 μg);丙二醛(MDA)试剂盒(批号:1508)、超氧化物歧化酶(SOD)试剂盒(批号:1672)均购自南京建成科技有限公司;肝素钠(南京新百药业有限公司,批号:H32035851,规格:2 mL:12500 U),B细胞淋巴瘤/白血病-2相关X蛋白(B cell lymphoma/lewkmia-2 associated X protein,bax)、 B细胞淋巴瘤/白血病-2(B cell lymphoma/lewkmia-2,bcl-2)、半胱氨酰天冬氨酸特异性蛋白酶-3(cysteinyl aspartate specific proteinase-3,caspase-3)及甘油醛-3-磷酸脱氢酶(glyceraldehyde-3-phosphate dehydrogenase,GAPDH)一抗(中国碧云天生物技术研究所,批号分别为C1256,C1305,C1375,C1298),二抗工作液(中国碧云天生物技术研究所,批号:SC6753,SC7876,SC8562,SC5219)。

1.3 仪器与设备

HX-100E小动物呼吸机(中国成都泰盟科技有限公司),电泳仪(美国Bio-rad公司)。

1.4 动物分组与模型的制备

采用随机数字表法将大鼠分为3组(n=16),假手术组(S组)只开左胸不夹闭肺门;缺血-再灌注(IR)组夹闭左肺门使左肺缺血45 min,再恢复灌注2 h;右美托咪定预处理+缺血-再灌注组(D组)夹闭左肺门前20 min经股静脉注射右美托咪定20 μg·kg-1。 参照改良的EPPINGER法[4]建立肺缺血-再灌注模型,大鼠经腹腔注射10%水合氯醛3 mL·kg-1麻醉,置于有保温设备的实验台上仰卧位固定,气管切开后插管,接小动物呼吸机,机械通气,潮气量双侧肺通气15~20 mL·kg-1,单侧肺通气8~10 mL·kg-1,通气频率60次·min-1,吸气与呼气比为1:2。维持呼气末二氧化碳分压(end tidal carbon dioxide tension,PETCO2)4.66~5.98 kPa,股静脉置入24 G静脉留置针,便于给药和输液。修剪左胸部皮毛,涂抹脱毛剂去毛,75%乙醇、碘酊消毒左胸部皮肤,逐步分离肌肉、筋膜,切断肋骨后打开胸腔,暴露左肺,无损伤钳游离左肺门,静脉注入肝素钠50 U,10 min后用无创血管夹夹闭左肺门45 min,可见左肺颜色从红色变为暗红色,说明缺血成功,45 min后松开血管夹恢复血供,左肺由暗紫色转为红色,表明再灌注成功。再灌注2 h后处死大鼠,留取左肺组织。制备模型过程中使用BWZ-50C6微量泵(浙江史密斯医学仪器有限公司)静脉泵注乳酸钠林格液6 mL·kg-1·h-1

1.5 测定大鼠肺组织湿/干重比(Wet/Dry,W/D)以及总肺含水量(total lung water,TLW)

处死大鼠,取左肺组织,用0.9%氯化钠溶液充分漂洗,多余水分用滤纸吸干,称重量即为湿重(W);80 ℃恒温箱中烘干48 h,称干重(D),计算肺W/D。TLW=(W-D)/D。另取部分左肺组织置于甲醛溶液,石蜡切片,苏木精-伊红(HE)染色,光镜下观察、比较各组肺组织病理学特征。

1.6 肺组织MDA含量和SOD活性测定

取部分左肺组织,制备10%组织匀浆,低温离心后取上层悬液,硫代巴比妥酸法测定MDA含量,黄嘌呤氧化酶法测定SOD活性。

1.7 Western blotting测定bax、caspase-3、bcl-2蛋白表达

取部分肺组织,研磨为组织匀浆,高速低温离心,取上清液,采用Bradford法测定蛋白浓度。蛋白煮沸变性,聚丙烯酰胺凝胶电泳法将蛋白质转移至硝酸纤维素膜,5%脱脂奶粉封闭,37 ℃反应后分别加入bax、caspase-3、bcl-2一抗和GAPDH一抗4 ℃下过夜,加入二抗室温下反应1.5 h。化学发光、显影、定影。Quantity One图像分析软件进行半定量分析。

