地塞米松和倍他米松在发育中的心血管系统中产生不良反应的分子机制。

Molecular mechanisms underlying adverse effects of dexamethasone and betamethasone in the developing cardiovascular system.

机构信息

Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.

Institute of Metabolic Science-Metabolic Research Laboratories, MRC Metabolic Diseases Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

出版信息

FASEB J. 2023 Jun;37(6):e22887. doi: 10.1096/fj.202200676RR.

Abstract

Antenatal glucocorticoids accelerate fetal lung maturation and reduce mortality in preterm babies but can trigger adverse effects on the cardiovascular system. The mechanisms underlying off-target effects of the synthetic glucocorticoids mostly used, Dexamethasone (Dex) and Betamethasone (Beta), are unknown. We investigated effects of Dex and Beta on cardiovascular structure and function, and underlying molecular mechanism using the chicken embryo, an established model system to isolate effects of therapy on the developing heart and vasculature, independent of effects on the mother or placenta. Fertilized eggs were treated with Dex (0.1 mg kg ), Beta (0.1 mg kg ), or water vehicle (Control) on embryonic day 14 (E14, term = 21 days). At E19, biometry, cardiovascular function, stereological, and molecular analyses were determined. Both glucocorticoids promoted growth restriction, with Beta being more severe. Beta compared with Dex induced greater cardiac diastolic dysfunction and also impaired systolic function. While Dex triggered cardiomyocyte hypertrophy, Beta promoted a decrease in cardiomyocyte number. Molecular changes of Dex on the developing heart included oxidative stress, activation of p38, and cleaved caspase 3. In contrast, impaired GR downregulation, activation of p53, p16, and MKK3 coupled with CDK2 transcriptional repression linked the effects of Beta on cardiomyocyte senescence. Beta but not Dex impaired NO-dependent relaxation of peripheral resistance arteries. Beta diminished contractile responses to potassium and phenylephrine, but Dex enhanced peripheral constrictor reactivity to endothelin-1. We conclude that Dex and Beta have direct differential detrimental effects on the developing cardiovascular system.

摘要

产前糖皮质激素可加速早产儿肺成熟并降低其死亡率,但也可能对心血管系统产生不良影响。目前尚不清楚被广泛应用的合成糖皮质激素(地塞米松(Dex)和倍他米松(Beta))产生非靶标作用的机制。我们使用鸡胚研究了 Dex 和 Beta 对心血管结构和功能的影响及其潜在的分子机制,鸡胚是一种成熟的模型系统,可在不影响母体或胎盘的情况下,分离治疗对发育中心脏和血管的影响。在胚胎第 14 天(E14,足月=21 天),用 Dex(0.1mg/kg)、Beta(0.1mg/kg)或水载体(对照)处理受精蛋。在 E19 时,进行生物测定、心血管功能、体视学和分子分析。两种糖皮质激素均促进生长受限,而 Beta 的作用更严重。与 Dex 相比,Beta 引起更严重的舒张期心脏功能障碍,同时也损害了收缩功能。虽然 Dex 引发了心肌细胞肥大,但 Beta 却导致心肌细胞数量减少。Dex 对发育中心脏的分子变化包括氧化应激、p38 激活和裂解的 caspase 3。相反,GR 下调受损、p53、p16 和 MKK3 激活以及 CDK2 转录抑制与 Beta 引起的心肌细胞衰老有关。只有 Beta 而不是 Dex 损害了外周阻力动脉中依赖 NO 的舒张作用。Beta 降低了对钾和苯肾上腺素的收缩反应,但 Dex 增强了对外源缩血管物质 1 的反应性。我们得出结论,Dex 和 Beta 对发育中的心血管系统有直接的、差异的有害影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c8/10946807/ab29889e1448/FSB2-37-0-g002.jpg

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