Garcia Ricardo A, Go Katrina V, Villarreal Francisco J
Department of Medicine, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Mol Cell Biochem. 2007 Jun;300(1-2):159-69. doi: 10.1007/s11010-006-9379-0. Epub 2006 Dec 6.
The development of strategies to ameliorate post-myocardial infarction (MI) remodeling and improve function continues to be an area of clinical importance. Use of steroids for this purpose is controversial since the effects of timed treatment on relevant inflammatory, biochemical and structure/function endpoints are unclear. In a previous report, we demonstrated that use of doxycycline pre-treatment improves post-MI remodeling and passive left ventricular (LV) function. However, the effects of timed doxycycline post-MI treatment are unknown. To examine these issues, we performed a study using a rat MI model. Animals were administered one of the following: doxycycline (DOX), the corticosteroid methylprednisolone (MP), or aqueous vehicle. Treatment was given early, short-term (at time of MI to 24 h post-MI) or late, long term (2-7 days post-MI). Animals were sacrificed at 3, 7 or 42 days post-surgery. We assessed LV hemodynamics, pressure-volume, and pressure-scar strains, histomorphometry, inflammation via measurements of myeloperoxidase activity, and matrix metalloproteinase (MMP) activity. Late MP treatment yielded a robust right-shifted pressure-volume curve, which was accompanied by increased scar strains. Late DOX treatment yielded reduced average heart weight and size and preserved scar thickness. DOX treatment did not suppress inflammation, which contrasts with the suppressive effects of MP. Use of early or late MP yielded increased MMP activity in infarcted and non-infarcted regions. Early and late treatment with DOX yielded infarct-associated MMP activity levels comparable to those of vehicle-treated animals. In conclusion, results indicate that late use of MP yields adverse post-MI structure/function outcomes that correlate with suppression of inflammation and increased MMP activity. These observations contrast with those of DOX, in particular, late treatment where improved outcomes were observed in LV structure and were accompanied by the lack of suppression of inflammation.
改善心肌梗死后(MI)重构并提高心脏功能的策略的研发一直是临床重点关注领域。为此使用类固醇存在争议,因为适时治疗对相关炎症、生化及结构/功能终点的影响尚不清楚。在之前的一份报告中,我们证明了使用强力霉素预处理可改善心肌梗死后的重构及左心室(LV)被动功能。然而,心肌梗死后适时使用强力霉素治疗的效果尚不清楚。为研究这些问题,我们使用大鼠心肌梗死模型进行了一项研究。给动物施用以下之一:强力霉素(DOX)、皮质类固醇甲泼尼龙(MP)或水性赋形剂。治疗分为早期短期(心肌梗死时到心肌梗死后24小时)或晚期长期(心肌梗死后2 - 7天)。在术后3、7或42天处死动物。我们评估了左心室血流动力学、压力-容积和压力-瘢痕应变、组织形态计量学、通过测量髓过氧化物酶活性评估炎症以及基质金属蛋白酶(MMP)活性。晚期MP治疗产生了明显右移的压力-容积曲线,并伴有瘢痕应变增加。晚期DOX治疗使平均心脏重量和大小降低,并保留了瘢痕厚度。DOX治疗并未抑制炎症,这与MP的抑制作用形成对比。早期或晚期使用MP均使梗死区和非梗死区的MMP活性增加。早期和晚期使用DOX产生的梗死相关MMP活性水平与赋形剂处理动物相当。总之,结果表明晚期使用MP会产生不良的心肌梗死后结构/功能结果,这与炎症抑制和MMP活性增加相关。这些观察结果与DOX的观察结果形成对比,特别是晚期治疗时,左心室结构出现改善结果且未伴有炎症抑制。