1.8 统计学方法

采用SPSS 19.0版统计学软件进行分析,计量资料以均数±标准差($\bar{x}± S$)表示,组间比较采用重复测量设计的方差分析,以P<0.05表示差异有统计学意义。

2 结果
2.1 肺组织W/D与TLW

与S组比较,其他两组W/D升高,差异有统计学意义 (F=98.152,94.131,P<0.01),TLW均升高,差异有统计学意义(F=96.172,92.386,P<0.01);与IR组比较,D组W/D、TLW明显降低,差异有统计学意义(F=105.163,101.231,P<0.01)。见表1。

表1 3组肺组织W/D与TLW测定结果
Tab.1 Results of W/D and TLW of lungs in three groups $\bar{x}$±s
组别 大鼠数 W/D TLW
S组 16 4.31±0.28 3.29±0.26
IR组 16 5.99 ±0.41*1 4.71±0.39*1
D组 16 5.30±0.12*1*2 4.23±0.21*1*2

与S组比较,*1P<0.01;与IR组比较,*2P<0.01

Compared with S group,*1P<0.01;Compared with IR group,*2P<0.01

表1 3组肺组织W/D与TLW测定结果

Tab.1 Results of W/D and TLW of lungs in three groups $\bar{x}$±s

2.2 肺组织结构

S组大鼠肺组织结构未见明显损伤性改变,肺泡及肺泡壁结构完整,肺间质无水肿,无中性粒细胞浸润;IR组肺泡结构破坏严重,肺泡内及肺泡壁充血实变,肺间隔增厚,肺泡腔和间质严重水肿,并可见大量红细胞漏出,中性粒细胞明显浸润。D组肺组织损伤程度明显减轻,肺泡及肺间质仅少量中性粒细胞浸润。

2.3 肺组织MDA含量及SOD活性比较

与S组比较,其他两组肺组织MDA含量升高,差异有统计学意义(F=91.769,95.832,P<0.01);SOD活性降低,差异有统计学意义(F=104.335,97.356,P<0.01);与IR组比较,D组肺组织MDA含量降低(F=95.534,P<0.01),SOD活性升高,差异有统计学意义(F=96.769,P<0.01),见表2。

表2 3组大鼠肺组织MDA含量与SOD活性测定结果
Tab.2 Results of MDA content and SOD activity of lungs in three groups of rats $\bar{x}$±s
组别 大鼠数 MDA/
(nmol·mg-1)
SOD/
(U·mg-1)
S组 16 0.372±0.019 112±5
IR组 16 0.671±0.036*1 61±6*1
D组 16 0.536±0.059*1*2 75±8*1*2

与S组比较,*1P<0.01;与IR组比较,*2P<0.01

Compared with S group,*1P<0.01;Compared with IR group,*2P<0.01

表2 3组大鼠肺组织MDA含量与SOD活性测定结果

Tab.2 Results of MDA content and SOD activity of lungs in three groups of rats $\bar{x}$±s

2.4 肺组织bax、caspase-3、bcl-2蛋白表达比较

与S组比较,其他两组肺组织bax蛋白表达升高,差异有统计学意义(F=102.535,99.765,P<0.01),caspase-3蛋白表达升高(F=103.325,95.126,P<0.01),bcl-2蛋白表达降低(F=98.635,95.396,P<0.01),差异有统计学意义;与IR组比较,D组肺组织bax、caspase-3蛋白表达降低(F=97.215,94.156,P<0.01),bcl-2蛋白表达升高(F=106.235,P<0.01),差异有统计学意义,见表3。

表3 3组大鼠肺组织bax、caspase-3、bcl-2蛋白表达情况
Tab.3 Protein expression of bax, caspase-3 and bcl-2 of lungs in three groups of rats $\bar{x}$±s
组别 大鼠数 bax caspase-3 bcl-2
S组 16 98.76±12.37 99.98±13.16 99.85±11.02
IR组 16 234.12±26.35*1 197.75±21.08*1 38.67±5.18*1
D组 16 172.23±16.87*1*2 143.79±14.25*1*2 68.91±7.76*1*2

与S组比较,*1P<0.01;与IR组比较,*2P<0.01

Compared with S group,*1P<0.01;Compared with IR group,*2P<0.01

表3 3组大鼠肺组织bax、caspase-3、bcl-2蛋白表达情况

Tab.3 Protein expression of bax, caspase-3 and bcl-2 of lungs in three groups of rats $\bar{x}$±s

