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他汀类药物可抑制大鼠视网膜中白细胞与内皮细胞的相互作用,并预防缺血再灌注损伤诱导的神经元死亡。

Statin inhibits leukocyte-endothelial interaction and prevents neuronal death induced by ischemia-reperfusion injury in the rat retina.

作者信息

Honjo Megumi, Tanihara Hidenobu, Nishijima Kazuaki, Kiryu Junichi, Honda Yoshihito, Yue Beatrice Y J T, Sawamura Tatsuya

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.

出版信息

Arch Ophthalmol. 2002 Dec;120(12):1707-13. doi: 10.1001/archopht.120.12.1707.

Abstract

BACKGROUND

Retinal ishchemia-induced neuronal death is believed to be a direct causal process in the development of many ocular diseases. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, statin, is known to improve endothelial function in proinflammatory conditions.

OBJECTIVE

To investigate the effects of statin on leukocyte accumulation during ischemia-reperfusion injury and on subsequent retinal damage.

METHODS

Transient retinal ischemia was induced in Long-Evans rats for 60 minutes using temporal ligation of the optic nerve. Leukocyte-endothelial interactions in the postischemic retina were evaluated in vivo with a scanning laser ophthalmoscope. Statin was administered 5 minutes before the induction of retinal ischemia. P-selectin and intercellular adhesion molecule-1 (ICAM-1) gene expression in the postischemic retina were studied with the semiquantitative polymerase chain reaction. Histologic studies were carried out to evaluate retinal damage.

RESULTS

The preadministration of statin attenuated the rolling and accumulation of leukocytes, decreased P-selectin and ICAM-1 expression, and reduced the number of apoptotic cells in the retina. Furthermore, histologic evaluation 168 hours after reperfusion showed that statin significantly diminished the resultant retinal tissue damage. The neuroprotective effect of statin was abolished when it was administered along with a nitric oxide synthase inhibitor, nitroglycerine-nitro-L-arginine methyl ester.

CONCLUSION

Statin may exert neuroprotective effects by inhibiting leukocyte-endothelial interaction through the release of nitric oxide from the endothelium.

CLINICAL RELEVANCE

As a result of its efficacy in preventing retinal neuronal death, statin may be developed into a novel therapeutic modality for many ocular ischemic diseases.

摘要

背景

视网膜缺血诱导的神经元死亡被认为是许多眼部疾病发生发展过程中的直接因果过程。3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂他汀类药物已知可在促炎条件下改善内皮功能。

目的

研究他汀类药物对缺血再灌注损伤期间白细胞积聚及随后视网膜损伤的影响。

方法

通过视神经颞侧结扎在Long-Evans大鼠中诱导短暂性视网膜缺血60分钟。使用扫描激光检眼镜在体内评估缺血后视网膜中的白细胞-内皮细胞相互作用。在诱导视网膜缺血前5分钟给予他汀类药物。采用半定量聚合酶链反应研究缺血后视网膜中P-选择素和细胞间黏附分子-1(ICAM-1)基因表达。进行组织学研究以评估视网膜损伤。

结果

预先给予他汀类药物可减轻白细胞的滚动和积聚,降低P-选择素和ICAM-1表达,并减少视网膜中凋亡细胞数量。此外,再灌注168小时后的组织学评估显示,他汀类药物显著减轻了由此导致的视网膜组织损伤。当他汀类药物与一氧化氮合酶抑制剂硝酸甘油-硝基-L-精氨酸甲酯一起给药时,其神经保护作用被消除。

结论

他汀类药物可能通过内皮细胞释放一氧化氮抑制白细胞-内皮细胞相互作用而发挥神经保护作用。

临床意义

由于其在预防视网膜神经元死亡方面的疗效,他汀类药物可能会被开发成为治疗多种眼部缺血性疾病的新型治疗方法。

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