Wang Zenggeng, Wu Qinghua, Nie Xiangbi, Guo Jinghua, Yang Chunli
Nanchang University, Nanchang, China; Intensive Care Unit, Jiangxi Provincial People's Hospital, Nanchang, China.
Department of Cardiology, Second Affiliated Hospital of Nanchang University, Nanchang, China.
J Surg Res. 2016 Jan;200(1):283-9. doi: 10.1016/j.jss.2015.07.015. Epub 2015 Jul 14.
Myocardial depression, as a well-recognized manifestation of cardiac dysfunction, often accompanies severe sepsis and septic shock. Inflammation-induced myocardial apoptosis is key to the development of sepsis-induced cardiac dysfunction. Increasing evidence suggests the anti-inflammatory role of β1-adrenergic blocker, esmolol, during lethal endotoxemia. However, the direct protective effect of esmolol on cardiomyocyte viability during sepsis is still not clear. Here, we aimed to study whether infusion of esmolol can directly inhibit myocardial apoptosis during lipopolysaccharide (LPS)-triggered inflammatory insult.
C57BL/6 mice were randomized into four groups as follows: control; esmolol infusion; LPS insult; and esmolol infusion + LPS insult. Function of left ventricle was assessed by invasive hemodynamics at 6 h after LPS insult. Terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) staining, caspase-3 expression level, and the Bcl-2/Bax ratio were used to evaluate myocardial apoptosis at 6 h after LPS insult or esmolol infusion.
Administration of LPS resulted in significant decrease in left ventricular end-systolic pressure, reduced maximal rate of change of left ventricular pressure, and the increase in left ventricular end-diastolic pressure. Esmolol infusion reversed LPS-induced impairment of cardiac function and reduced LPS-induced myocardial apoptosis that is associated with c-Jun N-terminal kinase (JNK) and p38 activation.
These data demonstrate that cardioprotection provided by esmolol infusion during LPS insult is associated with antiapoptotic effects and regulation of JNK and p38 activations.
心肌抑制作为一种公认的心脏功能障碍表现,常伴随严重脓毒症和脓毒性休克出现。炎症诱导的心肌细胞凋亡是脓毒症诱导的心脏功能障碍发生发展的关键。越来越多的证据表明,β1肾上腺素能阻滞剂艾司洛尔在致死性内毒素血症期间具有抗炎作用。然而,艾司洛尔在脓毒症期间对心肌细胞活力的直接保护作用仍不清楚。在此,我们旨在研究输注艾司洛尔是否能在脂多糖(LPS)引发的炎症损伤期间直接抑制心肌细胞凋亡。
将C57BL/6小鼠随机分为四组:对照组;艾司洛尔输注组;LPS损伤组;艾司洛尔输注 + LPS损伤组。在LPS损伤后6小时通过有创血流动力学评估左心室功能。采用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记(TUNEL)染色、半胱天冬酶-3表达水平以及Bcl-2/Bax比值来评估LPS损伤或艾司洛尔输注后6小时的心肌细胞凋亡情况。
给予LPS导致左心室收缩末期压力显著降低、左心室压力最大变化率降低以及左心室舒张末期压力升高。输注艾司洛尔可逆转LPS诱导的心脏功能损害,并减少与c-Jun氨基末端激酶(JNK)和p38激活相关的LPS诱导的心肌细胞凋亡。
这些数据表明,在LPS损伤期间输注艾司洛尔所提供的心脏保护作用与抗凋亡效应以及JNK和p38激活的调节有关。