3 讨论

肺缺血-再灌注损伤是临床常见问题,也是急性肺损伤的主要原因之一。预防和减轻肺缺血-再灌注损伤一直是临床研究热点。右美托咪定是一种高选择性α2-肾上腺素受体激动药,目前已发现其对缺血-再灌注所引起的脏器损伤具有良好的保护作用,机制与抗氧化应激、抑制炎症细胞因子释放以及抗细胞凋亡等有关[5,6]。目前临床围术期右美托咪定多预先给药,因此本研究亦采用右美托咪定预处理方式,以更接近临床实践。笔者根据相关报道选取右美托咪定浓度[7],即于缺血前20 min给予右美托咪定20 μg·kg-1。笔者在本研究采用改良EPPINGER[4]法建立大鼠肺缺血-再灌注模型,结果显示,IR组肺组织W/D、TLW均升高,肺组织形态、结构均发生明显损伤性改变,提示大鼠肺缺血-再灌注损伤模型制备成功。D组肺组织病理损伤明显轻于IR组,提示右美托咪定能减轻肺组织损伤。

组织器官发生缺血-再灌注时,体内氧自由基生成增多,膜磷脂中多不饱和脂肪酸与氧自由基发生脂质过氧化反应,产生大量有毒脂质过氧化产物,造成并加重组织损伤[8,9,10,11]。SOD是体内最主要的抗氧化酶和自由基清除剂,可以将脂质过氧化产物(如MDA等)歧化为过氧化氢和水,清除氧自由基并终止自由基病理性连锁反应,保护细胞免受损伤,其活性高低可反映机体清除氧自由基的能力[12]。MDA含量可直接反映机体脂质过氧化反应的程度,间接反映细胞损伤的程度[13]。本研究中,与S组比较,IR组肺组织MDA含量明显升高,SOD活性明显降低,说明大鼠肺缺血-再灌注损伤过程有氧化应激反应参与;D组肺组织MDA含量明显较IR组降低,SOD活性明显较IR组升高,提示右美托咪定可能通过抑制氧化应激反应减轻大鼠肺缺血-再灌注损伤。

研究表明,在IR损伤中,细胞凋亡是再灌注后炎性反应和组织损伤的重要因素[14]。因此细胞凋亡在肺缺血-再灌注损伤中具有重要作用[15]。bcl-2和bax对调节细胞凋亡非常重要,bcl-2使细胞色素C释放减少,具有抑制细胞凋亡作用,bcl-2介导的抑制凋亡作用能被bax所拮抗,两者处于平衡状态。缺血-再灌注会影响细胞中这种平衡,导致细胞色素C大量释放进入胞质,引起细胞caspase凋亡途径被激活,发生细胞凋亡、组织功能损伤[16]。本研究中,与S组比较,IR组大鼠肺组织bax、caspase-3表达量升高明显,bcl-2表达降低明显,提示缺血-再灌注可造成肺组织细胞过度凋亡。D组大鼠肺组织bax、caspase-3表达量明显较IR组低,bcl-2表达量明显较IR组高。提示右美托咪定可以抑制细胞凋亡。

总之,右美托咪定可以通过抑制氧化应激反应及细胞凋亡来减轻大鼠肺缺血-再灌注损伤。

The authors have declared that no competing interests exist.

