Jesmin S, Sakuma I, Hattori Y, Fujii S, Kitabatake A
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Diabetologia. 2002 Mar;45(3):402-15. doi: 10.1007/s00125-001-0765-6.
AIMS/HYPOTHESIS: Calcium channel blockers, widely used for the treatment of hypertension and angina, could prevent cardiovascular complications in patients with diabetes. They can improve cardiac remodelling in animal models of a variety of cardiovascular diseases. Here, we examined the therapeutic effect of benidipine, a long-acting calcium channel blocker, on cardiac remodelling in Otsuka-Long-Evans-Tokushima-Fatty (OLETF) rats, a Type II (non-insulin-dependent) diabetes mellitus model.
The methods for morphometric analysis included double staining for coronary capillaries, dye-binding staining for collagen content and Masson's trichrome staining for perivascular fibrosis. Immunohistochemical and in situ hybridization techniques were used for detecting protein and mRNA expressions for vascular endothelial growth factors (VEGF), basic fibroblast growth factors (bFGF) and TGF-beta(1), endothelial nitric oxide synthase (eNOS), and anti- and pro-apoptotic markers.
OLETF rats showed an increased coronary capillary density, a reduced venular capillary proportion, an increased cardiac collagen content and prominent cardiac perivascular fibrosis. In OLETF rat hearts, significant increases in vascular expressions for VEGF, bFGF and TGF- beta(1) were found. Furthermore, the apoptosis signalling pathways, involving eNOS and apoptotic markers, were markedly altered, and coronary endothelial cell apoptosis was lower. These alterations with the exception of eNOS expression were significantly blocked by benidipine treatment.
CONCLUSION/INTERPRETATION: The suppressive effect of benidipine on overproduction of angiogenic growth factors could prevent cardiac angiogenesis and fibrosis, resulting in an improvement of cardiac remodelling in diabetes. As VEGF and bFGF potently block endothelial cell apoptosis execution, physiological apoptosis revived by benidipine treatment could also contribute to coronary vessel regression.
目的/假设:钙通道阻滞剂广泛用于治疗高血压和心绞痛,可预防糖尿病患者的心血管并发症。它们能改善多种心血管疾病动物模型中的心脏重塑。在此,我们研究了长效钙通道阻滞剂贝尼地平对大冢-长-埃文斯-德岛-肥胖(OLETF)大鼠(一种II型(非胰岛素依赖型)糖尿病模型)心脏重塑的治疗效果。
形态计量分析方法包括冠状动脉毛细血管双重染色、胶原含量染料结合染色和血管周围纤维化的Masson三色染色。免疫组织化学和原位杂交技术用于检测血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)和转化生长因子-β(1)、内皮型一氧化氮合酶(eNOS)以及抗凋亡和促凋亡标志物的蛋白质和mRNA表达。
OLETF大鼠冠状动脉毛细血管密度增加,小静脉毛细血管比例降低,心脏胶原含量增加,心脏血管周围纤维化明显。在OLETF大鼠心脏中,发现VEGF、bFGF和转化生长因子-β(1)的血管表达显著增加。此外,涉及eNOS和凋亡标志物的凋亡信号通路明显改变,冠状动脉内皮细胞凋亡较低。除eNOS表达外,这些改变均被贝尼地平治疗显著阻断。
结论/解读:贝尼地平对血管生成生长因子过度产生的抑制作用可预防心脏血管生成和纤维化,从而改善糖尿病患者的心脏重塑。由于VEGF和bFGF能有效阻断内皮细胞凋亡的执行,贝尼地平治疗恢复的生理性凋亡也可能有助于冠状动脉血管消退。