Crisostomo Paul R, Wang Meijing, Wairiuko George M, Terrell Andrew M, Meldrum Daniel R
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
J Surg Res. 2006 Aug;134(2):342-7. doi: 10.1016/j.jss.2006.01.030. Epub 2006 Mar 29.
Postconditioning, a series of brief ischemia/reperfusion (I/R) cycles at reperfusion onset, is a recently described novel approach to attenuate I/R injury, and because it is an after-injury treatment strategy, it may have greater clinical potential than preconditioning. However, it has not been determined whether postconditioning is effective in women.
Adult male and female (250-300 g) Sprague-Dawley rat hearts (n = 25) were isolated, perfused via Langendorff model, and subjected to 15 min of equilibration, 20 or 25 min of global index ischemia (37 degrees C), and 40 min total reperfusion. Postconditioned hearts were subjected to 6 cycles of 10-s reperfusion/10-s ischemia immediately after release of the global index ischemia. Hearts were assigned randomly to one of four groups: 1) control hearts, 20 min index ischemia; 2) postconditioned hearts, 20 min index ischemia; 3) control hearts, 25 min index ischemia; or 4) postconditioned hearts, 25 min index ischemia. All data are reported as mean +/- SEM and were analyzed with unpaired student's t test; P < 0.05 considered significant.
Postconditioning in female rats after 20 min of ischemia reduced depression of left ventricular-developed pressure (93.9 +/- 6.7% postconditioning recovery versus 58.6 +/- 12.6% control recovery, P < 0.05), attenuated the increase of end-diastolic pressure (P < 0.05), and reduced the depression of +dP/dT and -dP/dT (P < 0.05). The postconditioning protective effect disappeared in female rats exposed to 25 min of ischemia. The postconditioning protective effect was observed in male rats after both 20 min and 25 min ischemia.
Postconditioning confers cardioprotection in leukocyte-free, buffer-perfused female hearts, but this protection may depend on ischemia duration. The attractive potential for the clinical application of postconditioning, however, warrants further studies to elucidate the mechanistic pathways and differences in males and female rats.
后适应是指在再灌注开始时进行一系列短暂的缺血/再灌注(I/R)循环,是一种最近描述的减轻I/R损伤的新方法,由于它是一种损伤后治疗策略,可能比预处理具有更大的临床潜力。然而,后适应在女性中是否有效尚未确定。
分离成年雄性和雌性(250 - 300 g)Sprague-Dawley大鼠心脏(n = 25),通过Langendorff模型进行灌注,先平衡15分钟,然后进行20或25分钟的全心缺血(37℃),再灌注40分钟。后适应组心脏在全心缺血解除后立即进行6个周期的10秒再灌注/10秒缺血。心脏随机分为四组之一:1)对照组心脏,20分钟缺血;2)后适应组心脏,20分钟缺血;3)对照组心脏,25分钟缺血;或4)后适应组心脏,25分钟缺血。所有数据以平均值±标准误表示,并用非配对学生t检验进行分析;P < 0.05认为具有显著性。
缺血20分钟后,雌性大鼠的后适应可减轻左心室舒张末压的降低(后适应恢复为93.9±6.7%,对照组恢复为58.6±12.6%,P < 0.05),减弱舒张末期压力的升高(P < 0.05),并降低 +dP/dT和 -dP/dT的降低幅度(P < 0.05)。在缺血25分钟的雌性大鼠中,后适应的保护作用消失。在缺血20分钟和25分钟后的雄性大鼠中均观察到后适应的保护作用。
后适应可为无白细胞、缓冲液灌注的雌性心脏提供心脏保护,但这种保护可能取决于缺血持续时间。然而,后适应在临床应用中的诱人潜力值得进一步研究,以阐明其机制途径以及雄性和雌性大鼠之间的差异。