Department of Anesthesiology, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan.
Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan.
J Thorac Cardiovasc Surg. 2021 May;161(5):e337-e347. doi: 10.1016/j.jtcvs.2019.10.151. Epub 2019 Nov 14.
Spinal cord ischemia (SCI) is one of the major concerns of postoperative paraplegia during major vascular or aortic surgery. Since mitochondrial dysfunction develops at the early stage of SCI, this study tested the neuronal protective effect of transplantation of viable mitochondria to the ischemic cord in rats.
SCI was induced by crossclamping of thoracic aorta at T6 level for 25 minutes, followed by release of vascular clip to restore aortic blood flow in the anesthetized rats. Mitochondria (100 μg) were isolated from freshly harvested soleus muscle and delivered via the internal jugular vein before releasing of vascular clip. The motor function was assessed independently up to 7 days after reperfusion. Spinal cords were harvested and analyzed for molecular and histological changes.
Whole-body in vivo images acquired by an in vivo imaging system confirmed the enhancement of MitoTracker fluorescence at the regions below crossclamping and in the ischemic cord. Compared with control vehicles, transplantation of mitochondria significantly improved the lower-limb locomotor function of rats subjected to cord ischemia up to 7 days after surgery. Mitochondrial transplantation suppressed the regional endoplasmic reticulum stress in the ischemic cord by attenuating CCAAT-enhancer-binding protein homologous protein expression and restoring binding immunoglobulin protein levels. In accordance, tissue levels of interleukin-6, tumor necrosis factor-α, and caspase-3 were attenuated in the mitochondrial transplanted group. Histologic examination also showed significant increase in numbers of Nissls bodies in the neurons at the ventral horn of ischemic cord following mitochondrial transplantation.
Our study showed that transplantation of freshly isolated mitochondria during the early stage of spinal cord ischemia-reperfusion injury suppressed the oxidative stress in endoplasmic reticulum of the injured cord, thereby reducing neuroapoptosis and improving locomotor function of rats with SCI.
脊髓缺血(SCI)是大血管或主动脉手术后截瘫的主要关注点之一。由于 SCI 早期即出现线粒体功能障碍,本研究检测了向缺血脊髓内移植有活力的线粒体对大鼠的神经保护作用。
通过夹闭胸主动脉 T6 水平 25 分钟来诱导 SCI,然后松开血管夹以恢复麻醉大鼠的主动脉血流。在松开血管夹前,从新鲜收获的比目鱼肌中分离出线粒体(100μg)并通过颈内静脉输送。在再灌注后长达 7 天,独立评估运动功能。收获脊髓并进行分子和组织学分析。
通过体内成像系统获得的全身活体图像证实了在夹闭下方和缺血脊髓区域的 MitoTracker 荧光增强。与对照载体相比,线粒体移植显著改善了缺血后 7 天内脊髓缺血大鼠的下肢运动功能。线粒体移植通过减弱 CCAAT 增强子结合蛋白同源蛋白表达和恢复结合免疫球蛋白蛋白水平来抑制缺血脊髓的局部内质网应激。相应地,线粒体移植组的组织中白细胞介素 6、肿瘤坏死因子-α 和半胱天冬酶-3 的水平降低。组织学检查还显示,在缺血脊髓腹角神经元中,Nissls 体的数量在移植线粒体后显著增加。
我们的研究表明,在脊髓缺血再灌注损伤的早期阶段移植新鲜分离的线粒体可抑制损伤脊髓内质网中的氧化应激,从而减少神经细胞凋亡并改善 SCI 大鼠的运动功能。