Department of Anesthesiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Surg Res. 2011 Sep;170(1):e3-9. doi: 10.1016/j.jss.2011.04.035. Epub 2011 May 17.
Previous studies have reported that female gender confers cardioprotection against ischemia/reperfusion (I/R) injury, partly because estrogen activates phosphatidylinositol-3-kinase/Akt (PI3K/Akt) pathway. We have previously proven that cardioprotection of sevoflurane postconditioning is mediated by PI3K/Akt pathway in male rats. The purpose of the present study was to determine whether the cardioprotection of sevoflurane postconditioning is influenced by gender, and the role of PI3K/Akt pathway in such gender difference.
Isolated hearts from 2-mo-old male and female SD rats were subjected to ischemia for 40 min and reperfusion for 2 h in the Langendorff apparatus, and were randomly assigned to the following groups: no ischemia/reperfusion (CON), ischemia/reperfusion (I/R), I/R+sevoflurane postconditioning (I/R+SPC), I/R+100 nM wortmannin (I/R+WOR), and I/R+SPC+WOR. Postconditioning was performed with administration of 3.0% sevoflurane at the first 10 min of reperfusion. Left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (LVEDP), and myocardial lactate dehydrogenase (LDH) release were measured. Infarct size was detected by riphenyltetrazolium chloride staining. The protein expression of total Akt (t-Akt) and phosphorylated Akt (Ser(473)) (p-Akt) were determined by Western blot.
The I/R group showed lower LVDP and higher LVEDP than CON group in the same gender during reperfusion period. The LDH release and infarct size were smaller in the female I/R group (P < 0.05 versus male I/R group). Sevoflurane postconditioning markedly improved left ventricular function and decreased LDH, infarct size in the male I/R+SPC group (P < 0.05 versus male I/R group) but not in the female I/R+SPC group. Wortmannin abolished the cardioprotection of sevoflurane postconditioning in the male I/R+SPC+Wort group (P < 0.05 versus male I/R+SPC group), and markedly increased the infarct size and LVEDP and decreased LVDP in female rats. The t-Akt protein expression was no significant difference in all groups. The ratio of p-Akt/t-Akt expression in the male CON group was a little lower than that in the female CON group, but there was no statistical significance. In male rats, the ratio of p-Akt/t-Akt was no difference between CON and I/R group, but it was higher in I/R+SPC group than that in I/R group (P < 0.05). In female rats, the level of p-Akt was markedly increased by I/R, which was markedly higher than that in male I/R group (P < 0.05). However, p-Akt was not different between I/R and I/R+SPC groups. Wortmannin decreased the p-Akt expression in both male and female rats.
It is concluded that female rat hearts showed greater resistance to I/R injury, and sevoflurane postconditioning developed cardioprotection in male rats but not in female rats. The PI3K/Akt pathway may be involved in the cardioprotection by both sevoflurane postconditioning and gender.
先前的研究表明,女性性别对缺血/再灌注(I/R)损伤具有心脏保护作用,部分原因是雌激素激活了磷脂酰肌醇-3-激酶/蛋白激酶 B(PI3K/Akt)途径。我们之前已经证明,七氟醚后处理对雄性大鼠的心脏保护作用是通过 PI3K/Akt 途径介导的。本研究的目的是确定七氟醚后处理的心脏保护作用是否受性别影响,以及 PI3K/Akt 途径在这种性别差异中的作用。
从 2 个月大的雄性和雌性 SD 大鼠的心脏中分离出来,在 Langendorff 仪器中进行缺血 40 分钟,再灌注 2 小时,并随机分为以下组:无缺血/再灌注(CON)、缺血/再灌注(I/R)、I/R+七氟醚后处理(I/R+SPC)、I/R+100 nMwortmannin(I/R+WOR)和 I/R+SPC+WOR。后处理是在再灌注的第 10 分钟用 3.0%七氟醚进行的。测量左心室发展压(LVDP)、左心室舒张末期压(LVEDP)和心肌乳酸脱氢酶(LDH)释放。通过三苯基四氮唑氯化物染色检测梗死面积。通过 Western blot 测定总 Akt(t-Akt)和磷酸化 Akt(Ser(473))(p-Akt)的蛋白表达。
与同一性别中的 CON 组相比,I/R 组在再灌注期间的 LVDP 较低,LVEDP 较高。在雌性 I/R 组中,LDH 释放和梗死面积较小(P<0.05,与雄性 I/R 组相比)。七氟醚后处理明显改善了雄性 I/R+SPC 组的左心室功能,减少了 LDH、梗死面积(P<0.05,与雄性 I/R 组相比),但对雌性 I/R+SPC 组没有影响。wortmannin 消除了雄性 I/R+SPC+wort 组中七氟醚后处理的心脏保护作用(P<0.05,与雄性 I/R+SPC 组相比),并显著增加了雌性大鼠的梗死面积和 LVEDP,降低了 LVDP。各组 t-Akt 蛋白表达无明显差异。雄性 CON 组的 p-Akt/t-Akt 表达比值略低于雌性 CON 组,但无统计学意义。在雄性大鼠中,CON 和 I/R 组之间的 p-Akt/t-Akt 比值没有差异,但在 I/R+SPC 组中高于 I/R 组(P<0.05)。在雌性大鼠中,I/R 显著增加了 p-Akt 水平,明显高于雄性 I/R 组(P<0.05)。然而,I/R 和 I/R+SPC 组之间的 p-Akt 没有差异。wortmannin 降低了雄性和雌性大鼠的 p-Akt 表达。
研究表明,雌性大鼠心脏对 I/R 损伤具有更强的抵抗力,七氟醚后处理对雄性大鼠具有心脏保护作用,但对雌性大鼠没有作用。PI3K/Akt 途径可能参与了七氟醚后处理和性别对心脏的保护作用。