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血管NAD(P)H氧化酶在心力衰竭内皮功能障碍中的作用及HMG-CoA还原酶抑制剂的治疗效果

Contribution of vascular NAD(P)H oxidase to endothelial dysfunction in heart failure and the therapeutic effects of HMG-CoA reductase inhibitor.

作者信息

Takayama Tomoyuki, Wada Atsuyuki, Tsutamoto Takayoshi, Ohnishi Masato, Fujii Masanori, Isono Takahiro, Horie Minoru

机构信息

Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan.

出版信息

Circ J. 2004 Nov;68(11):1067-75. doi: 10.1253/circj.68.1067.

Abstract

BACKGROUND

The vascular NAD(P)H oxidase-derived superoxide anion (O(2)-) plays a crucial role in the pathological progression of hypertension and atherosclerosis, and HMG-CoA reductase inhibitors (statins) have vascular antioxidant effects. However, it is unclear whether the vascular NAD(P)H oxidase is involved in the endothelial dysfunction of congestive heart failure (CHF) and whether HMG-CoA reductase inhibitors (statins) exert their vasoprotective effects in CHF. The present study examined both the involvement of vascular NAD(P)H oxidase in endothelial dysfunction in dogs with tachycardia-induced CHF and the therapeutic effect of a statin (pitavastatin).

METHODS AND RESULTS

Femoral blood flow (FBF) responses to acetylcholine was significantly impaired in the CHF group, but were improved by pitavastatin. Vascular O(2)- production, NAD(P)H oxidase activity and Nox4 and p47phox expression were significantly elevated in CHF compared with the normal group. The elevated O(2)-production in the CHF group was suppressed by the NAD(P)H oxidase inhibitor, apocynin, to the normal level. In contrast, neither the gene expression nor the activity of endothelial nitric oxide synthase (eNOS) differed significantly between the normal and CHF groups. However, pitavastatin significantly suppressed O(2)- production, NAD(P)H oxidase activity and Nox4 and p47phox expression and increased eNOS expression and activity compared with the CHF group.

CONCLUSIONS

The activated vascular NAD(P)H oxidase contributes to endothelial dysfunction in CHF, which was partly improved by pitavastatin via its inhibition of NAD(P)H oxidase.

摘要

背景

血管NAD(P)H氧化酶衍生的超氧阴离子(O(2)-)在高血压和动脉粥样硬化的病理进展中起关键作用,而HMG-CoA还原酶抑制剂(他汀类药物)具有血管抗氧化作用。然而,尚不清楚血管NAD(P)H氧化酶是否参与充血性心力衰竭(CHF)的内皮功能障碍,以及HMG-CoA还原酶抑制剂(他汀类药物)是否在CHF中发挥其血管保护作用。本研究探讨了血管NAD(P)H氧化酶在心动过速诱导的CHF犬内皮功能障碍中的作用以及他汀类药物(匹伐他汀)的治疗效果。

方法与结果

CHF组对乙酰胆碱的股动脉血流量(FBF)反应明显受损,但匹伐他汀可改善该反应。与正常组相比,CHF组的血管O(2)-生成、NAD(P)H氧化酶活性以及Nox4和p47phox表达显著升高。CHF组升高的O(2)-生成被NAD(P)H氧化酶抑制剂阿朴吗啡抑制至正常水平。相反,正常组和CHF组之间内皮型一氧化氮合酶(eNOS)的基因表达和活性均无显著差异。然而,与CHF组相比,匹伐他汀显著抑制了O(2)-生成、NAD(P)H氧化酶活性以及Nox4和p47phox表达,并增加了eNOS表达和活性。

结论

激活的血管NAD(P)H氧化酶导致CHF中的内皮功能障碍,匹伐他汀通过抑制NAD(P)H氧化酶部分改善了该功能障碍。

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