The Hatter Cardiovascular Institute, Institute of Cardiovascular Medicine, University College London, London, UK.
Basic Res Cardiol. 2013 Mar;108(2):331. doi: 10.1007/s00395-013-0331-7. Epub 2013 Jan 30.
The mitochondrial permeability transition pore (mPTP) is widely accepted as an end-effector mechanism of conditioning protection against injurious ischaemia/reperfusion. However, death can be initiated in cells without pre-requisite mPTP opening, implicating alternate targets for ischaemia/reperfusion injury amelioration. Matrix metalloproteinases (MMP) are known to activate extrinsic apoptotic cascades and therefore we hypothesised that MMP activity represents an mPTP-independent target for augmented attenuation of ischaemia/reperfusion injury. In ex vivo and in vivo mouse hearts, we investigated whether the MMP inhibitor, ilomastat (0.25 μmol/l), administered upon reperfusion could engender protection in the absence of cyclophilin-D (CyPD), a modulator of mPTP opening, against injurious ischaemia/reperfusion. Ilomastat attenuated infarct size in wild-type (WT) animals [37 ± 2.8 to 22 ± 4.3 %, equivalent to ischaemic postconditioning (iPostC), used as positive control, 27 ± 2.1 %, p < 0.05]. Control CyPD knockout (KO) hearts had smaller infarcts than control WT (28 ± 4.2 %) and iPostC failed to confer additional protection, yet ilomastat significantly attenuated infarct size in KO hearts (11 ± 3.0 %, p < 0.001), and similar protection was also seen in isolated cardiomyocytes. Moreover, ilomastat, unlike the cyclophilin inhibitor cyclosporine-A, had no impact upon reactive oxygen species-mediated mPTP opening. While MMP inhibition was associated with increased Akt and ERK phosphorylation, neither Wortmannin nor PD98059 abrogated ilomastat-mediated protection. We demonstrate that MMP inhibition is cardioprotective, independent of Akt/ERK/CyPD/mPTP activity and is additive to the protection observed following inhibition of mPTP opening, indicative of a parallel pathway to protection in ischaemic/reperfused heart that may have clinical applicability in attenuating injury in acute coronary syndromes and deserve further investigation.
线粒体通透性转换孔(mPTP)被广泛认为是调节性保护免受损伤性缺血/再灌注的最终效应机制。然而,在没有预先开放 mPTP 的情况下,细胞也可能引发死亡,这表明缺血/再灌注损伤的改善存在替代靶点。已知基质金属蛋白酶(MMP)能够激活外在凋亡级联反应,因此我们假设 MMP 活性代表 mPTP 独立的靶点,可以增强对缺血/再灌注损伤的抑制作用。在体外和体内的小鼠心脏中,我们研究了在没有环孢素 D(CyPD)的情况下,即在再灌注时给予 MMP 抑制剂伊洛马司他(0.25 μmol/L)是否可以在不受 mPTP 开放调节剂影响的情况下提供对损伤性缺血/再灌注的保护。伊洛马司他可减轻野生型(WT)动物的梗死面积[37±2.8%至 22±4.3%,与缺血后处理(iPostC)相当,用作阳性对照,27±2.1%,p<0.05]。对照 CyPD 敲除(KO)心脏的梗死面积小于对照 WT 心脏(28±4.2%),而 iPostC 未能提供额外的保护,但伊洛马司他可显著减轻 KO 心脏的梗死面积(11±3.0%,p<0.001),在分离的心肌细胞中也观察到类似的保护作用。此外,与亲环素抑制剂环孢菌素 A 不同,伊洛马司他对活性氧介导的 mPTP 开放没有影响。虽然 MMP 抑制与 Akt 和 ERK 磷酸化增加有关,但 Wortmannin 和 PD98059 均不能阻断伊洛马司他介导的保护作用。我们证明,MMP 抑制具有心脏保护作用,独立于 Akt/ERK/CyPD/mPTP 活性,并且与抑制 mPTP 开放后观察到的保护作用相加,表明在缺血/再灌注心脏中存在平行的保护途径,可能在减轻急性冠脉综合征中的损伤方面具有临床应用价值,值得进一步研究。