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缬沙坦逆转糖尿病心肌病心肌间质纤维化的机制

[Mechanism of reversion of myocardial interstitial fibrosis in diabetic cardiomyopathy by valsartan].

作者信息

Zhong Ming, Zhang Yun, Miao Ya, Li Li, Gong Hui-ping, Ma Xiao, Sun Hui, Zhang Wei

机构信息

Department of Cardiology, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Remodeling and Function Research, Ministry of Education and Ministry of Health, Jinan 250012, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Jan 24;86(4):232-6.

Abstract

OBJECTIVE

To investigate the mechanism of reversion of myocardial interstitial fibrosis in diabetic cardiomyopathy (DCM) by valsartan.

METHODS

Forty male wistar rats were randomly divided into 3 groups: DCM group, n = 16, fed with high-fat diet for 4 weeks and injected intraperitoneally with streptozocin (STZ) once to induce hyperglycemia so as to construct a DCM model, and then perfused into the stomach with normal saline; valsartan group, n = 16, to be constructed into DCM model and then perfused into the stomach with valsartan once daily; and control group (n = 8, fed with normal food and perfused into the stomach with normal saline. Four weeks after feeding (i.e., before injection of STZ), 1 week after STZ injection, and by the end of experiment after 12-hour fasting samples of venous blood were collected to detect the contents of triglyceride and fasting blood-glucose and insulin; by the end of experiment miniature cardiac catheter was inserted into the left ventricle to conduct hemodynamic examination. Then myocardium tissues were collected, collagen content was detected by Masson staining, real-time RT-PCR was used to detect the mRNA expression of thrombospondin (TSP)-1 and tumor growth factor (TGF)-beta(1) mRNA, expression, and Western blotting was used to detect the protein expression of TSP-1, active TGF-beta(1) (A-TGF-beta(1)) and latent TGF-beta(1) (L-TGF-beta(1)).

RESULTS

By the end of the experiment, the body weights, and insulin sensitivity index were significantly lower and fasting blood-glucose, and serum triglyceride and cholesterol were significantly higher in the DCM group and valsartan group in comparison with those in the control group (all P < 0.01), however, there was no significant differences in fasting insulin among these 3 groups. The values of left ventricular systolic pressure (LVSP) and +/- dp/dt(max) were significantly lower and left ventricular end diastolic pressure were significantly higher in the DCM group in comparison with the control group (all P < 0.01). The LVSP and -dp/dt(max) were significantly higher and LVEDP was significantly lower in the valsartan group than in the DCM group (all P < 0.05). The LVEDP was significantly higher and -dp/dt(max) was significantly lower in the valsartan group than in the control group. Electron microscopy showed the distribution of a great amount of collagen in the myocardial interstitial tissue. The collagen content of the DCM group was 17 +/- 3, significantly higher than that of the control group (11 +/- 3, P < 0.05), and the collagen content of the valsartan group was 13 +/- 3, significantly lower than that of the DCM group (P < 0.05). The mRNA expression of TSP-1 and that of TGF-beta(1) were significant higher in the DCM group than in the control group (both P < 0.05), and were significantly lower in the valsartan group than in the DCM group (both P < 0.05); however, the TGF-beta(1) mRNA expression in the valsartan group was significantly higher in the valsartan group than in the control group (P < 0.05). The values of protein expression of TSP-1, A-TGF-beta(1) and L-TGF-beta(1) were all significantly higher in the DCM group than in the control group (all P < 0.05), and the values of protein expression of TSP-1 and A-TGF-beta(1) in the valsartan group were both significantly lower than those in the DCM group (both P < 0.05), however, there was no significant difference in the protein expression of L-TGF-beta(1) between the valsartan group and DCM group.

CONCLUSION

Valsartan amelioorates myocardial interstitial fibrosis in DCM via TSP-1/TGF-beta(1) signaling pathway.

摘要

目的

探讨缬沙坦逆转糖尿病性心肌病(DCM)心肌间质纤维化的机制。

方法

40只雄性Wistar大鼠随机分为3组:DCM组,n = 16,给予高脂饮食4周,腹腔注射链脲佐菌素(STZ)1次以诱导高血糖,从而构建DCM模型,然后用生理盐水灌胃;缬沙坦组,n = 16,构建DCM模型后,每日1次用缬沙坦灌胃;对照组(n = 8,给予正常食物,用生理盐水灌胃。喂养4周后(即注射STZ前)、注射STZ后1周以及实验结束时,禁食12小时后采集静脉血样本,检测甘油三酯、空腹血糖和胰岛素含量;实验结束时,插入微型心导管至左心室进行血流动力学检查。然后采集心肌组织,采用Masson染色检测胶原含量,实时RT-PCR检测血小板反应蛋白(TSP)-1和肿瘤生长因子(TGF)-β1 mRNA的表达,Western印迹法检测TSP-1、活性TGF-β1(A-TGF-β1)和潜伏TGF-β1(L-TGF-β1)的蛋白表达。

结果

实验结束时,DCM组和缬沙坦组的体重、胰岛素敏感指数显著低于对照组,空腹血糖、血清甘油三酯和胆固醇显著高于对照组(均P < 0.01),然而,这3组间空腹胰岛素无显著差异。与对照组相比,DCM组左心室收缩压(LVSP)、±dp/dt(max)值显著降低,左心室舒张末期压力显著升高(均P < 0.01)。缬沙坦组的LVSP和 -dp/dt(max)显著高于DCM组,LVEDP显著低于DCM组(均P < 0.05)。缬沙坦组的LVEDP显著高于对照组,-dp/dt(max)显著低于对照组。电镜显示心肌间质组织中有大量胶原分布。DCM组的胶原含量为17±3,显著高于对照组(11±3,P < 0.05),缬沙坦组的胶原含量为13±3,显著低于DCM组(P < 0.05)。DCM组TSP-1和TGF-β1的mRNA表达显著高于对照组(均P < 0.05),缬沙坦组显著低于DCM组(均P < 0.05);然而,缬沙坦组的TGF-β1 mRNA表达显著高于对照组(P < 0.05)。DCM组TSP-1、A-TGF-β1和L-TGF-β1的蛋白表达值均显著高于对照组(均P < 0.05),缬沙坦组TSP-1和A-TGF-β1的蛋白表达值均显著低于DCM组(均P < 0.05),然而,缬沙坦组与DCM组L-TGF-β1的蛋白表达无显著差异。

结论

缬沙坦通过TSP-1/TGF-β1信号通路改善DCM心肌间质纤维化。

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