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地氟醚预处理对 2 型糖尿病患者右心房组织保护作用的机制研究。

Mechanisms involved in the desflurane-induced post-conditioning of isolated human right atria from patients with type 2 diabetes.

机构信息

Laboratory of Experimental Anaesthesiology and Cellular Physiology EA3212, Institut Fédératif de Recherche ICORE146, Université de Caen Basse Normandie, Caen, France.

出版信息

Br J Anaesth. 2011 Oct;107(4):510-8. doi: 10.1093/bja/aer201. Epub 2011 Jul 25.

Abstract

BACKGROUND

Desflurane triggers post-conditioning in the diabetic human myocardium. We determined whether protein kinase C (PKC), mitochondrial adenosine triphosphate-sensitive potassium (mitoK(ATP)) channels, Akt, and glycogen synthase kinase-3β (GSK-3β) were involved in the in vitro desflurane-induced post-conditioning of human myocardium from patients with type 2 diabetes.

METHODS

The isometric force of contraction (FoC) of human right atrial trabeculae obtained from patients with type 2 diabetes was recorded during 30 min of hypoxia followed by 60 min of reoxygenation. Desflurane (6%) was administered during the first 5 min of reoxygenation either alone or in the presence of calphostin C (PKC inhibitor) or 5-hydroxydecanoate (5-HD) (mitoK(ATP) channel antagonist). Phorbol 12-myristate 13-acetate (PKC activator) and diazoxide (a mitoK(ATP) channel opener) were superfused during early reoxygenation. The FoC at the end of the 60 min reoxygenation period was compared among treatment groups (FoC(60); mean and sd). The phosphorylation of Akt and GSK-3β was studied using western blotting.

RESULTS

Desflurane enhanced the recovery of force [FoC(60): 79 (3)% of baseline] after 60 min of reoxygenation when compared with the control group (P>0.0001). Calphostin C and 5-HD abolished the beneficial effect of desflurane-induced post-conditioning (both P<0.0001). Phorbol 12-myristate 13-acetate and diazoxide enhanced the FoC(60) when compared with the control group (both P<0.0001). Desflurane increased the level of phosphorylation of Akt and GSK-3β (P<0.0001).

CONCLUSIONS

Desflurane-induced post-conditioning in human myocardium from patients with type 2 diabetes was mediated by the activation of PKC, the opening of the mitoK(ATP) channels, and the phosphorylation of Akt and GSK-3β.

摘要

背景

地氟醚可引发糖尿病患者心肌的缺血后处理。我们旨在确定蛋白激酶 C(PKC)、线粒体三磷酸腺苷敏感钾(mitoKATP)通道、Akt 和糖原合酶激酶-3β(GSK-3β)是否参与了体外来自 2 型糖尿病患者的人心脏的地氟醚诱导的缺血后处理。

方法

记录来自 2 型糖尿病患者的右心房小梁的等长收缩力(FoC),在缺氧 30 分钟后进行 60 分钟的复氧。地氟醚(6%)在复氧的前 5 分钟内单独给药,或在 calphostin C(PKC 抑制剂)或 5-羟癸酸(mitoKATP 通道拮抗剂)存在下给药。佛波醇 12-肉豆蔻酸 13-醋酸盐(PKC 激活剂)和二氮嗪(mitoKATP 通道开放剂)在早期复氧期间超极化。比较各组复氧 60 分钟后的 FoC(FoC(60);均值和标准差)。使用 Western blot 研究 Akt 和 GSK-3β的磷酸化。

结果

与对照组相比,地氟醚增强了复氧 60 分钟后的力恢复[FoC(60):基础值的 79(3)%](P>0.0001)。calphostin C 和 5-羟癸酸消除了地氟醚诱导的缺血后处理的有益作用(均 P<0.0001)。佛波醇 12-肉豆蔻酸 13-醋酸盐和二氮嗪与对照组相比增强了 FoC(60)(均 P<0.0001)。地氟醚增加了 Akt 和 GSK-3β的磷酸化水平(P<0.0001)。

结论

来自 2 型糖尿病患者的人心肌的地氟醚诱导的缺血后处理是通过 PKC 的激活、mitoKATP 通道的开放以及 Akt 和 GSK-3β的磷酸化介导的。

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