Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Eur J Anaesthesiol. 2011 Jul;28(7):525-34. doi: 10.1097/EJA.0b013e32834296d5.
Perioperative myocardial ischaemia leads to an exceedingly high mortality. Previous studies have indicated that propofol pre-conditioning could mimic the cardioprotective effects of ischaemic pre-conditioning. The purpose of this study was to determine whether propofol post-conditioning is cardioprotective and to explore the possible molecular mechanism of propofol post-conditioning.
Primary cultured neonatal rat cardiomyocytes were exposed to 12 h of hypoxia followed by 4 h of reoxygenation (H/R) and post-conditioned by different concentrations of propofol at the onset of reperfusion with and without a specific inhibitor of extracellular signal-regulated kinases (ERKs). Cell apoptosis and the generation of intracellular reactive oxygen species were measured using FACScalibur flow cytometric analysis. ERK1/2 phosphorylation and nuclear factor-kappa B (NF-κB) translocation were determined by western blot and immunofluorescence, respectively.
Propofol post-conditioning enhanced cell viability (86.6 ± 6.5 versus 64.1 ± 3.4%) and reduced apoptosis (3.6 ± 0.4 versus 12.5 ± 2.1%) to protect cardiomyocytes against H/R injury. Meanwhile, propofol post-conditioning stimulated expression of phosphor-ERKs. H/R markedly induced p65 NF-κB nuclear translocation in cardiomyocytes, whereas propofol post-conditioning significantly suppressed H/R-primed NF-κB translocation. Moreover, addition of the mitogen-activated protein kinase kinase 1 inhibitor U0126 into cardiomyocytes 30 min before H/R eliminated the cardioprotection of propofol post-conditioning.
Propofol exerts cardioprotection when administered at the early phase of reperfusion. The effect is mediated through decrease in cardiomyocyte apoptosis and NF-κB nucleus translocation potentially via ERK signalling pathways.
围术期心肌缺血可导致极高的死亡率。既往研究表明,异丙酚预处理可模拟缺血预处理的心脏保护作用。本研究旨在确定异丙酚后处理是否具有心脏保护作用,并探讨异丙酚后处理的可能分子机制。
原代培养的新生大鼠心肌细胞在缺氧 12 h 后再复氧 4 h(H/R),复氧开始时用不同浓度的异丙酚进行后处理,并在有无细胞外信号调节激酶(ERK)特异性抑制剂的情况下进行。采用流式细胞术 FACScalibur 检测细胞凋亡和细胞内活性氧的产生。通过 Western blot 和免疫荧光分别测定 ERK1/2 磷酸化和核因子-κB(NF-κB)易位。
异丙酚后处理增强了细胞活力(86.6±6.5 比 64.1±3.4%)并减少了细胞凋亡(3.6±0.4 比 12.5±2.1%),从而保护心肌细胞免受 H/R 损伤。同时,异丙酚后处理刺激了 phosphor-ERK 的表达。H/R 可明显诱导心肌细胞中 p65 NF-κB 核易位,而异丙酚后处理可显著抑制 H/R 诱导的 NF-κB 易位。此外,在 H/R 前 30 min 加入丝裂原活化蛋白激酶激酶 1 抑制剂 U0126 可消除异丙酚后处理的心脏保护作用。
异丙酚在再灌注早期给药可发挥心脏保护作用。该作用是通过减少心肌细胞凋亡和 NF-κB 核易位来实现的,可能通过 ERK 信号通路。