Wang Meijing, Tsai Ben M, Crisostomo Paul R, Meldrum Daniel R
Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Circulation. 2006 Jul 4;114(1 Suppl):I282-9. doi: 10.1161/CIRCULATIONAHA.105.001164.
Tumor necrosis factor-alpha (TNF) is increased in myocardial tissue after ischemia and reperfusion (I/R). TNF contributes to postischemic myocardial dysfunction and induces proinflammatory signaling, which may be mediated by the 55-kDa TNF receptor (TNFR1). In humans, there is a direct correlation between functional capacity, survival, and circulating TNF levels. Although decreasing the TNF level in animals was beneficial after myocardial ischemia, simply decreasing the bioavailability of TNF in humans with heart failure was not beneficial. This led to the important appreciation that TNF may have beneficial or deleterious effects in the heart, depending on which of its receptors is activated. Females have a lower incidence of heart failure and a higher heart failure survival than males. We hypothesized that TNFR1 signaling resistance occurs in the female myocardium during ischemia.
Hearts from male and female TNFR1-knockout and wild-type (WT) mice were subjected to I/R. Female WT mice had better postischemic recovery than did male WT mice, an effect that appeared to be due to TNFR1 signaling resistance in females. Female WT mice had less myocardial depression after TNF infusion despite equivalent TNFR1 expression. Interestingly, TNFR1 ablation improved postischemic myocardial function, decreased activation of p38 mitogen-activated protein kinase, and reduced expression of interleukins-1beta and -6 in males but not in females. Furthermore, WT females expressed more of the suppressor of cytokine signaling protein 3 after I/R, which may in part explain TNFR1 signaling resistance in the female myocardium.
This study demonstrates that sex differences exist in myocardial TNF signaling by TNFR1 after I/R.
肿瘤坏死因子-α(TNF)在心肌缺血再灌注(I/R)后的心肌组织中水平升高。TNF 会导致缺血后心肌功能障碍并诱导促炎信号传导,这可能由 55 kDa 的 TNF 受体(TNFR1)介导。在人类中,功能能力、生存率与循环 TNF 水平之间存在直接关联。虽然在心肌缺血后降低动物体内的 TNF 水平有益,但单纯降低心力衰竭患者体内 TNF 的生物利用度并无益处。这使得人们认识到 TNF 根据其激活的受体不同,可能在心脏中产生有益或有害的影响。女性心力衰竭的发病率低于男性,且心力衰竭后的生存率高于男性。我们推测缺血期间雌性心肌中存在 TNFR1 信号抵抗。
对雄性和雌性 TNFR1 基因敲除小鼠及野生型(WT)小鼠的心脏进行 I/R 处理。雌性 WT 小鼠缺血后的恢复情况优于雄性 WT 小鼠,这种效应似乎是由于雌性存在 TNFR1 信号抵抗。尽管 TNFR1 表达相当,但雌性 WT 小鼠在输注 TNF 后心肌抑制较轻。有趣的是,TNFR1 基因敲除改善了雄性小鼠缺血后的心肌功能,降低了 p38 丝裂原活化蛋白激酶的激活,并减少了白细胞介素-1β和 -6 的表达,但对雌性小鼠没有影响。此外,WT 雌性小鼠在 I/R 后表达更多的细胞因子信号传导抑制蛋白 3,这可能部分解释了雌性心肌中的 TNFR1 信号抵抗。
本研究表明,I/R 后心肌中 TNFR1 介导的 TNF 信号存在性别差异。