Chen-Scarabelli Carol, Faggian Giuseppe, Yuan Zhaokan, Tessari Maddalena, Rungatscher Alessio, Di Rezze Justin, Scarabelli Gabriele M, Abounit Kadija, McCauley Roy, Saravolatz Louis, Mazzucco Alessandro, Scarabelli Tiziano M
VA Ann Arbor Healthcare System, University of Michigan, 2215 Fuller Road (111A), Ann Arbor, MI 48105, USA.
J Thorac Cardiovasc Surg. 2009 Nov;138(5):1213-21. doi: 10.1016/j.jtcvs.2009.03.041. Epub 2009 Jun 23.
This study investigates the cardioprotective role and mechanism of action of urocortin in patients undergoing cardiac surgery, with respect to protein kinase Cepsilon expression, activation, and relocation.
Cardioplegic arrest and subsequent reperfusion inevitably expose the heart to iatrogenic ischemia/reperfusion injury. We previously reported that iatrogenic ischemia/reperfusion injury caused myocyte induction of urocortin, an endogenous cardioprotective peptide.
Two sequential biopsies were obtained from the right atrium of 25 patients undergoing coronary artery bypass grafting at the start of grafting (internal control) and 10 minutes after release of the aortic clamp.
In hearts exposed to iatrogenic ischemia/reperfusion injury, induction of urocortin was documented at both the mRNA (255% of basic levels; P < .05) and the protein (4-fold increase; P < .01) levels. Iatrogenic ischemia/reperfusion injury also induced a selective increase of protein kinase Cepsilon mRNA (225% of internal control; P < .05) and a 2-fold overexpression of total protein kinase Cepsilon (P < .05), which paralleled a 2.9-fold increase in protein kinase Cepsilon phosphorylation (P < .01). Mitochondrial translocation of activated protein kinase Cepsilon was observed only in postcardioplegic samples, using both subcellular fractionation (P < .05) and immunostaining techniques (P < .05). Enhanced protein kinase Cepsilon/mitochondria colocalization was selectively observed in viable myocytes, showing concurrently positive staining for urocortin (P < .05). Finally, co immunoprecipitation experiments documented an iatrogenic ischemia/reperfusion injury-enhanced physical interaction of phosphorylated protein kinase Cepsilon with the 6.1 inwardly rectifying potassium channel subunit of the K(ATP) channels (P < .05).
After iatrogenic ischemia/reperfusion injury, urocortin expression in viable cells selectively colocalized with enhanced phosphorylation and mitochondrial relocation of protein kinase Cepsilon, suggesting a cardioprotective role for endogenous urocortin. The physical interaction of activated protein kinase Cepsilon with 6.1 inwardly rectifying potassium channel, enhanced by cardioplegic arrest, may represent a conjectural mechanism of urocortin-mediated cardioprotection.
本研究探讨尿皮质素在心脏手术患者中的心脏保护作用及其作用机制,涉及蛋白激酶Cε的表达、激活和重新定位。
心脏停搏及随后的再灌注不可避免地使心脏遭受医源性缺血/再灌注损伤。我们之前报道过医源性缺血/再灌注损伤会导致心肌细胞诱导产生尿皮质素,一种内源性心脏保护肽。
对25例行冠状动脉旁路移植术的患者,在移植开始时(内部对照)及松开主动脉夹后10分钟,从右心房获取两份连续的活检组织。
在遭受医源性缺血/再灌注损伤的心脏中,尿皮质素在mRNA水平(基础水平的255%;P <.05)和蛋白水平(增加4倍;P <.01)均有诱导表达。医源性缺血/再灌注损伤还诱导蛋白激酶Cε mRNA选择性增加(内部对照的225%;P <.05)以及总蛋白激酶Cε过表达2倍(P <.05),这与蛋白激酶Cε磷酸化增加2.9倍平行(P <.01)。仅在心脏停搏后的样本中观察到活化的蛋白激酶Cε向线粒体的转位,采用亚细胞分级分离法(P <.05)和免疫染色技术(P <.05)均如此。在存活的心肌细胞中选择性观察到蛋白激酶Cε/线粒体共定位增强,同时尿皮质素染色呈阳性(P <.05)。最后,免疫共沉淀实验证明医源性缺血/再灌注损伤增强了磷酸化蛋白激酶Cε与K(ATP)通道的6.1内向整流钾通道亚基的物理相互作用(P <.05)。
医源性缺血/再灌注损伤后,存活细胞中尿皮质素的表达与蛋白激酶Cε磷酸化增强及线粒体转位选择性共定位,提示内源性尿皮质素有心脏保护作用。心脏停搏增强了活化的蛋白激酶Cε与6.1内向整流钾通道的物理相互作用,这可能是尿皮质素介导的心脏保护的一种推测机制。