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[2] 万占海,张红,冷玉芳,.右美托咪定对大鼠肺缺血再灌注损伤的影响[J].中华麻醉学杂志,2014,34(9):1066-1068.
目的 评价右美托咪定对大鼠肺缺血再灌注损伤的影响.方法 健康SPF级雄性Wistar大鼠96只,体重250~350 g,8~ 12周龄,采用随机数字表法,将其分为4组(n=24):假手术组(S组)、肺缺血再灌注组(I/R组)、右美托咪定低剂量组(DL组)和右美托咪定高剂 量组(DH组).DL组和DH组分别腹腔注射右美托咪定100和500μg· kg-1·d-1,1次/d,连续2d,S组和I/R组给予等容量生理盐水.于第2天给药后30 min采用夹闭左肺门45 min时开放的方法制备肺缺血再灌注损伤模型.分别于缺血45 min、再灌注60 min和120 min时处死6只大鼠,取肺组织,检测TNF-α含量和髓过氧化物酶(MPO)活性,于再灌注120 min时取肺组织,确定损伤肺泡百分比,另取6只大鼠,进行支气管肺泡灌洗,测定支气管肺泡灌洗液(BALF)总蛋白浓度.结果 与S组比较,I/R组、DL组和DH组肺组织TNF-α含量、MPO活性、损伤肺泡百分比和BALF总蛋白浓度升高(P<0.05);与I/R组比 较,DL组和DH组肺组织TNF-α含量、MPO活性、损伤肺泡百分比和BALF总蛋白浓度降低(P<0.05).结论 右美托咪定可减轻大鼠肺缺血再灌注损伤,其机制与抑制炎性反应有关.
[本文引用:1]
[3] KONISHI T.Brain oxidative stress as basic target of antioxidant traditional oriental medicines[J].Neurochem Res,2009,34(4):711-715.
Prevention and amelioration of Mibyou (sub-healthy condition) is the critical target for disease prevention including age-related diseases and cancer although the Mibyou condition is not yet pathologically defined. Since the oxidative stress is an underlying basic etiology associated with many diseases and aging, the psychologically induced oxidative stress, especially in the brain was supposed as one of the pathology of Mibyou. Several traditional herbal prescriptions applied for the brain disorder were found effective to prevent cerebral oxidative stress induced by ischemia/reperfusion and also under psychological distress produced by whiskers cut in mice. Shengmai San comprising three herbs, Panax ginseng , Ophiopogon japonicus and Schisandra chinensis is a traditional herbal medicine formula having a long history of using as a remedy and clinical prescription to treat coronal heart diseases. Multifunctional aspect of traditional herbal prescription was discussed in terms of preventing oxidative injury in the brain using Shengmai San as a typical prescription.
DOI:10.1007/s11064-008-9872-9      PMID:18502333      Magsci     URL    
[本文引用:1]
[4] EPPINGER M J,JONES M L,DEEB M,et al.Pattern of injury and the role of neutrophil in reperfusion injury in the rat lung[J].Surg Res,1995,58(6):276-280.
Using a rat lung model, we sought to characterize the time course for ischemia-reperfusion injury and the role of neutrophils in the development of injury. Adult male Long-Evans rats underwent left thoracotomy with dissection and clamping of the left pulmonary artery, bronchus, and vein for 90 min, resulting in complete left lung ischemia. The lungs were then ventilated and reperfused for up to 4 hr. Time-matched sham animals underwent the identical thoracotomy and hilar dissection, but the lungs were not rendered ischemic. Using vascular permeability of 125I-labeled bovine serum albumin as a measure of reperfusion injury, a bimodal pattern of injury was observed. Compared to sham controls, animals undergoing ischemia-reperfusion demonstrated a significant early phase of lung injury at 30 min of reperfusion (P lt 0. 0001), followed by partial recovery. A second peak of lung injury was noted after 4 hr of reperfusion (P lt 0.001). Myeloperoxidase activity in reperfused lung tissue, a measure of neutrophil sequestration, increased during the reperfusion time course. To determine the role of neutrophils in the development of lung reperfusion injury, additional animals undergoing the identical ischemia-reperfusion protocol received either rabbit anti-rat neutrophil serum or preimmune serum the day prior to operation. Profound neutropenia ( lt 75/mm-3 blood) was confirmed by differential leukocyte counts. Neutropenia had no protective effect against microvascular permeability at 30 min of reperfusion, but there was a significant reduction in lung injury at 4 hr (P lt 0.005). We conclude that, during lung ischemia-reperfusion, there is a bimodal pattern of injury, consisting of both neutrophil-independent and neutrophil-mediated events.
