Chen Keyan, Sun YingJie, Dong Wanwei, Zhang Tiezheng, Zhou Nan, Yu Weiwei, Diao Yugang, Guo Shanbin, Tian Yue
Department of Laboratory Animal Science, China Medical University, Shenyang North New Area, Shenyang, China.
Department of Anesthesiology, General Hospital of Shenyang Military Area Command, Shenyang, China.
Cell Physiol Biochem. 2018;46(3):1175-1188. doi: 10.1159/000489068. Epub 2018 Apr 16.
Backgrund/Aims: To investigate the effects of activated α7 nicotinic acetylcholine receptor (α7nAChR) on postoperative cognitive dysfunction (POCD) and intestinal injury induced by cardiopulmonary bypass (CPB) and its relationship with the Th17 response in order to provide a theoretical basis for organ protection and targeted drug therapy during the perioperative period.
Sprague-Dawley rat models of CPB were established. Rat intestinal and brain injuries were observed after CPB using hematoxylin and eosin staining. Cell apoptosis was determined using terminal deoxynucleotidyl transferase dUTP nick end labeling. Inflammatory factors and markers of brain injury in rat serum were measured using enzyme-linked immunosorbent assay. The expression levels of Bcl-2, Bax, caspase-3, ZO-1, occludin, AQP4, RORγT, and α7nAchR were examined using western blotting. Transcription factor RORγT expression was determined using real-time fluorescent quantitative polymerase chain reaction. Th17 cells in the peripheral blood and spleen were determined using flow cytometry. α7nAchR knockout rats were established. The Th17 response in the peripheral blood and spleen of α7nAchR knockout rats was further verified using flow cytometry.
CPB can induce POCD and intestinal injury in rats. α7nAchR activation markedly reduced intestinal injury, POCD, neuronal apoptosis, proinflammatory factor expression, and number of CD4+IL-17+ cells. α7nAchR knockout significantly increased serum D-lactic acid, FABP2, S-100β, NSE, TNF-α, IL-6, and IL-17 secretion. The number of CD4+IL-17+ cells was also significantly increased.
α7nAchR activation markedly ameliorates the intestinal injury and POCD induced by CPB. Inhibition of the Th17 immune response can reduce the proinflammatory response, which could provide a new method for clinical perioperative organ protection and targeted drug therapy.
背景/目的:研究激活的α7烟碱型乙酰胆碱受体(α7nAChR)对体外循环(CPB)诱导的术后认知功能障碍(POCD)和肠道损伤的影响及其与Th17反应的关系,为围手术期器官保护和靶向药物治疗提供理论依据。
建立CPB的Sprague-Dawley大鼠模型。CPB后用苏木精-伊红染色观察大鼠肠道和脑损伤。用末端脱氧核苷酸转移酶dUTP缺口末端标记法测定细胞凋亡。用酶联免疫吸附测定法测定大鼠血清中的炎症因子和脑损伤标志物。用蛋白质免疫印迹法检测Bcl-2、Bax、caspase-3、ZO-1、闭合蛋白、水通道蛋白4、RORγT和α7nAchR的表达水平。用实时荧光定量聚合酶链反应测定转录因子RORγT的表达。用流式细胞术测定外周血和脾脏中的Th17细胞。建立α7nAchR基因敲除大鼠。用流式细胞术进一步验证α7nAchR基因敲除大鼠外周血和脾脏中的Th17反应。
CPB可诱导大鼠POCD和肠道损伤。α7nAchR激活显著减轻肠道损伤、POCD、神经元凋亡、促炎因子表达和CD4+IL-17+细胞数量。α7nAchR基因敲除显著增加血清D-乳酸、脂肪酸结合蛋白2、S-100β、神经元特异性烯醇化酶、肿瘤坏死因子-α、白细胞介素-6和白细胞介素-17的分泌。CD4+IL-17+细胞数量也显著增加。
α7nAchR激活显著改善CPB诱导的肠道损伤和POCD。抑制Th17免疫反应可减少促炎反应,为临床围手术期器官保护和靶向药物治疗提供新方法。