Department of Anesthesioiogy, People's Hospital of Rizhao, Rizhao, China.
Eur Rev Med Pharmacol Sci. 2019 Oct;23(19):8616-8624. doi: 10.26355/eurrev_201910_19178.
The aim of this study was to investigate the effect of morphine on myocardial ischemia/reperfusion (I/R) injury in rats and its underlying mechanism, thereby providing a reference for the prevention and treatment of myocardial I/R injury in clinical practice.
A total of 60 male Sprague-Dawley (SD) rats were randomly divided into 3 groups, including: Sham group (n=20), I/R group (n=20) and I/R + morphine group (n=20) using a random number table. The left anterior descending coronary artery (LAD) of rat was ligated and re-canalized, and the I/R model was established in rats. Rats in I/R + sevoflurane (SEV) group were pretreated with 2.5% SEV. Infarction area of heart in each group was detected using triphenyltetrazolium chloride (TTC) test. Ejection fraction % (EF%) and fraction shortening % (FS%) were determined by echocardiography. Hematoxylin-eosin (HE) staining assay was performed to detect the morphological changes of cardiac myocardial cells in each group. Meanwhile, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling (TUNEL) staining was adopted to detect the apoptosis of myocardial cells and fibroblasts. In addition, the expression levels of toll-like receptor 4 (TLR4) and p65 in heart samples of rats in each group were measured via immuno-histochemical staining. Finally, the influence of morphine on TLR4/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway was detected using Western blotting.
Morphine significantly alleviated I/R-induced cardiac dysfunction in rats, whereas significantly increased EF% and FS% (p<0.05). In addition, morphine evidently inhibited myocardial infarction caused by I/R injury. Meanwhile, it reduced the infarction area from [(59.61±3.41) %] to [(26.67±3.62) %] (p<0.05). The results of HE staining showed that compared with I/R group, I/R + morphine group exhibited remarkably tidier cardiac myofilament, less degradation and necrosis, as well as significantly relieved cellular edema. Immuno-histochemical staining results revealed that morphine overtly reversed decreased expressions of TLR4 and p65 induced by I/R in rats (p<0.05). Furthermore, Western blotting found that morphine significantly inhibited the protein expressions of TLR4 and phosphorylated p65.
Morphine clearly alleviates I/R-induced myocardial injury in rats. The possible mechanism may be associated with the inhibition on TLR4/NF-κB signaling pathway.
本研究旨在探讨吗啡对大鼠心肌缺血/再灌注(I/R)损伤的影响及其作用机制,为临床防治心肌 I/R 损伤提供参考。
60 只雄性 Sprague-Dawley(SD)大鼠采用随机数字表法分为 3 组:假手术组(n=20)、I/R 组(n=20)和 I/R+吗啡组(n=20)。结扎大鼠左前降支冠状动脉(LAD)并再通,建立大鼠 I/R 模型。I/R+七氟醚(SEV)组大鼠预先用 2.5% SEV 预处理。采用氯化三苯基四氮唑(TTC)试验检测各组大鼠的心肌梗死面积。通过超声心动图检测射血分数%(EF%)和短轴缩短率%(FS%)。苏木精-伊红(HE)染色法检测各组大鼠心肌细胞形态变化。同时,采用末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记(TUNEL)染色法检测心肌细胞和成纤维细胞的凋亡情况。此外,采用免疫组织化学染色法检测各组大鼠心脏组织中 toll 样受体 4(TLR4)和 p65 的表达水平。最后,采用 Western blot 检测吗啡对 TLR4/核因子κB(NF-κB)信号通路的影响。
吗啡显著减轻大鼠 I/R 引起的心脏功能障碍,EF%和 FS%显著升高(p<0.05)。此外,吗啡明显抑制 I/R 损伤引起的心肌梗死,使梗死面积从(59.61±3.41)%降低至(26.67±3.62)%(p<0.05)。HE 染色结果显示,与 I/R 组相比,I/R+吗啡组大鼠心肌肌丝排列更整齐,降解坏死减少,细胞水肿明显减轻。免疫组织化学染色结果显示,吗啡明显逆转了 I/R 诱导的大鼠 TLR4 和 p65 表达的降低(p<0.05)。此外,Western blot 发现吗啡显著抑制 TLR4 和磷酸化 p65 的蛋白表达。
吗啡明显减轻大鼠 I/R 引起的心肌损伤,其可能的作用机制与抑制 TLR4/NF-κB 信号通路有关。