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扰乱外周肌源性反应的昼夜节律控制可减轻心肌梗死后的心脏损伤。

Disrupting circadian control of peripheral myogenic reactivity mitigates cardiac injury following myocardial infarction.

机构信息

Department of Physiology, University of Toronto, Toronto, Canada.

Toronto Centre for Microvascular Medicine at The Ted Rogers Centre for Heart Research Translational Biology and Engineering Program, University of Toronto, 661 University Avenue, 14th Floor, Toronto, Ontario M5G 1M1, Canada.

出版信息

Cardiovasc Res. 2023 Jun 13;119(6):1403-1415. doi: 10.1093/cvr/cvac174.

Abstract

AIMS

Circadian rhythms orchestrate important functions in the cardiovascular system: the contribution of microvascular rhythms to cardiovascular disease progression/severity is unknown. This study hypothesized that (i) myogenic reactivity in skeletal muscle resistance arteries is rhythmic and (ii) disrupting this rhythmicity would alter cardiac injury post-myocardial infarction (MI).

METHODS AND RESULTS

Cremaster skeletal muscle resistance arteries were isolated and assessed using standard pressure myography. Circadian rhythmicity was globally disrupted with the ClockΔ19/Δ19 mutation or discretely through smooth muscle cell-specific Bmal1 deletion (Sm-Bmal1 KO). Cardiac structure and function were determined by echocardiographic, hemodynamic and histological assessments. Myogenic reactivity in cremaster muscle resistance arteries is rhythmic. This rhythm is putatively mediated by the circadian modulation of a mechanosensitive signalosome incorporating tumour necrosis factor and casein kinase 1. Following left anterior descending coronary artery ligation, myogenic responsiveness is locked at the circadian maximum, although circadian molecular clock gene expression cycles normally. Disrupting the molecular clock abolishes myogenic rhythmicity: myogenic tone is suspended at the circadian minimum and is no longer augmented by MI. The reduced myogenic tone in ClockΔ19/Δ19 mice and Sm-Bmal1 KO mice associates with reduced total peripheral resistance (TPR), improved cardiac function and reduced infarct expansion post-MI.

CONCLUSIONS

Augmented microvascular constriction aggravates cardiac injury post-MI. Following MI, skeletal muscle resistance artery myogenic reactivity increases specifically within the rest phase, when TPR would normally decline. Disrupting the circadian clock interrupts the MI-induced augmentation in myogenic reactivity: therapeutics targeting the molecular clock, therefore, may be useful for improving MI outcomes.

摘要

目的

昼夜节律协调心血管系统的重要功能:微血管节律对心血管疾病进展/严重程度的贡献尚不清楚。本研究假设:(i)骨骼肌阻力动脉的肌源性反应具有节律性,(ii)破坏这种节律性会改变心肌梗死后的心脏损伤。

方法和结果

使用标准压力血管描记术分离并评估提睾肌骨骼肌阻力动脉的昼夜节律性。通过 ClockΔ19/Δ19 突变或平滑肌细胞特异性 Bmal1 缺失(Sm-Bmal1 KO)全局破坏昼夜节律性。通过超声心动图、血流动力学和组织学评估确定心脏结构和功能。提睾肌阻力动脉的肌源性反应具有节律性。这种节律性可能是通过包含肿瘤坏死因子和酪蛋白激酶 1 的机械敏感信号小体的昼夜节律调节介导的。在左前降支冠状动脉结扎后,尽管昼夜节律分子钟基因表达周期正常,但肌源性反应性被锁定在昼夜节律最大值。破坏分子钟会消除肌源性节律性:肌源性张力在昼夜节律最小值处暂停,并且不再因 MI 而增强。ClockΔ19/Δ19 小鼠和 Sm-Bmal1 KO 小鼠的肌源性张力降低与总外周阻力(TPR)降低、心脏功能改善和 MI 后梗死扩张减少有关。

结论

增强微血管收缩会加重心肌梗死后的心脏损伤。在 MI 后,骨骼肌阻力动脉的肌源性反应性在休息期内特异性增加,而此时 TPR 通常会下降。破坏生物钟会中断 MI 诱导的肌源性反应性增强:因此,针对分子钟的治疗方法可能有助于改善 MI 结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dab/10262184/1fa67be67861/cvac174_ga1.jpg

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