Cao Chen, Liu Hui-Min, Li Wei, Wu Yang, Leng Yan, Xue Rui, Chen Rong, Tang Ling-Hua, Sun Qian, Xia Zhongyuan, Tang Qi-Zhu, Shen Di-Fei, Meng Qing-Tao
PhD, Department of Endocrinology, 3rdHospital of Wuhan City, Wuhan, Hubei 430074, China. Conception and design of the study, final approval.
PhD, Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China. Conception and design of the study, final approval.
Acta Cir Bras. 2020 Mar 23;35(1):e202000107. doi: 10.1590/s0102-865020200010000007. eCollection 2020.
Patients with diabetes are vulnerable to myocardial I/R (ischaemia/reperfusion) injury, but are not responsive to IPO (ischaemic post-conditioning). We hypothesized that decreased cardiac Adiponectin (APN) is responsible for the loss of diabetic heart sensitivity to IPO cardioprotecton.
Diabetic rats were subjected to I/R injury (30 min of LAD occlusion followed by 120 min of reperfusion). Myocardial infarct area was determined by TTC staining. Cardiac function was monitored by a microcatheter. ANP, 15-F2t-isoprostane, nitrotyrosine and MDA were measured by assay kits. Levels of p-Akt, total-Akt and GAPDH were determined by Western Blot.
Diabetic rats subjected to myocardial IR exhibited severe myocardial infarction and oxidative stress injury, lower APN in the plasma and cardiac p-Akt expression ( P <0.05). IPO significantly attenuated myocardial injury and up-regulated plasma APN content and cardiac p-Akt expression in non-diabetic rats but not in diabetic rats. Linear correlation analysis showed that the expression of adiponectin was positively correlated with p-Akt and negatively correlated with myocardial infarction area ( P <0.01).
Protective effect of IPO was tightly correlated with the expression of adiponectin, exacerbation of I/R injury and ineffectiveness of IPO was partially due to the decline of adiponectin and inactivation of Akt in diabetes mellitus.
糖尿病患者易发生心肌缺血/再灌注(I/R)损伤,但对缺血后处理(IPO)无反应。我们假设心脏脂联素(APN)降低是糖尿病心脏对IPO心脏保护作用敏感性丧失的原因。
对糖尿病大鼠进行I/R损伤(左冠状动脉前降支闭塞30分钟,随后再灌注120分钟)。通过TTC染色确定心肌梗死面积。用微导管监测心脏功能。用试剂盒检测心钠素、15-F2t-异前列腺素、硝基酪氨酸和丙二醛。通过蛋白质免疫印迹法测定p-Akt、总Akt和甘油醛-3-磷酸脱氢酶(GAPDH)的水平。
遭受心肌缺血再灌注的糖尿病大鼠表现出严重的心肌梗死和氧化应激损伤,血浆中APN较低,心脏p-Akt表达降低(P<0.05)。IPO可显著减轻非糖尿病大鼠的心肌损伤,上调血浆APN含量和心脏p-Akt表达,但对糖尿病大鼠无效。线性相关分析表明,脂联素的表达与p-Akt呈正相关,与心肌梗死面积呈负相关(P<0.01)。
IPO的保护作用与脂联素的表达密切相关,I/R损伤的加重及IPO无效部分归因于糖尿病中脂联素的下降和Akt的失活。