DOI:10.1006/jsre.1995.1112      PMID:7791351      URL    
[本文引用:2]
[5] JIANG L,LI L,SHEN J,et al.Effecl of dexmedetomidine on lung ischemia-reperfusion injuryI[J].Mol Med Rep,2014,9(2):419-426.
Dexmedetomidine, a specific selective (2)-adrenergic agonist, does not only have the characteristics of being a sedative and analgesic, but also exhibits a protective role in brain ischemia-reperfusion injury and inhibits the inflammation in animals with sepsis. The objective of the present study was to investigate whether dexmedetomidine is capable of attenuating rat pulmonary damage induced by ischemia-reperfusion injury, which is a type of acute sterile lung injury. Sprague-Dawley rats were randomly assigned into six groups: The sham-operated (sham) group, the lung ischemia-reperfusion (I/R) group, intravenous injection of dexmedetomidine 2.5 g/kg/h (Dex2.5) or 5 g/kg/h (Dex5) for 1 h prior to ischemia, combination of (2)-adrenergic antagonist yohimbine prior to dexmedetomidine pre-treatment (Dex+Yoh) and pre-administration of yohimbine alone (Yoh) prior to ischemia. Lung injury was assessed by the histopathological changes, arterial blood gas, wet/dry (w/d) weight ratio and myeloperoxidase (MPO) activity of the lung. The concentration of tumor necrosis factor- (TNF-), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) in bronchoalveolar lavage fluid (BALF) was measured by an enzyme-linked immunosorbent assay. The expression of toll-like receptor-4 (TLR4) and myeloid differentiation factor 88 (MyD88) mRNA in the lung were determined by quantitative PCR, and phosphorylated levels of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase (ERK)1/2 were determined by western blotting. Pre-treatment with dexmedetomidine significantly reduced the lung injury, w/d weight ratio and MPO activity, and decreased the concentration of TNF-, IL-6 and MCP-1 in BALF compared with the I/R group. The expression of TLR4 and MyD88 mRNA and the levels of phosphorylated JNK and ERK1/2 in the lung tissue were markedly downregulated by intravenous injection of dexmedetomidne for 1 h prior to lung I/R. The protective effects of dexmedetomidine on the lung were not completely reversed by the (2)-adrenergic antagonist, yohimbine. Pre-treatment with dexmedetomidine is capable of reducing pulmonary damage and inhibiting sterile inflammation induced by lung I/R injury. TLR4/MyD88/mitogen-activated protein kinase (MAPK) signaling is involved in the protective mechanism of dexmedetomidine through (2)-adrenoceptor independence.
DOI:10.3892/mmr.2013.1867      Magsci    
[本文引用:1]
[6] CAI Y,XU H,YAN J,et al.Molecular targets and mechanism of dexmedetomidine in treatment of ischemia/reperfusion iniury[J].Mol Med Rep,2014,9(5):1542-1550.
