Pôle Anesthésie Réanimation Chirurgicale, SAMU, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
J Vasc Surg. 2013 Apr;57(4):1100-1108.e2. doi: 10.1016/j.jvs.2012.09.020. Epub 2013 Jan 18.
By binding to cyclophilin D, cyclosporine A (CsA) inhibits mitochondrial permeability transition pore (mPTP) opening and prevents mitochondrial dysfunction and ultimately cell death after ischemia-reperfusion (IR) injury in cardiac muscle. This study tested whether CsA would decrease skeletal muscle oxidative stress and mitochondrial dysfunctions after aortic cross-clamping related IR.
Forty-five Wistar rats were investigated. The sham group (n = 8) had aortic exposure but no ischemia, the IR group (n = 10) had aortic cross-clamping for 3 hours followed by 2 hours of reperfusion, and the IR+CsA group (n = 9) had two intraperitoneal injections of 10 mg of CsA at 90 and 150 minutes of ischemia before reperfusion. Mitochondrial coupling (acceptor control ratio) and mitochondrial respiratory chain complexes' activities were measured. Reactive oxygen species (ROS) production, cyclophilin D expression, and muscle inflammation were determined using dihydroethidium staining, Western blot, and immunohistochemistry, respectively. An additional 18 sham rats were investigated to determine CsA blood levels and the effects of CsA on mitochondrial respiration and calcium retention capacity, a marker of mPTP opening, both in myocardium and gastrocnemius with and without CsA.
Compared with sham, IR decreased mitochondrial coupling (1.38 ± 0.06 vs 1.98 ± 0.20; P = .0092), increased ROS production (3992 ± 706 arbitrary units [AU] vs 1812 ± 322 AU; P = .033), was associated with macrophage infiltration, and decreased maximal oxidative capacity (V(max): 4.08 ± 0.38 μmol O(2)/min/g vs 5.98 ± 0.56 μmol O(2)/min/g; P = .015). Despite IR, CsA treatment totally restored mitochondrial coupling (1.93 ± 0.12; P = .023 vs IR), normalized ROS (1569 ± 348 AU; P = .0098 vs IR), and decreased inflammation. The V(max) was slightly enhanced (5.02 ± 0.39 μmol O(2)/min/g; P = .33 vs IR; P = .35 vs sham). Compared with myocardium, gastrocnemius muscle was characterized by a decreased cyclophilin D content (-50%) associated with an earlier opening of mPTP (calcium retention capacity increased from 10.85 ± 1.35 μM/mg dry weight [DW] to 12.11 ± 2.77 μM/mg DW; P = .65; and from 11.07 ± 1.67 to 37.65 ± 11.41 μM/mg DW; P = .0098 in gastrocnemius and heart, respectively).
Cyclosporine A normalized ROS production, decreased inflammation, and restored mitochondrial coupling during aortic cross-clamping. Incomplete Vmax protection might be due to low cyclophilin D expression in gastrocnemius, preventing CsA from blocking mPTP opening.
环孢素 A(CsA)通过与亲环素 D 结合,抑制线粒体通透性转换孔(mPTP)开放,防止线粒体功能障碍,最终防止心脏在缺血再灌注(IR)损伤后发生细胞死亡。本研究检测 CsA 是否会减少主动脉夹闭相关 IR 后骨骼肌的氧化应激和线粒体功能障碍。
研究了 45 只 Wistar 大鼠。假手术组(n = 8)仅暴露主动脉,无缺血;IR 组(n = 10)行主动脉夹闭 3 小时,再灌注 2 小时;IR+CsA 组(n = 9)在再灌注前 90 和 150 分钟时两次腹腔内注射 10 mg CsA。测量线粒体偶联(受体控制比)和线粒体呼吸链复合物的活性。使用二氢乙啶染色、Western blot 和免疫组织化学分别测定活性氧(ROS)的产生、亲环素 D 的表达和肌肉炎症。另外还研究了 18 只假手术大鼠,以确定 CsA 的血药浓度以及 CsA 对心肌和比目鱼肌线粒体呼吸和钙保留能力(mPTP 开放的标志物)的影响,同时在有无 CsA 的情况下进行测定。
与假手术组相比,IR 降低了线粒体偶联(1.38 ± 0.06 比 1.98 ± 0.20;P =.0092),增加了 ROS 产生(3992 ± 706 任意单位 [AU] 比 1812 ± 322 AU;P =.033),与巨噬细胞浸润有关,并降低了最大氧化能力(Vmax:4.08 ± 0.38 μmol O2/min/g 比 5.98 ± 0.56 μmol O2/min/g;P =.015)。尽管存在 IR,CsA 治疗完全恢复了线粒体偶联(1.93 ± 0.12;P =.023 比 IR),使 ROS 正常化(1569 ± 348 AU;P =.0098 比 IR),并减少了炎症。Vmax 略有增强(5.02 ± 0.39 μmol O2/min/g;P =.33 比 IR;P =.35 比假手术组)。与心肌相比,比目鱼肌的亲环素 D 含量降低(-50%),mPTP 更早开放(钙保留能力从 10.85 ± 1.35 μM/mg 干重(DW)增加到 12.11 ± 2.77 μM/mg DW;P =.65;从 11.07 ± 1.67 增加到 37.65 ± 11.41 μM/mg DW;P =.0098 在比目鱼肌和心脏中分别)。
CsA 在主动脉夹闭期间使 ROS 产生正常化,减少炎症,并恢复线粒体偶联。不完全的 Vmax 保护可能是由于比目鱼肌中亲环素 D 表达降低,阻止 CsA 阻断 mPTP 开放。