国际麻醉学与复苏杂志   2015, Issue (1): 3-3
    
雷帕霉素减弱七氟烷预处理对心肌缺血/再灌损伤的保护作用
刘琨, 许鹏程1()
1.江苏省徐州市徐州医学院研究生学院麻醉系2011级
Rapamycin decreases the protective effective of sevoflurane preconditioning on myocardial ischemia/reperfusion injury
 全文:
摘要:

目的 观察自噬增强剂雷帕霉素(rapamycin, RAPA)对七氟烷预处理离体大鼠心脏缺血/再灌注损伤(ischemia/reperfusion injury, I/RI)保护作用的影响,探讨自噬在七氟烷预处理对心肌I/RI保护中的作用。 方法 36只健康成年雄性Wistar大鼠,体重250 g~280 g,采用随机数字表法分为3组(每组12只):缺血/再灌注(ischemia/reperfusion, I/R)组,七氟烷预处理组(S+I/R组),七氟烷预处理+RAPA组(S+I/R+RAPA组)。采用Langendorff灌注装置制备离体心脏I/R模型,缺血30 min、再灌注120 min,记录平衡末及再灌注末的左室舒张末期压(left ventricular diastolic pressure, LVEDP)、左室发展压(left ventricular developed pressure, LVDP)、左心室内压最大上升/下降速率(the maximum rate of increase or decrease of left ventricular pressure, ±dp/dtmax)、心率(heart rate, HR)。再灌注120 min后,收集冠状动脉流出液测乳酸脱氢酶(lactate dehydrogenase, LDH)活性;取心肌,计算心肌梗死面积百分比。Western blot半定量检测自噬标记物微管相关蛋白1轻链3(microtubule-associated protein 1 light 3, LC3)、RAPA靶蛋白(target of rapamycin, mTOR)及磷酸化mTOR(phosphorylated mTOR, p-mTOR)蛋白表达量。 结果 再灌注末,与I/R组比较,S+I/R组心功能明显改善(P<0.05),心肌梗死面积[(47±6)%、 (29±5)%]、冠状动脉流出液LDH活性[(29±5) U/L、 (19±4) U/L]均降低,心肌LC3-Ⅱ表达下调,p-mTOR表达上调(P<0.05);S+I/R+RAPA组各指标与I/R组比较,差异无统计学意义。与S+I/R组比较,S+I/R+RAPA组心功能各项指标呈损害性变化(P<0.05)、梗死面积增大[(29±5)%、 (46±3)%]、冠状动脉流出液LDH活性[(19±4) U/L、(27±5) U/L]均增加(P<0.05),LC3-Ⅱ表达水平增加,p-mTOR表达降低。 结论 RAPA能够减弱七氟烷预处理对I/RI产生的保护作用,可能与其降低p-mTOR表达,减弱对自噬的抑制作用有关。

关键词: 七氟烷; 预处理; 心肌; 缺血/再灌注损伤; 自噬; 雷帕霉素
Abstract:

Objective To study the effects of rapamycin(RAPA) on sevoflurane preconditioning during myocardial ischemia/reperfusion(I/R) in rats. Methods Thirty-six healthy adult male Wistar rats, 250 g-280 g, were randomly divided into three groups(n=12): group I/R, group sevoflurane preconditioning(group S+I/R), group sevoflurane preconditioning plus RAPA(group S+I/R+RAPA). The hearts were excised and perfused in a langendorff apparatus. The left ventricular diastolic pressure(LVEDP), left ventricular developed pressure(LVDP), the maximum rate of increase or decrease of left ventricular pressure(±dp/dtmax), heart rate(HR) were recorded at 30 min of equilibrium and 120 min of reperfusion respectively. Myocardial infarct size and lactate dehydrogenase(LDH) levels were examined by 2,3,5-triphenyltetrazolium chloride(TTC) staining and enzyme standard method at 120 min of reperfusion. Expressions of microtubule-associated protein 1 light 3 (LC3), target of rapamycin (mTOR), phosphorylated mTOR(p-mTOR) were determined by Western blotting. Results After reperfusion, compared with that in group I/R, the cardiac function in group S+I/R was improved(P<0.05), the myocardial infarct size[(47±6)%,(29±5)%], LDH levels[(29±5) U/L,(19±4) U/L] and the expressions of LC3-Ⅱwere decreased(P<0.05), while the expression of p-mTOR increased in group S+I/R(P<0.05). Compared with that in group S+I/R, the cardiac function in group S+I/R+RAPA was worse(P<0.05), the myocardial infarct size[(29±5)%,(46±3)%], LDH levels[(19±4) U/L,(27±5) U/L] and the expressions of LC3-Ⅱwere increased(P<0.05), while the expression of p-mTOR decreased (P<0.05) in group S+I/R+RAPA(P<0.05). Conclusions Rapamycin could decrease the protective effective of sevoflurane preconditioning and may be related to p-mTOR and autophagy.

Key words: Sevoflrane; Preconditioning; Myocardium; Reperfusion injury; Autophagy; Rapamycin