去神经支配与突触前和突触后肌肉固定：对乙酰胆碱和肌肉特异性酪氨酸激酶受体的影响。
Denervation versus pre- and postsynaptic muscle immobilization: Effects On acetylcholine- and muscle-specific tyrosine kinase receptors.
作者信息
Kramer Christopher, Zoubaa Saida, Kretschmer Alexander, Jordan Denis, Blobner Manfred, Fink Heidrun
机构信息
Klinik für Anaesthesiologie, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, München, Germany.
Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München, Klinikum rechts der Isar, München, Germany.
出版信息
Muscle Nerve. 2017 Jan;55(1):101-108. doi: 10.1002/mus.25159. Epub 2016 Sep 23.
INTRODUCTION
Functional immobility of the diaphragm by mechanical ventilation impairs neuromuscular transmission and may result in ventilator-induced diaphragmatic dysfunction. We compared 3 diaphragmatic immobilization models with respect to their effects on expression of adult and fetal acetylcholine receptors (AChRs), muscle-specific receptor tyrosine kinase (MuSK), and muscle fiber morphology.
METHODS
Diaphragms of rats were immobilized by either: (1) phrenicotomy; (2) presynaptic tetrodotoxin nerve blockade; or (3) postsynaptic polyethylene orthosis. AChR subtypes and MuSK were quantified by Western blot and immunohistochemistry. Muscle fiber morphology was evaluated by hematoxylin-eosin staining.
RESULTS
Adult AChRs remained unchanged, whereas fetal AChRs and MuSK were upregulated in all models. Denervation induced the strongest changes in muscle morphology.
CONCLUSIONS
Each diaphragm immobilization model led to severe morphologic and postsynaptic receptor changes. Postsynaptic polyethylene orthosis, a new model with an intact and functioning motor unit, best reflects the clinical picture of a functionally immobilized diaphragm. Muscle Nerve 55: 101-108, 2017.
引言
机械通气导致膈肌功能固定会损害神经肌肉传递，并可能导致呼吸机诱发的膈肌功能障碍。我们比较了3种膈肌固定模型对成年和胎儿乙酰胆碱受体（AChR）、肌肉特异性受体酪氨酸激酶（MuSK）表达以及肌纤维形态的影响。
方法
通过以下方法使大鼠膈肌固定：（1）膈神经切断术；（2）突触前河豚毒素神经阻滞；或（3）突触后聚乙烯矫形器。通过蛋白质免疫印迹法和免疫组织化学法定量分析AChR亚型和MuSK。通过苏木精-伊红染色评估肌纤维形态。
结果
成年AChR保持不变，而在所有模型中胎儿AChR和MuSK均上调。去神经支配引起肌肉形态的变化最为明显。
结论
每种膈肌固定模型均导致严重的形态学和突触后受体变化。突触后聚乙烯矫形器作为一种运动单位完整且功能正常的新模型，最能反映功能固定膈肌的临床表现。《肌肉与神经》55: 101 - 108, 2017年。
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