Dexmedetomidine (DEX), a highly specific α262adrenergic agonist, which exhibits anaesthetic62sparing, analgesia and sympatholytic properties. DEX modulates gene expression, channel activation, transmitter release, inflammatory processes and apoptotic and necrotic cell death. It has also been demonstrated to have protective effects in a variety of animal models of ischemia/reperfusion (I/R) injury, including the intestine, myocardial, renal, lung, cerebral and liver. The broad spectrum of biological activities associated with DEX continues to expand, and its diverse effects suggest that it may offer a novel therapeutic approach for the treatment of human diseases with I/R involvement.
DOI:10.3892/mmr.2014.2034      PMID:24627001      Magsci     URL    
[本文引用:1]
[7] GU J,CHEN J,XIA P,et al.Dexmedetomidine attenuates remote lung injury induced by renal ischemia-reperfusion in mice[J].Acta aesthesiol Scand,2011,55(10):1272-1278.
BackgroundRenal ischemia–reperfusion (I/R) may cause acute lung injury (ALI). The mortality of combined acute kidney injury and ALI is extremely high. Dexmedetomidine, an α2 adrenergic agonist, exerts potent anti-inflammatory and organoprotective effects in addition to its sedative and analgesic properties. We sought to elucidate whether dexmedetomidine can attenuate lung injury following renal I/R in a murine model of renal I/R.MethodsAdult C57BL/6J male mice were randomized to five groups: sham-operated control (Sham); renal I/R (I/R); intraperitoneal injection of dexmedetomidine 2565μg/kg before ischemia (pre-dex) and after perfusion (post-dex); combination of α2 adrenergic antagonist atipamezole 25065μg/kg prior to dexmedetomidine pre-treatment (atip-dex). Kidney I/R was induced by bilateral renal pedicle clamping for 4565min and followed by 665h reperfusion. The pulmonary tissues were harvested for histopathological evaluation, wet/dry ratio measurement, biochemical analysis of myeloperoxidase (MPO), Polymerase chain reaction (PCR) determination of Inter-cellular adhesion molecule (ICAM-1) and Tumor necrosis factor – alpha (TNF-α) mRNA.ResultsRenal IR induced significant pulmonary injuries, increased wet/dry ratio together with the enhanced of MPO activities and increased ICAM-1 and TNF-α mRNA level. Both pre- and post-treatment with dexmedetomidine markedly reduced lung edema and inflammatory response and lowered MPO activity and ICAM-1 and TNF-α mRNA expression. The protective effects of dexmedetomidine in the lung were partially reversed by atipamezole, but there were no effect on ICAM-1 and TNF-α mRNA expression level.ConclusionsDexmedetomidine is capable of attenuating remote lung injury induced by renal IRvia both α2 adrenoceptors dependent and independent mechanisms.
DOI:10.1111/j.1399-6576.2011.02526.x      PMID:22092133      URL    
[本文引用:1]
[8] HE F,XU B L,CHEN C,et al.Methylophiopogonanone A sup-presses ischemia/reperfusion-induced myocardial apoptosis in mice via activating P13K/Akt/eNOS signaling pathway[J].Acta Pharmacol Sin,2016,37(6):763-771.
The dried tuber root ofOphiopogon japonicushas been used in the traditional Chinese medicine for treatment of myocardial ischemia and thrombosis. In this study we investigated the effects of methylophiopogonanone A (MO-A), a major homoisoflavonoid inOphiopogon japonicus, on myocardial ischemia/reperfusion (I/R) injury. Mice were pretreated with MO-A (10 mgd-1,po) for 2 weeks and then subjected to transient occlusion of the left anterior descending coronary artery. Cardiac function was evaluated, and the infarct size and apoptosis index were assessed. The mechanisms underlying the cardio-protection of MO-A were analyzed in H9C2 rat cardiomyocytes subjected to hypoxia/reoxygenation (H/R). The cell viability and apoptosis were evaluated; apoptotic and relevant signaling proteins