缺血性与非缺血性小鼠心力衰竭导致贫血的机制不同。

Separate mechanisms cause anemia in ischemic vs. nonischemic murine heart failure.

机构信息

Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2010 Mar;298(3):R808-14. doi: 10.1152/ajpregu.00250.2009. Epub 2009 Dec 23.

Abstract

In ischemic congestive heart failure (CHF), anemia is associated with poor prognosis. Whether anemia develops in nonischemic CHF is uncertain. The hematopoietic inhibitors TNF-alpha and nitric oxide (NO) are activated in ischemic CHF. We examined whether mice with ischemic or nonischemic CHF develop anemia and whether TNF-alpha and NO are involved. We studied mice (n = 7-9 per group) with CHF either due to myocardial infarction (MI) or to overexpression of the Ca(2+)-binding protein calsequestrin (CSQ) or to induced cardiac disruption of the sarcoplasmic reticulum Ca(2+)-ATPase 2 gene (SERCA2 KO). Hematopoiesis was analyzed by colony formation of CD34(+) bone marrow cells. Hemoglobin concentration was 14.0 +/- 0.4 g/dl (mean +/- SD) in controls, while it was decreased to 10.1 +/- 0.4, 9.7 +/- 0.4, and 9.6 +/- 0.3 g/dl in MI, CSQ, and SERCA2 KO, respectively (P < 0.05). Colony numbers per 100,000 CD34(+) cells in the three CHF groups were reduced to 33 +/- 3 (MI), 34 +/- 3 (CSQ), and 39 +/- 3 (SERCA2 KO) compared with 68 +/- 4 in controls (P < 0.05). Plasma TNF-alpha nearly doubled in MI, and addition of anti-TNF-alpha antibody normalized colony formation. Inhibition of colony formation was completely abolished with blockade of endothelial NO synthase in CSQ and SERCA2 KO, but not in MI. In conclusion, the mechanism of anemia in CHF depends on the etiology of cardiac disease; whereas TNF-alpha impairs hematopoiesis in CHF following MI, NO inhibits blood cell formation in nonischemic murine CHF.

摘要

在缺血性充血性心力衰竭(CHF)中,贫血与预后不良有关。非缺血性 CHF 是否会发生贫血尚不确定。在缺血性 CHF 中,造血抑制剂 TNF-α和一氧化氮(NO)被激活。我们检查了患有缺血性或非缺血性 CHF 的小鼠是否会出现贫血,以及 TNF-α和 NO 是否参与其中。我们研究了由于心肌梗塞(MI)或钙结合蛋白 calsequestrin(CSQ)过表达或肌浆网 Ca2+-ATPase 2 基因(SERCA2 KO)的心脏破坏而导致 CHF 的小鼠(每组 7-9 只)。通过 CD34+骨髓细胞的集落形成分析造血。对照的血红蛋白浓度为 14.0 +/- 0.4 g/dl(平均值 +/- SD),而 MI、CSQ 和 SERCA2 KO 分别降至 10.1 +/- 0.4、9.7 +/- 0.4 和 9.6 +/- 0.3 g/dl(P < 0.05)。三个 CHF 组中每 100,000 CD34+细胞的集落数减少至 33 +/- 3(MI)、34 +/- 3(CSQ)和 39 +/- 3(SERCA2 KO),而对照为 68 +/- 4(P < 0.05)。MI 中血浆 TNF-α几乎增加了一倍,并且添加抗 TNF-α抗体可使集落形成正常化。在 CSQ 和 SERCA2 KO 中阻断内皮型一氧化氮合酶可完全消除对集落形成的抑制,但在 MI 中则不然。总之,CHF 中贫血的机制取决于心脏病的病因;TNF-α可损害 MI 后 CHF 中的造血功能,而 NO 可抑制非缺血性鼠 CHF 中的血细胞形成。

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