Wang Meijing, Tsai Ben M, Turrentine Mark W, Mahomed Yousuf, Brown John W, Meldrum Daniel R
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Ann Thorac Surg. 2005 Dec;80(6):2235-41. doi: 10.1016/j.athoracsur.2005.05.070.
Understanding the myocardial inflammatory response to ischemia is an important part of achieving the elusive clinical goal of long-enduring myocardial protection. p38 mitogen-activated protein kinase (MAPK) has been implicated in oxidant stress-induced myocardial tumor necrosis factor production. However, it is unknown whether p38 MAPK mediates the following important events in both myocardial apoptosis and functional depression: mitogen-activated protein kinase-activated protein kinase 2, caspase-1, caspase-3, and caspase-11 activation, and tumor necrosis factor, interleukin-1beta and interleukin-6 production.
Isolated rat hearts were perfused and subjected to an ischemia-reperfusion insult, with and without preischemic infusion of 20 microM SB203580 (p38 MAPK inhibitor). Myocardial functional measurements were continuously recorded throughout the experiments. Myocardial tissue was then assessed for products of p38 MAPK activation, expression of tumor necrosis factor, interleukin-1beta and interleukin-6, and activation of caspase-1, caspase-3 and caspase-11.
Postischemic recovery of left ventricular developed pressure, +dP/dt and -dP/dt was significantly increased by p38 MAPK inhibition (MKI) (left ventricular developed pressure: 48.4 +/- 3.87 MKI versus 32.7 +/- 4.32 mm Hg; +dP/dt: 1392.0 +/- 141.7 MKI versus 896.7 +/- 128.5 mm Hg/s; -dP/dt: -889.9 +/- 97.63 MKI versus -548.9 +/- 71.29 mmHg/s). p38 MAPK inhibition also significantly reduced ischemia-reperfusion-induced elevation of left ventricular end-diastolic pressure (82.76 +/- 4.59 MKI vs 69.95 +/- 3.55 mm Hg). p38 MKI decreased myocardial tumor necrosis factor, interleukin-1beta and interleukin-6 protein levels, and reduced active myocardial caspase-1, caspase-3 and caspase-11.
The p38 MAPK pathway indeed mediates the following important events in myocardial apoptosis and functional depression: mitogen-activated protein kinase-activated protein kinase 2, caspase-1, caspase-3 and caspase-11 activation, and tumor necrosis factor, interleukin-1beta, interleukin-6 production after myocardial ischemia. Single site (p38 MAPK) inhibition of these events may have important therapeutic implications in myocardial protection.
了解心肌对缺血的炎症反应是实现长期心肌保护这一难以捉摸的临床目标的重要组成部分。p38丝裂原活化蛋白激酶(MAPK)与氧化应激诱导的心肌肿瘤坏死因子产生有关。然而,p38 MAPK是否介导心肌凋亡和功能抑制中的以下重要事件尚不清楚:丝裂原活化蛋白激酶激活的蛋白激酶2、半胱天冬酶-1、半胱天冬酶-3和半胱天冬酶-11的激活,以及肿瘤坏死因子、白细胞介素-1β和白细胞介素-6的产生。
对离体大鼠心脏进行灌注,并给予缺血再灌注损伤,分别在缺血前输注或不输注20微摩尔SB203580(p38 MAPK抑制剂)。在整个实验过程中持续记录心肌功能指标。然后评估心肌组织中p38 MAPK激活产物、肿瘤坏死因子、白细胞介素-1β和白细胞介素-6的表达,以及半胱天冬酶-1、半胱天冬酶-3和半胱天冬酶-11的激活情况。
p38 MAPK抑制(MKI)显著提高了缺血后左心室舒张末压、+dP/dt和-dP/dt的恢复水平(左心室舒张末压:MKI组为48.4±3.87,对照组为32.7±4.32 mmHg;+dP/dt:MKI组为1392.0±141.7,对照组为896.7±128.5 mmHg/s;-dP/dt:MKI组为-889.9±97.63,对照组为-548.9±71.29 mmHg/s)。p38 MAPK抑制还显著降低了缺血再灌注诱导的左心室舒张末压升高(MKI组为82.76±4.59,对照组为69.95±3.55 mmHg)。p38 MKI降低了心肌肿瘤坏死因子、白细胞介素-1β和白细胞介素-6的蛋白水平,并减少了活性心肌半胱天冬酶-1、半胱天冬酶-3和半胱天冬酶-11。
p38 MAPK通路确实介导了心肌凋亡和功能抑制中的以下重要事件:丝裂原活化蛋白激酶激活的蛋白激酶2、半胱天冬酶-1、半胱天冬酶-3和半胱天冬酶-11的激活,以及心肌缺血后肿瘤坏死因子、白细胞介素-1β、白细胞介素-6的产生。对这些事件的单靶点(p38 MAPK)抑制可能对心肌保护具有重要的治疗意义。