Cao Yan, Liu Zhifeng, Xiao Weiwei, Gu Zhengtao, Xiao Guizhen, Yuan Fangfang, Chen Fang, Pei Yanfang, Li Hui, Su Lei
The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Intensive Care Medicine, General Hospital of Southern Theatre Command of PLA, Guangzhou, China.
Shock. 2020 Jul;54(1):102-109. doi: 10.1097/SHK.0000000000001419.
Heatstroke can induce serious physiological dysfunction in the intestine. However, the underlying mechanisms of this condition are unknown, and therapeutic strategies are not available. In this study, we explored the role of endoplasmic reticulum (ER) stress signaling in this process and assessed whether pretreating mice with an inhibitor of ER stress could alleviate intestinal damage.
A heatstroke model was established in male mice. Mice were pretreated with 4-phenylbutyrate (4-PBA) before exposure to heat stress. Intestinal morphological changes were observed by hematoxylin and eosin (H&E) staining and transmission electron microscopy. The TUNEL assay was used to detect intestinal apoptosis. The expression of the ER stress-related proteins and apoptosis-related proteins was investigated by the Western blot assay.
Compared with control group, mice with heatstroke exhibited evidence of intestinal injury and epithelial apoptosis, accompanied by significantly increased expression of ER stress-related proteins in the intestines. The intestinal injury score and level of intestinal epithelial apoptosis were significantly reduced after administration of 4-PBA. Furthermore, the levels of the intestinal ER stress-related proteins GRP78, PERK, p-eIF2α, ATF4, and CHOP were decreased after 4-PBA treatment.
Our results indicate that the ER stress-mediated apoptosis pathway is activated during heat stress-induced intestinal injury. 4-PBA can inhibit heatstroke-induced intestinal ER stress and attenuate intestinal injury. We provide evidence that the beneficial effect of 4-PBA is closely related to the inhibition of ER stress-mediated apoptosis. These findings suggest that ER stress may be a novel therapeutic target in patients with heatstroke.
中暑可诱发肠道严重的生理功能障碍。然而,这种情况的潜在机制尚不清楚,且尚无治疗策略。在本研究中,我们探讨了内质网(ER)应激信号在此过程中的作用,并评估用ER应激抑制剂预处理小鼠是否能减轻肠道损伤。
在雄性小鼠中建立中暑模型。小鼠在暴露于热应激之前用4-苯基丁酸(4-PBA)进行预处理。通过苏木精和伊红(H&E)染色及透射电子显微镜观察肠道形态变化。采用TUNEL法检测肠道细胞凋亡。通过蛋白质印迹法研究ER应激相关蛋白和凋亡相关蛋白的表达。
与对照组相比,中暑小鼠表现出肠道损伤和上皮细胞凋亡的迹象,同时肠道中ER应激相关蛋白的表达显著增加。给予4-PBA后,肠道损伤评分和肠道上皮细胞凋亡水平显著降低。此外,4-PBA处理后肠道ER应激相关蛋白GRP78、PERK、p-eIF2α、ATF4和CHOP的水平降低。
我们的结果表明,在热应激诱导的肠道损伤过程中,ER应激介导的凋亡途径被激活。4-PBA可抑制中暑诱导的肠道ER应激并减轻肠道损伤。我们提供的证据表明,4-PBA的有益作用与抑制ER应激介导的凋亡密切相关。这些发现提示ER应激可能是中暑患者的一个新的治疗靶点。