国际麻醉学与复苏杂志   2013, Issue (2): 13-13
    
吸入麻醉药后处理心肌保护作用的细胞信号通路及效应器研究进展
朱曼华, 严敏1()
1.徐州医学院江苏省麻醉学重点实验室
Advances in the study of cell signaling pathways and downstream effectors in volatile anesthetic postconditioning-induced cardioprotection
 全文:
摘要:

背景 给予缺血性心肌吸入麻醉药后处理(inhaled anesthetics-induced postconditioning, APO)产生了极强的保护作用,该作用机制复杂,涉及到一系列细胞信号转导反应。 目的 就APO心肌保护涉及的主要细胞信号通路及效应器进行回顾和总结。 内容 大量研究证实APO通过激活再灌注损伤补救激酶通路,经由蛋白激酶C、一氧化氮(NO)等中间因子的级联放大,抑制了再灌注期间活性氧自由基爆发,降低了细胞内钙超载,从而发挥抑制线粒体依赖性心肌细胞凋亡、减少心肌缺血/再灌注(ischemia/reperfusion, I/R)损伤的作用。 趋向 明晰APO心肌保护作用的主要细胞信号通路及其下游效应器,有助于发现临床上治疗心肌I/R损伤的新靶点,优化APO心肌保护方案,具有重要的转化医学意义。

关键词: 吸入麻醉药; 后处理; 细胞信号通路; 心肌缺血/再灌注
Abstract:

Background Inhaled anesthetics postconditioning (APO) exerts potent protection against myocardial ischemia/reperfusion (I/R) injury. This cardioprotection of APO involves complex cell signaling pathways. Objective Here we retrospectively summarized cell signaling pathways and downstream effectors in volatile anesthetic postconditioning-induced cardioprotection. Contents A great deal of studies show that APO exerts cardioprotection against I/R injury through activating reperfusion injury salvage kinase pathways, the following protein kinase C and nitric oxide cascades, as well as inhibiting reactive oxygen species overproduction, cellular Ca2+ overload, and mitochondrial apoptosis. Trend To clarify the key cell signaling pathway and downstream effectors in the cardioprotection of APO is helpful to find a new potential target for treatment of myocardial I/R injury, which is important to optimize the APO strategy against myocardial I/R injury and has translational medical meaning.

Key words: Inhaled anesthetics; Postconditioning; Cell signaling pathway; Myicardial ischemia/reperfusion