Kawaguchi Ryoichi, Hirata Naoyuki, Tokinaga Yasuyuki, Hayashi Shunsuke, Inoue Shigeaki, Watanabe Nobuo, Yamakage Michiaki
Department of Anesthesiology, Sapporo Medical University School of Medicine, South-1 West-16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
J Anesth. 2017 Dec;31(6):885-894. doi: 10.1007/s00540-017-2417-0. Epub 2017 Oct 23.
A specific therapeutic strategy in sepsis-induced myocardial dysfunction remains to be determined. Nitrite may have cardioprotective effects against sepsis-induced myocardial dysfunction. This study investigated the cardioprotective effects of nitrite on myocardial function, mitochondrial bioenergetics, and its underlying molecular mechanisms in severe septic rats.
Sepsis was induced in male Wistar rats by cecal ligation and puncture (CLP). After CLP, we administered normal saline (NS group) or nitrite (nitrite group) subcutaneously. We administered nitrite at different doses (0.1-10 mg/kg) to ascertain the most effective dose and examined cardiac function in an isolated heart experiment 8 h after CLP. We investigated mitochondrial bioenergetics and molecular mechanisms underlying the administration of nitrite in vitro.
In isolated heart experiments, the left ventricular developed pressure (96 ± 5 mmHg) at a moderate nitrite dose (1.0 mg/kg) was significantly higher than that in the NS group (75 ± 4 mmHg, P < 0.05). Mitochondrial oxidative phosphorylation in the nitrite group was significantly higher than that in the NS group (P < 0.01). Immunoblotting revealed that nitrite significantly increased the phosphorylation of Akt (P < 0.05) and reduced the nuclear translocation of NF-κB (P < 0.05) compared with the NS group. Nitrite was also shown to improve the rate of survival in severe septic rats (P < 0.001).
Our results showed that a moderate nitrite dose improved septic myocardial dysfunction at organ, cellular, and molecular levels via modulation of stress signal responses, which resulted in an improvement in survival.
脓毒症诱导的心肌功能障碍的具体治疗策略仍有待确定。亚硝酸盐可能对脓毒症诱导的心肌功能障碍具有心脏保护作用。本研究调查了亚硝酸盐对严重脓毒症大鼠心肌功能、线粒体生物能量学及其潜在分子机制的心脏保护作用。
通过盲肠结扎和穿刺(CLP)诱导雄性Wistar大鼠发生脓毒症。CLP后,我们皮下注射生理盐水(NS组)或亚硝酸盐(亚硝酸盐组)。我们给予不同剂量(0.1 - 10 mg/kg)的亚硝酸盐以确定最有效剂量,并在CLP后8小时的离体心脏实验中检查心脏功能。我们在体外研究了亚硝酸盐给药的线粒体生物能量学和分子机制。
在离体心脏实验中,中等剂量亚硝酸盐(1.0 mg/kg)时左心室舒张末压(96 ± 5 mmHg)显著高于NS组(75 ± 4 mmHg,P < 0.05)。亚硝酸盐组的线粒体氧化磷酸化显著高于NS组(P < 0.01)。免疫印迹显示,与NS组相比,亚硝酸盐显著增加了Akt的磷酸化(P < 0.05)并减少了NF-κB的核转位(P < 0.05)。亚硝酸盐还显示可提高严重脓毒症大鼠的生存率(P < 0.001)。
我们的结果表明,中等剂量的亚硝酸盐通过调节应激信号反应在器官、细胞和分子水平上改善了脓毒症性心肌功能障碍,从而提高了生存率。