Guo H, Zheng M, Jiao Y B, Zheng H
Department of Anesthesiology, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2018 Sep 24;46(9):719-724. doi: 10.3760/cma.j.issn.0253-3758.2018.09.009.
To investigate if paclitaxel can enhance the protective effect of myocardial ischemia preconditioning on ischemia/reperfusion injury in aged ratand explore related mechanism. Primary cardiomyocytes of Sprague-Dawley rats were isolated by trypsin and divided into 5 groups(6 each): control group, hypoxia injury group, hypoxia preconditioning group, paclitaxel group,and paclitaxel+hypoxia preconditioning group. The structure of microtubules and the expression of hypoxia-inducible factor-1α(HIF-1α) were analyzed by immunofluorescence staining. The Langendorff isolated heart perfusion model was applied in 4 groups: hypoxia reperfusion injury group, hypoxia preconditioning group, paclitaxel group, and paclitaxel+hypoxia preconditioning group. Each group was further divided into elderly subgroup and adult subgroup (6 each). Left ventricular developed pressure and maximum rate of rise in left ventricular pressure were analyzed. (1) Primary cardiomyocyte experiments showed that the myocardial tubular microtubule structure in control group was intact and evenly stained; most of the microtubules in the hypoxia-injured group were absent and the tubular tissue was broken; the hypoxia-induced damage on microtubule structure was smaller in the hypoxic preconditioning group compared with the hypoxic injury group (microtubule staining was not uniform, and the lattice structure was broken, but not that obvious as in the hypoxia group); the tubular structure of the microtubules of the paclitaxel group was basically complete, and the staining was basically uniform.The integrity of tubular structure was maintained to some extent, similar to a normal microtubule structure in paclitaxel+hypoxia preconditioning group. The expression of HIF-1α in the cytoplasm and nucleus was very low in the control group, which was evidenced in both cytoplasm and nucleus in the hypoxic injury group.The expression was further increased in hypoxic preconditioning group, significant nuclear HIF-1 expression was found in the paclitaxel group, the expression was aggregated in the nucleus in the Paclitaxel+ hypoxia preconditioning group. (2)In Langendorff isolated heart perfusion model, left ventricular developed pressure was similar between the elderly subgroup and the adult subgroup at the end of the infusion,after precondition, 5 minutes of reperfusion, 30 minutes of reperfusion, and 60 minutes of reperfusion in the hypoxic injury group (all 0.05).In the hypoxic injury group, both the elderly subgroup and the adult subgroup had lower left ventricular developed pressure at 30 minutes of reperfusion when compared with the end of the infusion((15.63±4.88) mmHg (1 mmHg=0.133 kPa) vs. (95.63±22.14)mmHg and (17.31±2.75)mmHg vs. (91.00±9.58)mmHg, respectively,all 0.05). In the hypoxic preconditioning group, the adult subgroup had higher left ventricular developed pressure at 5 and 30 minutes of reperfusion when compared with the elderly subgroup((7.13±1.02) mmHg vs. (3.75±1.06)mmHg and (43.94±3.21)mmHg vs.(16.31±1.54)mmHg, respectively,all 0.01). In the paclitaxel group, the adult subgroup had higher left ventricular developed pressure at 30 and 60 minutes of reperfusion when compared with the elderly subgroup((44.31±7.59)mmHg vs. (5.44±1.21)mmHg, (51.56±6.03)mmHg vs. (22.19±5.14)mmHg, respectively, all 0.01). In the paclitaxel+hypoxia preconditioning group, both the elderly subgroup and the adult subgroup had lower left ventricular developed pressure at 30 minutes of reperfusion when compared with the end of the infusion((18.63±4.30)mmHg vs. (99.94±8.23) mmHg, 0.01; (49.69±5.34)mmHg vs. (95.31±5.26)mmHg, 0.05). Meanwhile, the adult subgroup had higher left ventricular developed pressure at 30 minutes of reperfusion when compared with the elderly subgroup((49.69±5.34)mmHg vs. (18.63±4.33)mmHg, 0.01).The adult subgroup had higher change rate of maximum rate of rise in left ventricular pressure at 60 minutes of reperfusion when compared with the elderly subgroup in hypoxia preconditioning group, paclitaxel group, and paclitaxel combined hypoxia preconditioning group((62.83±3.92)% vs. (33.33±3.20)%, (44.17±2.32)% vs. (36.67±2.88)%, (72.50±2.66)% vs. (53.17±2.56)%, respectively,all 0.01). Paclitaxel can enhance the myocardial protective effect of myocardial ischemia preconditioning through stabilizing microtubules of cardiomyocytes and promoting HIF-1α localization in the nucleus.