were analyzed. NO levels in the culture medium were assessed. In I/R mice, pretreatment with MO-A significantly reduced the infarct size (by 60.7%) and myocardial apoptosis (by 56.8%), and improved cardiac function. In H9C2 cells subjected to H/R, pretreatment with MO-A (10 ol/L) significantly decreased apoptosis and cleaved caspase-3 expression, elevated the Bcl-2/Bax ratio and restored NO production. Furthermore, pretreatment with MO-A markedly increased the activation of PI3K/Akt/eNOS pathway in H9C2 cells subjected to H/R, and the protective effects of MO-A were abolished in the presence of the PI3K inhibitor wortmannin (100 nmol/L). MO-A attenuates I/R-induced myocardial apoptosis in mice via activating the PI3K/Akt/eNOS signaling pathway.
DOI:10.1038/aps.2016.14      PMID:27063216      URL    
[本文引用:1]
[9] FANG J,HU F,KE D,et al.N-dimethylsphingosine attenuates myocardial ischemia-reperfusion injury by recruiting regulatory T cells through P13K/Akt pathway in mice[J].Basic Res Cardiol,2016,111(3):32-34.
N, N-dimethylsphingosine (DMS) has been documented to be in vitro protective against myocardial ischemia–reperfusion injury (IRI) and can recruit CD4+CD25+Foxp3+regulatory T cells (Tregs), which may...
DOI:10.1007/s00395-016-0548-3      PMID:27048490      URL    
[本文引用:1]
[10] 张引,金世云,何淑芳,.JNK信号通路和p38MAPK信号通路在吗啡预处理减轻心力衰竭大鼠心肌缺血再灌注损伤中的作用[J].中华麻醉学杂志,2016,36(2):219-222.
目的 评价c-Jun氨基末端激酶(JNK)信号通路和p38丝裂原活化蛋白激酶(p38 MAPK)信号通路在吗啡预处理减轻心力衰竭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,200~ 230 g,尾静脉注射盐酸多柔比星2 mg/kg,1次/周,连续6周,建立大鼠慢性心力衰竭模型.于第8周末,取成功制备慢性心力衰竭模型的45只大鼠,采用随机数字表法分为5组(n=9):假手术组(S组)、缺血再灌注组(I/R组)、吗啡预处理组(MPC组)、JNK抑制剂SP600125+吗啡预处理组(MSP组)和p38MAPK抑制剂SB203580+吗啡预处理组(MSB组).采用结扎冠状动脉左前降支30 min,再灌注120 min的方法建立心肌缺血再灌注损伤模型;MPC组于缺血前股静脉输注吗啡0.1 mg/kg,输注5 min后停止输注5 min,重复3次进行预处理;MSP组和MSB组于吗啡预处理前10 min时股静脉注射SP600125 0.5 mg/kg或SB203580 0.2 mg/kg.于再灌注120 min时处死大鼠,取心肌组织,计算左心室与右心室总体积(LV +RV),测定缺血危险区体积(AAR)和梗死区体积(IS),计算IS/AAR比值;采用免疫组化法测定心肌组织蛋白激酶δ(PKC δ)的表达水平.结果 5组间LV+RV和AAR比较差异无统计学意义(P>0.05);与S组比较,I/R组和MSB组IS和IS/AAR比值升高,心肌组织PKC δ表达上调(P<0.05);与I/R组比较,MPC组和MSP组IS和IS/AAR比值降低,心肌组织PKC δ表达下调(P<0.05),与MPC组比较,MSB组IS和IS/AAR比值升高,心肌组织PKC δ表达上调(P<0.05),MSP组上述各指标差异无统计学意义(P>0.05).结论 p38MAPK信号通路的激活参与了吗啡预处理减轻心力衰竭大鼠心肌缺血再灌注损伤,其机制与下调PKC δ的表达有关;JNK信号通路无此作用.
[本文引用:1]
[11] STOOPS W W,HATTON K W,LOFWALL M R,et al.Intravenous oxycodone,hydreeodone,and morphine in recreational opioid users:abuse potential and relative potencies[J].Psychopharmacology(Bed),2010,212(2):193-203.
Rationale Nonmedical use and abuse of prescription opioids is an increasing public health problem. Intravenous (IV) administration of opioid analgesics intended for oral use is not uncommon; yet, little is known about the relative abuse potential of these drugs when administered intravenously to recreational opioid abusers without physical dependence. Methods This inpatient study employed a double-blind, randomized, within-subject, placebo-controlled design to examine the relative abuse potential of IV doses of oxycodone, hydrocodone, and morphine. Nine healthy adult participants reporting recreational opioid use and histories of IV opioid use completed 11 experimental sessions, including one active-dose practice session. IV doses were infused over 5min and included three identical doses of each opioid (5, 10, and 20mg/10ml) and saline placebo. Physiological, subjective, and performance effects were collected before and for 6h after drug administration. Results All three opioids produced prototypical