Takahama Hiroyuki, Minamino Tetsuo, Hirata Akio, Ogai Akiko, Asanuma Hiroshi, Fujita Masashi, Wakeno Masakatsu, Tsukamoto Osamu, Okada Ken-ichiro, Komamura Kazuo, Takashima Seiji, Shinozaki Yoshiro, Mori Hidezo, Mochizuki Naoki, Kitakaze Masafumi
Department of Cardiovascular Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
Cardiovasc Drugs Ther. 2006 Jun;20(3):159-65. doi: 10.1007/s10557-006-8285-8.
Recent studies suggest that G-CSF prevents cardiac remodeling following myocardial infarction (MI) likely through regeneration of the myocardium and coronary vessels. However, it remains unclear whether G-CSF administered at the onset of reperfusion prevents ischemia/reperfusion injury in the acute phase. We investigated acute effects of G-CSF on myocardial infarct size and the incidence of lethal arrhythmia and evaluated the involvement of the phosphatidylinositol-3 kinase (PI3K) in the in vivo canine models.
In open-chest dogs, left anterior descending coronary artery (LAD) was occluded for 90 minutes followed by 6 hours of reperfusion. We intravenously administered G-CSF (0.33 micro/kg/min) for 30 minutes from the onset of reperfusion. Wortmannin, a PI3K inhibitor, was selectively administered into the LAD after the onset of reperfusion.
G-CSF significantly (p<0.05) reduced myocardial infarct size (38.7+/-4.3% to 15.7+/-5.3%) and the incidence of ventricular fibrillation during reperfusion periods (50% to 0%) compared with the control. G-CSF enhanced Akt phospholylation in ischemic canine myocardium. Wortmannin blunted both the infarct size-limiting and anti-arrhythmic effects of G-CSF. G-CSF did not change myeloperoxidase activity, a marker of neutrophil accumulation, in the infarcted myocardium.
An intravenous administration of G-CSF at the onset of reperfusion attenuates ischemia/reperfusion injury through PI3K/Akt pathway in the in vivo model. G-CSF administration can be a promising candidate for the adjunctive therapy for patients with acute myocardial infarction.
近期研究表明,粒细胞集落刺激因子(G-CSF)可能通过心肌和冠状血管的再生来预防心肌梗死后的心脏重塑。然而,在再灌注开始时给予G-CSF是否能预防急性期的缺血/再灌注损伤仍不清楚。我们在体内犬模型中研究了G-CSF对心肌梗死面积和致死性心律失常发生率的急性影响,并评估了磷脂酰肌醇-3激酶(PI3K)的作用。
在开胸犬中,左冠状动脉前降支(LAD)闭塞90分钟,随后再灌注6小时。从再灌注开始静脉注射G-CSF(0.33微克/千克/分钟)30分钟。在再灌注开始后,将PI3K抑制剂渥曼青霉素选择性注入LAD。
与对照组相比,G-CSF显著(p<0.05)减小了心肌梗死面积(从38.7±4.3%降至15.7±5.3%),并降低了再灌注期间室颤的发生率(从50%降至0%)。G-CSF增强了缺血犬心肌中Akt的磷酸化。渥曼青霉素减弱了G-CSF的梗死面积限制和抗心律失常作用。G-CSF未改变梗死心肌中髓过氧化物酶活性,这是中性粒细胞聚集的标志物。
在体内模型中,再灌注开始时静脉注射G-CSF可通过PI3K/Akt途径减轻缺血/再灌注损伤。G-CSF给药可能是急性心肌梗死患者辅助治疗的一个有前景的选择。