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[心肌缺血/再灌注损伤后瘦素变化及机制的初步研究]

[Preliminary investigation of the changes and mechanism of Leptin after myocardial ischemia/reperfusion injury].

作者信息

Xue Hui, Yan Guang-tao, Lin Ji, Hao Xiu-hua

机构信息

Research Laboratory of Biochemistry, Basic Medical Institute, General Hospital of PLA, Beijing 100853, China.

出版信息

Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010 Nov;22(11):680-3.

Abstract

OBJECTIVE

To explore the effect of rat myocardial ischemia/reperfusion (I/R) injury on serum Leptin, endothelin (ET), C-reactive protein (CRP) and myocardial Leptin expression, and discuss the role of Leptin in myocardial I/R injury.

METHODS

Fifty Sprague-Dawley (SD) rats were randomly divided into sham-operation, ischemia and I/R 1, 2, 3 hours groups, with 10 rats in each group. Anterior descending artery of the left coronary artery was ligated for 45 minutes and released for 1, 2 and 3 hours to establish myocardial I/R model, and the said artery of the rats in sham-operation group was not ligated. Blood from left femoral artery was collected at different time points, and serum Leptin, ET and CRP contents were detected. Myocardial tissue was harvested, and stained with hematoxylin-eosin (HE) and immunohistochemistry for its observation of the myocardial pathological changes and Leptin protein expression.

RESULTS

Serum Leptin content (μg/L) of ischemia group was significantly lower than that of sham-operation group (4.69±1.67 vs. 6.48±2.02, P<0.05); as the reperfusion time was prolonged, serum Leptin level increased gradually, and the level of I/R 3-hour group recovered to that before injury [(6.59±2.58) μg/L]. ET content (ng/L) of ischemia group was significantly higher than that of sham-operation group (110.58±37.86 vs. 80.74±34.43, P<0.05), the levels of ET in I/R 1, 2 and 3 hours groups were significantly lower than those of ischemia group (35.87±13.56, 31.98±10.88, 34.56±14.37 vs. 110.58±37.86, all P<0.05). CRP content (mg/L) of ischemia group was significantly higher than that of sham-operation group (13.12±4.82 vs. 3.24±1.72, P<0.01); as the reperfusion time was prolonged, serum CRP level increased gradually, and the levels of I/R 1, 2 and 3 hours groups were significantly higher than those of ischemia group (18.37±6.48, 24.30±9.51, 27.08±8.32 vs. 13.12±4.82, all P<0.05). Pathological examination showed that there was necrosis of ischemic myocardial cells in ischemia group, with mild congestion and edema in interstitial spaces. After I/R injury, the myocardial cells showed coagulative necrosis, and there was severe congestion of myocardial interstitial. Immunohistochemistry results showed that there was a tendency of decrease in Leptin protein expression in the early phase but increase in the late phase after the injury.

CONCLUSION

Leptin content in the serum and myocardial tissue decreases significantly in the early phase after myocardial I/R but increases gradually in the rehabilitative phase, suggesting that Leptin maybe a stress protective factor against I/R-induced myocardial injury. There is a possible association between Leptin and the early increase followed by a delayed decrease of ET as well as the increase of CRP.

摘要

目的

探讨大鼠心肌缺血/再灌注(I/R)损伤对血清瘦素、内皮素(ET)、C反应蛋白(CRP)及心肌瘦素表达的影响,探讨瘦素在心肌I/R损伤中的作用。

方法

将50只Sprague-Dawley(SD)大鼠随机分为假手术组、缺血组、I/R 1小时组、I/R 2小时组、I/R 3小时组,每组10只。结扎左冠状动脉前降支45分钟,再分别再灌注1、2、3小时,建立心肌I/R模型,假手术组大鼠冠状动脉不结扎。于不同时间点采集左股动脉血,检测血清瘦素、ET及CRP含量。取心肌组织,行苏木精-伊红(HE)染色及免疫组化染色,观察心肌病理变化及瘦素蛋白表达。

结果

缺血组血清瘦素含量(μg/L)明显低于假手术组(4.69±1.67 vs. 6.48±2.02,P<0.05);随着再灌注时间延长,血清瘦素水平逐渐升高,I/R 3小时组水平恢复至损伤前水平[(6.59±2.58)μg/L]。缺血组ET含量(ng/L)明显高于假手术组(110.58±37.86 vs. 80.74±34.43,P<0.05),I/R 1小时组、I/R 2小时组、I/R 3小时组ET水平明显低于缺血组(35.87±13.56、31.98±10.88、34.56±14.37 vs. 110.58±37.86,均P<0.05)。缺血组CRP含量(mg/L)明显高于假手术组(13.12±4.82 vs. 3.24±1.72,P<0.01);随着再灌注时间延长,血清CRP水平逐渐升高,I/R 1小时组、I/R 2小时组、I/R 3小时组CRP水平明显高于缺血组(18.37±6.48、24.30±9.51、27.08±8.32 vs. 13.12±4.82,均P<0.05)。病理检查显示,缺血组心肌细胞缺血性坏死,间质轻度充血、水肿。I/R损伤后,心肌细胞呈凝固性坏死,心肌间质重度充血。免疫组化结果显示,损伤后早期瘦素蛋白表达呈下降趋势,后期呈上升趋势。

结论

心肌I/R后早期血清及心肌组织中瘦素含量明显降低,恢复阶段逐渐升高,提示瘦素可能是I/R诱导心肌损伤的应激保护因子。瘦素与ET早期升高及随后延迟下降以及CRP升高之间可能存在关联。

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