Davis Heart and Lung Research Institute, The Ohio State Univ., 473 W. 12th Ave., Columbus, OH 43210, USA.
Am J Physiol Heart Circ Physiol. 2010 Aug;299(2):H437-45. doi: 10.1152/ajpheart.00384.2010. Epub 2010 Jun 4.
Ischemic preconditioning (IPC) is a powerful phenomenon that provides potent cardioprotection in mammalian hearts; however, the role of endothelial nitric oxide (NO) synthase (eNOS)-mediated NO in this process remains highly controversial. Questions also remain regarding this pathway as a function of sex and ischemic duration. Therefore, we performed extensive experiments in wild-type (WT) and eNOS knockout (eNOS(-/-)) mice to evaluate whether the infarct-limiting effect of IPC depends on eNOS, ischemic periods, and sex. Classical IPC was induced by three cycles of 5 min of regional coronary ischemia separated by 5 min of reperfusion and was followed by 30 or 60 min of sustained ischemia and 24 h of reperfusion. The control ischemia-reperfusion protocol had 30 or 60 min of ischemia followed by 24 h of reperfusion. Protection was evaluated by measuring the myocardial infarct size as a percentage of the area at risk. The major findings were that regardless of sex, WT mice exhibited robust IPC with significantly smaller myocardial infarction, whereas eNOS(-/-) mice did not. IPC-induced cardiac protection was absent in eNOS(-/-) mice of both Jackson and Harvard origin. In general, female WT mice had smaller infarctions compared with male WT mice. Although prolonged ischemia caused significantly larger infarctions in WT mice of both sexes, they were consistently protected by IPC. Importantly, prolonged myocardial ischemia was associated with increased mortality in eNOS(-/-) mice, and the survival rate was higher in female eNOS(-/-) mice compared with male eNOS(-/-) mice. In conclusion, IPC protects WT mice against in vivo myocardial ischemia-reperfusion injury regardless of sex and ischemic duration, but the deletion of eNOS abolishes the cardioprotective effect of classical IPC.
缺血预处理(IPC)是一种强大的现象,可在哺乳动物心脏中提供强大的心脏保护作用;然而,内皮型一氧化氮合酶(eNOS)介导的 NO 在这个过程中的作用仍然存在很大争议。关于这个途径作为性别和缺血持续时间的函数的问题仍然存在。因此,我们在野生型(WT)和 eNOS 敲除(eNOS(-/-))小鼠中进行了广泛的实验,以评估 IPC 的梗死限制作用是否依赖于 eNOS、缺血时间和性别。经典的 IPC 通过三个循环的 5 分钟区域冠状动脉缺血,每个循环间隔 5 分钟再灌注来诱导,随后进行 30 或 60 分钟的持续缺血和 24 小时的再灌注。对照的缺血再灌注方案有 30 或 60 分钟的缺血,然后进行 24 小时的再灌注。通过测量心肌梗死面积占危险区域的百分比来评估保护作用。主要发现是,无论性别如何,WT 小鼠都表现出强大的 IPC,心肌梗死明显较小,而 eNOS(-/-)小鼠则没有。IPC 诱导的心脏保护作用在杰克逊和哈佛来源的 eNOS(-/-)小鼠中均不存在。一般来说,雌性 WT 小鼠的梗死比雄性 WT 小鼠小。尽管延长的缺血导致 WT 小鼠的梗死明显增大,但 IPC 始终能保护它们。重要的是,延长的心肌缺血与 eNOS(-/-)小鼠的死亡率增加有关,并且与 eNOS(-/-)雄性小鼠相比,雌性 eNOS(-/-)小鼠的存活率更高。总之,IPC 可保护 WT 小鼠免受体内心肌缺血再灌注损伤,而与性别和缺血持续时间无关,但 eNOS 的缺失会消除经典 IPC 的心脏保护作用。