探讨紫杉醇是否能增强老年大鼠心肌缺血预处理对缺血/再灌注损伤的保护作用并探究相关机制。采用胰蛋白酶分离Sprague-Dawley大鼠原代心肌细胞,分为5组(每组6个):对照组、缺氧损伤组、缺氧预处理组、紫杉醇组、紫杉醇+缺氧预处理组。通过免疫荧光染色分析微管结构及缺氧诱导因子-1α(HIF-1α)的表达。对4组采用Langendorff离体心脏灌注模型:缺氧再灌注损伤组、缺氧预处理组、紫杉醇组、紫杉醇+缺氧预处理组。每组再分为老年亚组和成年亚组(每组6个)。分析左心室舒张末压及左心室压力最大上升速率。(1)原代心肌细胞实验显示,对照组心肌微管结构完整且染色均匀;缺氧损伤组多数微管缺失且管状组织破坏;与缺氧损伤组相比,缺氧预处理组对微管结构的缺氧诱导损伤较小(微管染色不均匀,晶格结构破坏,但不如缺氧组明显);紫杉醇组微管的管状结构基本完整,染色基本均匀。在紫杉醇+缺氧预处理组,管状结构完整性在一定程度上得以维持,类似于正常微管结构。对照组细胞质和细胞核中HIF-1α的表达很低,缺氧损伤组在细胞质和细胞核中均有表达。缺氧预处理组表达进一步增加,紫杉醇组细胞核中有明显的HIF-1表达,在紫杉醇+缺氧预处理组表达聚集在细胞核中。(2)在Langendorff离体心脏灌注模型中,缺氧损伤组老年亚组和成年亚组在灌注结束时、预处理后、再灌注5分钟、30分钟和60分钟时左心室舒张末压相似(均P>0.05)。在缺氧损伤组,与灌注结束时相比,老年亚组和成年亚组在再灌注30分钟时左心室舒张末压均降低(分别为(15.63±4.88)mmHg(1mmHg=0.133kPa)对(95.63±22.14)mmHg和(17.31±2.75)mmHg对(91.00±9.58)mmHg,均P<0.05)。在缺氧预处理组,成年亚组在再灌注5分钟和30分钟时左心室舒张末压高于老年亚组(分别为(7.13±1.02)mmHg对(3.75±1.06)mmHg和(43.94±3.21)mmHg对(16.31±1.54)mmHg,均P<0.01)。在紫杉醇组,成年亚组在再灌注30分钟和60分钟时左心室舒张末压高于老年亚组(分别为(44.31±7.59)mmHg对(5.44±1.21)mmHg,(51.56±6.03)mmHg对(22.19±5.14)mmHg,均P<0.01)。在紫杉醇+缺氧预处理组,与灌注结束时相比,老年亚组和成年亚组在再灌注30分钟时左心室舒张末压均降低(分别为(18.63±4.30)mmHg对(99.94±8.23)mmHg,P<0.01;(49.69±5.34)mmHg对(95.31±5.26)mmHg,P<0.05)。同时,成年亚组在再灌注30分钟时左心室舒张末压高于老年亚组((49.69±5.34)mmHg对(18.63±4.33)mmHg,P<0.01)。在缺氧预处理组、紫杉醇组和紫杉醇联合缺氧预处理组中,成年亚组在再灌注60分钟时左心室压力最大上升速率变化率高于老年亚组(分别为(62.83±3.92)%对(33.33±3.20)%,(44.17±