mu agonist effects (e.g., miosis; increased ratings of liking) that were generally dose-related. Pharmacodynamic effects were observed within 5min of IV administration. Physiological effects were more prolonged than subjective effects for all three drugs. While the magnitude of effects was generally comparable across drugs and qualitatively similar, valid potency assays indicated the following potency relationship: oxycodone > morphine > hydrocodone. Conclusions There were modest potency differences between oxycodone, hydrocodone, and morphine, but their overall profile of effects was similar, indicating significant abuse potential when administered intravenously.
DOI:10.1007/s00213-010-1942-4      PMID:20665209      URL    
[本文引用:1]
[12] 王英,谢平,张琳,.P13K/Akt/GSK.3B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:离体实验[J].中华麻醉学杂志,2014,34(10):1237-1240.
目的 评价磷酸肌醇3激酶/蛋白激酶B/糖原合成酶激酶3β(PI3K/Akt/GSK-3β)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 取清洁级SD成年大鼠,制备离体灌注心脏30个,采用随机数字表法分为5组(n=6):正常对照组(C组)、缺血再灌注组(I/R组)、二氮嗪后处理组 (DZ组)、PI3K抑制剂LY294002组(LY组)和二氮嗪后处理+LY294002组(DZ+ LY组).C组采用K-H液平衡灌注70 min;I/R组灌注4℃ST-Thomas停跳液10 ml/kg,继之停止灌注泵造成全心缺血,40 min后再次灌注K-H液30 min;DZ组于再灌注开始即刻经主动脉逆行灌注50 μmol/L二氮嗪5 min; LY组于再灌注开始即刻经主动逆行脉灌注15μmol/L LY294002 5 min;DZ+ LY组于再灌注开始即刻经主动脉逆行灌注15 μmol/L LY294002 5 min,随后逆行灌注50 μmol/L二氮嗪5 min.于平衡灌注20 min时(T1)和再灌注30 min时(T2)记录HR、冠状动脉流量(CF)、左心室发展压(LVDP)、左室舒张末压(LVEDP)和压力瞬时最大变化率(±dp/dtmax). 采用Western blot法测定心肌组织总Akt(t-Akt)和总GSK-3β(t-GSK-3β)表达水平及其磷酸化水平.结果 与C组比较,其余4组T2时HR、LVDP和±dp/dtmax降低,LVEDP升高,I/R组、LY组和DZ+ LY组CF降低,DZ组心肌组织Akt和GSK-3β磷酸化水平升高(P<0.01);与I/R组比较,DZ组T2时HR、CF、LVDP和±dp /dtmax升高,LVEDP降低,心肌组织Akt和GSK-3β磷酸化水平升高(P<0.01),LY组和DZ+ LY组心肌组织Akt和GSK-3β磷酸化水平差异无统计学意义(P>0.05);与DZ组比较,LY组和DZ+ LY组HR、CF、LVDP和±dp/dtmax降低,LVEDP升高,心肌组织Akt和GSK-3β磷酸化水平降低(P<0.01).结论 PI3K/Akt/GSK-3β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.
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[13] 刘春伟,丛洪良,于雪芳,.P13K-Akt、mira-KATP通道及mPTP在阿托伐他汀后处理减轻大鼠心肌缺血再灌注损伤中的作用[J].天津医药,2015,43(1):46-50.
目的:观察阿托伐他汀(ATV)后处理对离体大鼠心肌缺血再灌注损伤的保护作用,探讨磷脂酰肌醇-3-激酶-蛋白激酶B(PI3K-Akt)、线粒体ATP敏感性钾通道(mito-KATP通道)及线粒体膜通透性转换孔(mPTP)在其中的作用。方法将雄性Wistar大鼠随机分为对照组(I/R组)、阿托伐他汀后处理组(ATV组)、ATV复合PI3K抑制剂LY294002组(ATV+LY294002组)、LY294002组、ATV复合mito-KATP通道抑制剂5-羟葵酸(5-HD)组(ATV+5-HD组)、5-HD组、ATV复合mPTP开放剂苍术甙(ATR)组(ATV+ATR组)、ATR组,乙醇对照组。进行30 min缺血,120 min再灌注。观察各组心肌梗死范围,血流动力学指标,肌酸磷酸激酶同工酶(CK-MB)和乳酸脱氢酶(LDH)含量,烟酰胺腺嘌呤二核苷酸(NAD+)含量,心肌Akt和磷酸化Akt表达水平。结果 ATV组心肌梗死范围、LDH、CK-MB较I/R组下降(P<0.05),心肌NAD+含量较I/R组增加(P<0.05);ATV+LY294002组、ATV+5-HD组,ATV+ATR组心肌梗死范围、CK-MB、LDH,NAD+较I/R组差异无统计学意义。ATV组较I/R组血流动力学指标改善。Western blot显示ATV组、ATV+5-HD组和ATV+ATR组磷酸化Akt表达较I/R组增加,ATV+LY-294002组、LY-294002组、ATR组、5-HD组磷酸化Akt表达与I/R组相比无增加。结论阿托伐他汀后处理通过激活PI3K-Akt、促进mito-KATP通道开放,抑制mPTP开放,产生心肌保护作用。
[本文引用:1]
[14] HATCHER H C,TESFAY L,TORTI S V,et al.Cytoproteetive effect of ferritinh in renal isehemia reperfusion injury[J].PLoS One,2015,10(9):138-140.
[本文引用:1]
[15] AHMAD A,OLAH G,SZESNY B,et al.AP39,A mitoehondrially targeted hydrogen sulfide donor,exerts protective effects in renal epithelial ceils subjected to oxidative stress in vitro and in acute renal injury in vivo[J].Shock,2016,45(1):88-97.
[本文引用:1]
[16] HANCI V,EROL B,BEKTAS S,et al.Effect of dexmedetomidine on testicular torsion/detorsion damage in rats[J].Urol Int,2010,84(1):105-111.
[本文引用:1]
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关键词(key words)
右美托咪定
预处理
缺血-再灌注损伤/肺

Dexmedetomidine
Pretreatment
Ischemia-reperfusion inju...

作者
孔岚
白玉
韩圣娜

KONG Lan
BAI Yu
HAN Shengna