Beresewicz Andrzej, Maczewski Michal, Duda Monika
Department of Clinical Physiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland.
Cardiovasc Res. 2004 Jul 1;63(1):118-29. doi: 10.1016/j.cardiores.2004.02.012.
A hypothesis was tested that a reaction product between superoxide (O2-) and nitric oxide (NO) mediates post-ischemic coronary endothelial dysfunction that ischemic preconditioning (IPC) protects the endothelium by preventing post-ischemic cardiac O2- and/or NO formation, and that the opening of the mitochondrial ATP-dependent potassium channel (mKATP) plays a role in the mechanism of IPC.
Langendorff-perfused guinea-pig hearts were subjected either to 30 min global ischemia/30 min reperfusion (IR) or were preconditioned prior to IR with three cycles of either 5 min ischemia/5 min reperfusion or 5 min infusion/5 min wash-out of mKATP opener, diazoxide (0.5 microM). Coronary flow responses to acetylcholine (ACh) and nitroprusside were used as measures of endothelium-dependent and -independent vascular function, respectively. Myocardial outflow of O2- and NO, and functional recoveries were followed during reperfusion.
IR impaired the ACh response by approximately 60% and augmented cardiac O2- and NO outflow. Superoxide dismutase (150 U/ml) and NO synthase inhibitor, l-NMMA (100 microM) inhibited the burst of O2- and NO, respectively, and afforded partial preservation of the ACh response in IR hearts. NO scavenger, oxyhemoglobin (25 microM), afforded similar endothelial protection. IPC and diazoxide preconditioning attenuated post-ischemic burst of O2-, but not of NO, and afforded a complete endothelial protection. Diazoxide given after 30-min ischemia increased the O2- burst and was not protective. The effects of IPC and diazoxide preconditioning were not affected by HMR-1098 (25 microM), a selective blocker of plasmalemmal KATP, and were abolished by glibenclamide (0.6 microM) and 5-hydroxydecanoate (100 microM), a nonselective and selective mK(ATP) blocker, respectively. 5-Hydroxydecanoate produced similar effects, whether it was given as a continuous treatment or was washed out prior to IR.
The results suggest that in guinea-pig heart: (i) a reaction product between O2- and NO mediates the post-ischemic endothelial dysfunction; (ii) the mK(ATP) opening serves as a trigger of the IPC and diazoxide protection; and (iii) the mK(ATP) opening protects the endothelium in the mechanism that involves the attenuation of the O2- burst at reperfusion.
验证以下假说:超氧化物(O2-)与一氧化氮(NO)之间的反应产物介导缺血后冠状动脉内皮功能障碍,缺血预处理(IPC)通过防止缺血后心脏产生O2-和/或NO来保护内皮,并且线粒体ATP依赖性钾通道(mKATP)的开放在IPC机制中起作用。
用Langendorff灌流的豚鼠心脏,要么经历30分钟全心缺血/30分钟再灌注(IR),要么在IR之前用三个周期的5分钟缺血/5分钟再灌注或5分钟输注/5分钟洗脱mKATP开放剂二氮嗪(0.5微摩尔)进行预处理。分别用冠状动脉对乙酰胆碱(ACh)和硝普钠的反应来衡量内皮依赖性和非依赖性血管功能。在再灌注期间跟踪心肌O2-和NO的流出以及功能恢复情况。
IR使ACh反应受损约60%,并增加了心脏O2-和NO的流出。超氧化物歧化酶(150单位/毫升)和NO合酶抑制剂L-NMMA(100微摩尔)分别抑制了O2-和NO的爆发,并部分保留了IR心脏中的ACh反应。NO清除剂氧合血红蛋白(25微摩尔)提供了类似的内皮保护作用。IPC和二氮嗪预处理减弱了缺血后O2-的爆发,但没有减弱NO的爆发,并提供了完全的内皮保护。在30分钟缺血后给予二氮嗪增加了O2-的爆发,且没有保护作用。IPC和二氮嗪预处理的效果不受质膜KATP的选择性阻滞剂HMR-1098(25微摩尔)的影响,但分别被格列本脲(0.6微摩尔)和5-羟基癸酸(100微摩尔)(一种非选择性和选择性mK(ATP)阻滞剂)消除。无论5-羟基癸酸是连续给药还是在IR之前洗脱,都产生了类似的效果。
结果表明,在豚鼠心脏中:(i)O2-与NO之间的反应产物介导缺血后内皮功能障碍;(ii)mK(ATP)开放是IPC和二氮嗪保护作用的触发因素;(iii)mK(ATP)开放在涉及再灌注时减弱O2-爆发的机制中保护内皮。