Xiong J, Xue F S, Xu Y C, Yang Q Y, Liao X, Wang W L
Department of Anaesthesiology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100144, China.
Med Hypotheses. 2009 Sep;73(3):312-4. doi: 10.1016/j.mehy.2009.03.026. Epub 2009 Apr 28.
The best treatment for myocardial infarction is to restore blood flow in the ischaemic region, though it will bring new myocardial damage known as myocardial ischaemia/reperfusion (I/R) injury. Both the ischaemia preconditioning and the ischaemia postcondioning have been shown to reduce the myocardial I/R injury, but their deficits restrict wide clinical availability. It has been demonstrated that inflammation plays a critical role in the I/R injury process. Also plasma levels of cytokines and inflammation response can be regulated by specifically augmenting cholinergic signaling via the efferent vagus nerve and alpha7 subunit-containing nicotinic acetylcholine receptor (alpha7nAChR). Because cholinergic modalities, acting through vagus nerve- and/or alpha7nAChR-mediated mechanism, have been confirmed to suppress excessive inflammation during the I/R injury in kidney, liver, lung and intestine, therefore, we hypothesize that cholinergic agonists may also provide a protection for the myocardial I/R injury.
心肌梗死的最佳治疗方法是恢复缺血区域的血流，尽管这会带来新的心肌损伤，即心肌缺血/再灌注（I/R）损伤。缺血预处理和缺血后处理均已被证明可减轻心肌I/R损伤，但其不足之处限制了其在临床上的广泛应用。已经证明炎症在I/R损伤过程中起关键作用。此外，通过传出迷走神经和含α7亚基的烟碱型乙酰胆碱受体（α7nAChR）特异性增强胆碱能信号传导，可以调节细胞因子的血浆水平和炎症反应。由于通过迷走神经和/或α7nAChR介导的机制起作用的胆碱能方式已被证实在肾脏、肝脏、肺和肠道的I/R损伤期间可抑制过度炎症，因此，我们假设胆碱能激动剂也可能为心肌I/R损伤提供保护。
