Universidad de Buenos Aires, Facultad de Medicina, Departamento de Patología, Instituto de Fisiopatología Cardiovascular , Buenos Aires , Argentina.
Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Bioquímica y Medicina Molecular, Facultad de Medicina , Buenos Aires , Argentina.
Am J Physiol Heart Circ Physiol. 2018 Jun 1;314(6):H1289-H1297. doi: 10.1152/ajpheart.00286.2017. Epub 2018 Apr 6.
Vagal stimulation (VS) during myocardial ischemia and reperfusion has beneficial effects. However, it is not known whether short-term VS applied before ischemia or at the onset of reperfusion protects the ischemic myocardium. This study was designed to determine whether short-term VS applied before ischemia or at the onset of reperfusion reduces myocardial infarct size (IS), mimicking classic preconditioning and postconditioning. A second objective was to study the participation of muscarinic and nicotinic receptors in the protection of both preischemic and reperfusion stimulation. FVB mice were subjected to 30 min of regional myocardial ischemia followed by 2 h of reperfusion without VS, with 10-min preischemic VS (pVS), or with VS during the first 10 min of reperfusion (rVS). pVS reduced IS, and this effect was abolished by atropine and wortmannin. rVS also reduced IS in a similar manner, and this effect was abolished by the α-nicotinic acetylcholine receptor blocker methyllycaconitine. pVS increased Akt and glycogen synthase kinase (GSK)-3β phosphorylation. No changes in Akt and GSK-3β phosphorylation were observed in rVS. Stimulation-mediated IS protection was abolished with the JAK2 blocker AG490. rVS did not modify IL-6 and IL-10 levels in the plasma or myocardium. Splenic denervation and splenectomy did not abolish the protective effect of rVS. In conclusion, pVS and rVS reduced IS by different mechanisms: pVS activated the Akt/GSK-3β muscarinic pathway, whereas rVS activated α-nicotinic acetylcholine receptors and JAK2, independently of the cholinergic anti-inflammatory pathway. NEW & NOTEWORTHY Our data suggest, for the first time, that vagal stimulation applied briefly either before ischemia or at the beginning of reperfusion mimics classic preconditioning and postconditioning and reduces myocardial infarction, activating different mechanisms. We also infer an important role of α-nicotinic receptors for myocardial protection independent of the cholinergic anti-inflammatory pathway.
迷走神经刺激(VS)在心肌缺血再灌注期间具有有益作用。然而,尚不清楚在缺血前或再灌注开始时应用短期 VS 是否可以保护缺血心肌。本研究旨在确定在缺血前或再灌注开始时应用短期 VS 是否可以减少心肌梗死面积(IS),模拟经典的预处理和后处理。第二个目的是研究烟碱型和毒蕈碱型受体在缺血前和再灌注刺激保护中的参与。FVB 小鼠接受 30 分钟的区域性心肌缺血,然后再灌注 2 小时,无 VS、缺血前 10 分钟 VS(pVS)或再灌注的前 10 分钟 VS(rVS)。pVS 减少 IS,这种作用被阿托品和wortmannin 所消除。rVS 也以类似的方式减少 IS,这种作用被α-烟碱型乙酰胆碱受体阻滞剂甲基-lycaconitine 所消除。pVS 增加 Akt 和糖原合酶激酶(GSK)-3β磷酸化。在 rVS 中未观察到 Akt 和 GSK-3β磷酸化的变化。用 JAK2 阻滞剂 AG490 消除了刺激介导的 IS 保护作用。rVS 并未改变血浆或心肌中的 IL-6 和 IL-10 水平。脾神经切断术和脾切除术并未消除 rVS 的保护作用。总之,pVS 和 rVS 通过不同的机制减少 IS:pVS 激活了 Akt/GSK-3β毒蕈碱途径,而 rVS 激活了α-烟碱型乙酰胆碱受体和 JAK2,独立于胆碱能抗炎途径。
我们的数据首次表明,短暂地在缺血前或再灌注开始时应用迷走神经刺激模拟经典的预处理和后处理,并减少心肌梗死,激活不同的机制。我们还推断,α-烟碱型受体在独立于胆碱能抗炎途径的情况下对心肌保护具有重要作用。