Cardiology Section, Department of Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
Clin Sci (Lond). 2012 Oct;123(7):445-57. doi: 10.1042/CS20120080.
Sympathetic activities are elevated in the central SNSs (sympathetic nervous systems) of hypertensive animals, but it is not known whether sympathetic innervation is also elevated in the heart. Sympathetic hyper-responsiveness in hypertension may result from oxidative stress. The aim of the present study was to investigate sympathetic hyperinnervation in DOCA (deoxycorticosterone acetate)-salt hypertensive rats with established hypertension. At 4 weeks after the start of DOCA-salt treatment and uninephrectomization, male Wistar rats were randomized into three groups for 8 weeks: vehicle, NAC (N-acetylcysteine) and triple therapy (hydralazine, hydrochlorothiazide and reserpine). DOCA-salt was associated with increased oxidant release. DOCA-salt produced concentric left ventricular hypertrophy and cardiomyocyte hypertrophy. Sympathetic hyperinnervation was observed in DOCA-salt rats, as assessed by myocardial noradrenaline levels, immunofluorescent analysis of tyrosine hydroxylase, growth-associated factor 43 and neurofilament and Western blotting and real-time quantitative RT-PCR (reverse transcription-PCR) of NGF (nerve growth factor). Arrhythmic scores during programmed stimulation in DOCA-salt rats were significantly higher than those in the control rats. Triple therapy, despite being effective on BP (blood pressure), offered neither attenuated cardiomyocyte hypertrophy nor anti-arrhythmia. The effects of DOCA-salt treatment on NGF expression, sympathetic hyperinnervation and arrhythmias were attenuated by NAC. Furthermore, the effects of NAC on NGF were abolished by administering BSO (L-buthionine sulfoximine), an inhibitor of glutamate-cysteine ligase. In conclusion, DOCA-salt treatment contributes to up-regulation of NGF proteins probably through a free radical-dependent pathway in a BP-independent manner. DOCA-salt rats treated with NAC attenuate sympathetic hyperinnervation and thus show a beneficial effect on arrhythmogenic response to programmed electrical stimulation.
高血压动物的中枢 SNS(交感神经系统)中的交感活性升高,但尚不清楚心脏中的交感神经支配是否也升高。高血压中的交感神经高反应性可能是由于氧化应激引起的。本研究的目的是研究已建立高血压的 DOCA(醋酸脱氧皮质酮)-盐高血压大鼠中的交感神经过度支配。在 DOCA-盐治疗和单侧肾切除开始后 4 周,雄性 Wistar 大鼠被随机分为三组,持续 8 周:载体、NAC(N-乙酰半胱氨酸)和三联疗法(肼屈嗪、氢氯噻嗪和利血平)。DOCA-盐与氧化应激产物的释放增加有关。DOCA-盐导致左心室向心性肥厚和心肌细胞肥大。通过心肌去甲肾上腺素水平、酪氨酸羟化酶、生长相关因子 43 和神经丝免疫荧光分析以及 Western blot 和实时定量 RT-PCR(逆转录-PCR)检测 NGF(神经生长因子),观察到 DOCA-盐大鼠中存在交感神经过度支配。DOCA-盐大鼠在程序刺激期间的心律失常评分明显高于对照组大鼠。三联疗法虽然对血压(BP)有效,但既不能减轻心肌细胞肥大,也不能抗心律失常。NAC 减弱了 DOCA-盐处理对 NGF 表达、交感神经过度支配和心律失常的影响。此外,给予 L-丁硫氨酸亚砜(L-buthionine sulfoximine),一种谷氨酸-半胱氨酸连接酶抑制剂,可消除 NAC 对 NGF 的作用。总之,DOCA-盐处理可能通过一种与血压无关的自由基依赖性途径促进 NGF 蛋白的上调。用 NAC 处理的 DOCA-盐大鼠减轻了交感神经过度支配,因此对程序电刺激的致心律失常反应具有有益作用。