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异丙酚后处理通过细胞外信号调节激酶丝裂原活化蛋白激酶通路抑制核因子-κB 易位,防止低氧/复氧损伤引起的心肌细胞凋亡。

Propofol post-conditioning protects against cardiomyocyte apoptosis in hypoxia/reoxygenation injury by suppressing nuclear factor-kappa B translocation via extracellular signal-regulated kinase mitogen-activated protein kinase pathway.

机构信息

Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.

出版信息

Eur J Anaesthesiol. 2011 Jul;28(7):525-34. doi: 10.1097/EJA.0b013e32834296d5.

Abstract

BACKGROUND AND OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景与目的

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。

方法

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。

结果

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。

结论

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。

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