Zunyi Medical University, Zunyi, Guizhou - China.
Affiliated Hospital of North Sichuan Medical College, NanChong, SiChuan - China.
Arq Bras Cardiol. 2021 Dec;117(6):1134-1144. doi: 10.36660/abc.20200672.
Ischemic heart disease has attracted much attention due to its high mortality rates, treatment costs and the increasing morbidity in the young population. Strategies for reperfusion have reduced mortality. However, reperfusion can lead to cardiomyocyte death and subsequent irreversible myocardial damage. At present, the timely and targeted treatment of ischemia-reperfusion (I/R) injury is often lacking.
To evaluate if dexmedetomidine (DEX) has a protective effect in myocardiual I/R and explore the possible mechanism behind it.
Rat hearts were perfused with a Langendorff perfusion system, and randomly assigned to five groups: control group, perfused with Krebs-Henseleit (K-H) solution for 205 minutes without ischemia; and four test groups that underwent 40 minutes of global ischemia and 120 min of reperfusion. The DEX group, the yohimbine (YOH) group and the DEX + YOH group were perfused with DEX (10 nM), YOH (1 μM) or the combination of DEX and YOH prior to reperfusion, respectively. Cardiac hemodynamics, myocardial infarct size, and myocardial histology were evaluated. The expression of glucose-related protein 78 (GRP78), protein kinase R-like ER kinase (PERK), phosphorylated PERK, eukaryotic initiation factor 2α (eIF2α), phosphorylated eIF2α, activating transcription factor 4 (ATF4), and CCAAT/enhancer-binding protein homologous protein (CHOP) were assessed. P<0.05 was considered to indicate a statistically significant difference.
DEX preconditioning improved the cardiac function of I/R hearts, reduced myocardial infarction, myocardial apoptosis, and the expression of GRP78, p-PERK, eIF2α, p-eIF2α, ATF4 and CHOP.
DEX pretreatment reduced myocardial I/R injury by suppressing apoptosis, which was induced by the PERK pathway.
由于其高死亡率、治疗费用和年轻人群发病率的增加,缺血性心脏病引起了广泛关注。再灌注策略降低了死亡率。然而,再灌注会导致心肌细胞死亡和随后的不可逆心肌损伤。目前,缺血再灌注(I/R)损伤的及时和靶向治疗往往缺乏。
评估右美托咪定(DEX)是否对心肌 I/R 具有保护作用,并探讨其可能的机制。
采用 Langendorff 灌注系统对大鼠心脏进行灌注,随机分为 5 组:对照组,用 Krebs-Henseleit(K-H)溶液灌注 205 分钟,无缺血;4 个实验组行 40 分钟全缺血和 120 分钟再灌注。DEX 组、育亨宾(YOH)组和 DEX+YOH 组分别在再灌注前用 DEX(10 nM)、YOH(1 μM)或 DEX 和 YOH 的混合物进行灌注。评估心脏血流动力学、心肌梗死面积和心肌组织学。评估葡萄糖相关蛋白 78(GRP78)、蛋白激酶 R 样内质网激酶(PERK)、磷酸化 PERK、真核起始因子 2α(eIF2α)、磷酸化 eIF2α、激活转录因子 4(ATF4)和 CCAAT/增强子结合蛋白同源蛋白(CHOP)的表达。P<0.05 表示具有统计学意义。
DEX 预处理通过抑制凋亡改善了 I/R 心脏的心脏功能,减少了心肌梗死、心肌细胞凋亡以及 GRP78、p-PERK、eIF2α、p-eIF2α、ATF4 和 CHOP 的表达。
DEX 预处理通过抑制 PERK 通路诱导的细胞凋亡减轻了心肌 I/R 损伤。