Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Jiangxi 3300063, Nanchang, China.
Department of Anesthesiology, Lushan Rehabilitation and Recuperation Center, PLA Joint Service Forces, Jiujiang 3320000, China.
Aging (Albany NY). 2020 Nov 24;12(23):24270-24287. doi: 10.18632/aging.202143.
Ischemia/reperfusion (I/R) injury is a life-threatening vascular emergency following myocardial infarction. Our previous study showed cardioprotective effects of metformin against myocardial I/R injury. In this study, we further examined the involvement of AMPK mediated activation of NLRP3 inflammasome in this cardioprotective effect of metformin. Myocardial I/R injury was simulated in a rat heart Langendorff model and neonatal rat ventricle myocytes (NRVMs) were subjected to hypoxi/reoxygenation (H/R) to establish an in vitro model. Outcome measures included myocardial infarct size, hemodynamic monitoring, myocardial tissue injury, myocardial apoptotic index and the inflammatory response. myocardial infarct size and cardiac enzyme activities. First, we found that metformin postconditioning can not only significantly alleviated myocardial infarct size, attenuated cell apoptosis, and inhibited myocardial fibrosis. Furthermore, metformin activated phosphorylated AMPK, decreased pro-inflammatory cytokines, TNF-α, IL-6 and IL-1β, and decreased NLRP3 inflammasome activation. In isolated NRVMs metformin increased cellular viability, decreased LDH activity and inhibited cellular apoptosis and inflammation. Importantly, inhibition of AMPK phosphorylation by Compound C (CC) resulted in decreased survival of cardiomyocytes mainly by inducing the release of inflammatory cytokines and increasing NLRP3 inflammasome activation. Finally, in vitro studies revealed that the NLRP3 activator nigericin abolished the anti-inflammatory effects of metformin in NRVMs, but it had little effect on AMPK phosphorylation. Collectively, our study confirmed that metformin exerts cardioprotective effects by regulating myocardial I/R injury-induced inflammatory response, which was largely dependent on the enhancement of the AMPK pathway, thereby suppressing NLRP3 inflammasome activation.
缺血/再灌注(I/R)损伤是心肌梗死后危及生命的血管急症。我们之前的研究表明二甲双胍对心肌 I/R 损伤具有保护作用。在这项研究中,我们进一步研究了 AMPK 介导的 NLRP3 炎性小体激活在二甲双胍这种心脏保护作用中的作用。在大鼠心脏 Langendorff 模型中模拟心肌 I/R 损伤,并用缺氧/复氧(H/R)处理新生大鼠心室肌细胞(NRVMs)建立体外模型。观察指标包括心肌梗死面积、血流动力学监测、心肌组织损伤、心肌细胞凋亡指数和炎症反应。同时检测心肌梗死面积和心脏酶活性。首先,我们发现二甲双胍后处理不仅可以显著减轻心肌梗死面积,减弱细胞凋亡,抑制心肌纤维化。此外,二甲双胍还能激活磷酸化 AMPK,减少促炎细胞因子 TNF-α、IL-6 和 IL-1β的释放,并抑制 NLRP3 炎性小体的激活。在分离的 NRVMs 中,二甲双胍可增加细胞活力,降低 LDH 活性,并抑制细胞凋亡和炎症。重要的是,用 Compound C (CC) 抑制 AMPK 磷酸化可导致心肌细胞存活率降低,主要是通过诱导炎症细胞因子的释放和增加 NLRP3 炎性小体的激活。最后,体外研究表明,NLRP3 激活剂 Nigericin 可消除二甲双胍在 NRVMs 中的抗炎作用,但对 AMPK 磷酸化的影响较小。综上所述,我们的研究证实,二甲双胍通过调节心肌 I/R 损伤诱导的炎症反应发挥心脏保护作用,这在很大程度上依赖于增强 AMPK 通路,从而抑制 NLRP3 炎性小体的激活。
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