Li Zhen, Yang Yue-jin, Qin Xue-wen, Ruan Ying-mao, Chen Xi, Meng Liang, Zhang Hui-dong
Center of Diagnosis and Treatment of Coronary Artery Disease, Fuwai Hospital, China Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2006 Nov 28;86(44):3146-50.
To evaluate the plaque stabilization effects of Tongxinluo and Simvastatin in aortic atherosclerosis, and to explore molecular mechanism.
Twenty-three New Zealand white rabbits underwent aortic balloon injury and fed with high-cholesterol diet for 16 weeks and then randomly divided into 3 groups: Tongxinluo group (n = 6, undergoing gastric perfusion of Tongxinluo 1 gxkg(-1)xd(-1)), simvastatin group (n = 9, undergoing gastric perfusion of simvastatin 2 mgxkg(-1)xd(-1)), and model group (n = 8, without drug administration). Another 6 rabbits were used as normal controls. Peripheral blood samples were collected 10 weeks before the administration, and 3 and 16 weeks after the administration to detect the levels of total cholesterol (TG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and by the end of experiment peripheral blood samples were collected to detect the levels of serum endothelin (ET) and nitric oxide (NO). Then the rabbits were killed and their aortas were taken out to undergo pathological examination. Western blotting was used to detect the protein expression of Metalloproteinase (MMP)-1 and cyclooxygenase (COX)-2 and RT-PCR was used to detect the mRNA expression of FasL and bcl-2.
By the end of the experiment the levels of blood lipids were raised by 1 approximately 2 times in the normal group (P < 0.05), and raised more significantly in the model and intervention groups (P < 0.05 approximately 0.01), especially the TC level of the model group was raised by 40 tomes. The levels of blood lipids of the simvastatin group were significantly lower than those of the model group (P < 0.05 approximately 0.01), however, between the Tongxinluo and model groups there were no significant differences in the levels of blood lipids. In the model group the blood level of ET was raised significantly and the level of NO was significantly decreased (both P < 0.01). The ET levels of the 2 intervention groups were both significantly lower than that of the model group (both P < 0.01), and the NO levels of the 2 intervention groups were both significantly higher than those of the normal group (P < 0.01 approximately 0.05), however, there were no significant differences in the ET and NO levels between these 2 intervention groups (all P > 0.05). Sclerotic plaques were distributed intensely at high degrees in the model group. The sclerotic changes of the 2 intervention groups were significantly milder. The contents of collagen of the 2 intervention groups were 0.11 +/- 0.08 and 0.22 +/- 0.11 respectively, both significantly higher then that of the model group (0.01 +/- 0.01, both P < 0.05). The intima/media ratios of aorta of the 2 intervention groups were 0.25 +/- 0.13 and 0.28 +/- 0.12 respectively, both significantly lower than that of the model group (0.60 +/- 0.37). The macrophage amount in the plaque (RAM-11 positively stained area) of the 2 intervention groups were 0.11 +/- 0.10 and 0.06 +/- 0.43 respectively, both significantly lower than that of the model group (0.24 +/- 0.14). The levels of protein expression of MMP-1 and COX-2 in the atherosclerotic lesions of the model group were both significantly higher than those of the normal group and the MMP-1 and COX-2 protein expression levels of the 2 intervention groups were all significantly lower than those of the model group (P < 0.05 approximately 0.01), however, there were no significant differences between these 2 groups (both P > 0.05). Significant linear correlation existed in the MMP-1 and COX-2 positively stained areas (r = 0.533, P = 0.007) and protein expression level (r = 0.833, P < 0.01). Compared with the normal group, the mRNA expression level of FasL in the aorta tissue of the model group was significantly higher (2.44 +/- 0.44) and the mRNA expression level of bcl was significantly lower (0.17 +/- 0.11). Compared with the model group, the mRNA expression levels of FasL of the 2 intervention groups were 0.47 +/- 0.36 and 1.32 +/- 0.61 respectively, both significantly lower and the mRNA expression levels of bcl were 0.64 +/- 0.16 and 1.66 +/- 0.94 respectively, both significantly higher (all P < 0.05 approximately 0.01), with the FasL mRNA expression of the Tongxinluo group significantly higher than that of the simvastatin group (P < 0.05).
Tongxinluo and simvastatin have the same effects of stabilizing the vulnerable plaques, and the mechanism may be related with inhibition of expression of COX-2 and MMP and reduction of the apoptosis in the atherosclerotic plaque.
评价通心络与辛伐他汀对兔主动脉粥样硬化斑块的稳定作用,并探讨其分子机制。
23只新西兰白兔行主动脉球囊损伤术后,高脂饮食16周,然后随机分为3组:通心络组(n = 6,胃灌注通心络1 g·kg-1·d-1)、辛伐他汀组(n = 9,胃灌注辛伐他汀2 mg·kg-1·d-1)和模型组(n = 8,不给药)。另取6只兔作为正常对照。给药前10周、给药后3周和16周采集外周血样本,检测总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,实验结束时采集外周血样本检测血清内皮素(ET)和一氧化氮(NO)水平。然后处死动物,取出主动脉进行病理检查。采用蛋白质印迹法检测基质金属蛋白酶(MMP)-1和环氧化酶(COX)-2蛋白表达,采用逆转录聚合酶链反应(RT-PCR)检测FasL和bcl-2 mRNA表达。
实验结束时,正常组血脂水平升高1~2倍(P < 0.05),模型组和干预组升高更显著(P < 0.05~0.01),尤其是模型组TC水平升高了40倍。辛伐他汀组血脂水平显著低于模型组(P < 0.05~0.01),但通心络组与模型组血脂水平差异无统计学意义。模型组ET水平显著升高,NO水平显著降低(均P < 0.01)。2个干预组ET水平均显著低于模型组(均P < 0.01),2个干预组NO水平均显著高于正常组(P < 0.01~0.05),但2个干预组ET和NO水平差异无统计学意义(均P > 0.05)。模型组硬化斑块高度密集分布。2个干预组硬化改变明显较轻。2个干预组胶原含量分别为0.11±0.08和0.22±0.11,均显著高于模型组(0.01±0.01,均P < 0.05)。2个干预组主动脉内膜/中膜比值分别为0.25±0.13和0.28±0.12,均显著低于模型组(0.60±0.37)。2个干预组斑块内巨噬细胞数量(RAM-11阳性染色面积)分别为0.11±0.10和0.06±0.43,均显著低于模型组(0.24±0.14)。模型组动脉粥样硬化病变中MMP-1和COX-2蛋白表达水平均显著高于正常组,2个干预组MMP-1和COX-2蛋白表达水平均显著低于模型组(P < 0.05~0.01),但2组间差异无统计学意义(均P > 0.05)。MMP-1和COX-2阳性染色面积(r = 0.533,P = 0.007)及蛋白表达水平(r = 0.833,P < 0.01)呈显著线性相关。与正常组比较,模型组主动脉组织中FasL mRNA表达水平显著升高(2.44±0.44),bcl mRNA表达水平显著降低(0.17±0.11)。与模型组比较,2个干预组FasL mRNA表达水平分别为0.47±0.36和1.32±0.61,均显著降低,bcl mRNA表达水平分别为0.64±0.16和1.66±0.94,均显著升高(均P < 0.05~0.01),通心络组FasL mRNA表达高于辛伐他汀组(P < 0.05)。
通心络与辛伐他汀具有相同的稳定易损斑块作用,其机制可能与抑制COX-2和MMP表达及减少动脉粥样硬化斑块内细胞凋亡有关。