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再灌注开始时给予间歇性腺苷不会引发心脏保护作用。

Intermittent adenosine at the beginning of reperfusion does not trigger cardioprotection.

作者信息

Penna Claudia, Mancardi Daniele, Tullio Francesca, Pagliaro Pasquale

机构信息

Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy.

出版信息

J Surg Res. 2009 May 15;153(2):231-8. doi: 10.1016/j.jss.2008.02.070. Epub 2008 Apr 8.

Abstract

BACKGROUND

Postconditioning (PostC) maneuvers allow post-ischemic accumulation of autacoids, which may trigger protection. Intermittent infusion of either bradykinin or diazoxide during early reperfusion triggered PostC protection via redox signaling. Here we tested whether intermittent adenosine (ADO) may trigger PostC-like cardioprotection.

MATERIALS AND METHODS

Isolated rat hearts underwent 30 min ischemia and 120 min reperfusion. PostC (5 cycles of 10-s reperfusion/ischemia) or short-term ADO treatment were performed immediately after the 30 min ischemia. Non-selective ADO receptor-antagonist (8-SPT) was infused during PostC maneuvers. Left ventricular pressure was monitored, and infarct size was evaluated by using nitro-blue-tetrazolium staining.

RESULTS

In Control hearts after ischemia/reperfusion, infarct size was 64% +/- 4% of risk-area. PostC reduced infarct size to 28% +/- 3% (P < 0.01). PostC protection was abolished by 3 min of the infusion of 8-SPT during PostC maneuvers. Since 3 min of ADO infusion (1 mum or 30 mum) did not trigger PostC protection, protocol with intermittent ADO infusion (5 cycles of 10-s buffer-no-ADO/buffer-plus-ADO) was used to mimic PostC. Also intermittent ADO did not attenuate infarct size (75% +/- 2%; P = NS versus ADO and Control; P < 0.01 versus PostC). Despite disparities on infarct size, post-ischemic systolic function was similar among groups.

CONCLUSIONS

Data suggest a strong ADO-dependent anti-infarct effect, but no an anti-stunning effect, by ischemic PostC. Neither intermittent ADO nor 3 min continuous ADO can trigger protection against infarct size extension. Yet, 3 min ADO antagonist can prevent PostC protection. It is thus likely that endogenous ADO binding with receptors during early reperfusion is necessary, but nonsufficient to induce protection against infarct size extension.

摘要

背景

后适应(PostC)操作可使缺血后自分泌物质积聚,这可能触发保护作用。在早期再灌注期间间歇性输注缓激肽或二氮嗪可通过氧化还原信号传导触发后适应保护作用。在此,我们测试了间歇性腺苷(ADO)是否可触发类似后适应的心脏保护作用。

材料与方法

分离的大鼠心脏经历30分钟缺血和120分钟再灌注。在30分钟缺血后立即进行后适应(10秒再灌注/缺血的5个循环)或短期ADO治疗。在后适应操作期间输注非选择性ADO受体拮抗剂(8-SPT)。监测左心室压力,并使用硝基蓝四氮唑染色评估梗死面积。

结果

在缺血/再灌注后的对照心脏中,梗死面积为危险区域的64%±4%。后适应将梗死面积减少至28%±3%(P<0.01)。在后适应操作期间输注3分钟的8-SPT可消除后适应保护作用。由于输注3分钟的ADO(1μM或30μM)未触发后适应保护作用,因此采用间歇性ADO输注方案(10秒缓冲液-无ADO/缓冲液+ADO的5个循环)来模拟后适应。间歇性ADO也未减小梗死面积(75%±2%;与ADO和对照组相比,P=无显著性差异;与后适应相比,P<0.01)。尽管梗死面积存在差异,但各组缺血后收缩功能相似。

结论

数据表明,缺血性后适应具有强烈的依赖ADO的抗梗死作用,但无抗顿抑作用。间歇性ADO和3分钟持续ADO均不能触发对梗死面积扩大的保护作用。然而,3分钟的ADO拮抗剂可预防后适应保护作用。因此,早期再灌注期间内源性ADO与受体结合可能是必要的,但不足以诱导对梗死面积扩大的保护作用。

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