Tan Ying, Bao Xue, Li Yuyu, Song Guo, Lu He, Sun Xuan, Gu Rong, Kang Lina, Xu Biao
Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, Jiangsu, China.
Key Laboratory of Remodeling-Related Cardiovascular Diseases (Ministry of Education) and Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing Anzhen, Hospital Affiliated to Capital Medical University, Beijing, 100029, China.
Cardiovasc Drugs Ther. 2025 Apr;39(2):259-273. doi: 10.1007/s10557-023-07528-y. Epub 2023 Dec 8.
Complete and rapid recanalization of blood flow by percutaneous coronary intervention (PCI) is the most effective intervention for patients with ST-segment elevation myocardial infarction (STEMI). However, myocardial ischemia/reperfusion (I/R) injury leads to microvascular obstruction (MVO), limiting its efficacy. Colchicine can reduce myocardial I/R injury, but its effect on MVO is unclear. Hence, this study aimed to assess the role and mechanism of colchicine on MVO.
Clinical data on STEMI patients with PCI were collected and risk factors related to MVO were analyzed. The rat myocardial I/R model was established to evaluate the MVO by thioflavin S staining. The myocardial I/R model of mice was treated with PBS or colchicine at the reperfusion. The effect of colchicine on cardiomyocyte apoptosis after I/R was evaluated by TUNEL and expression of cleaved caspase-3. ROS levels were detected in H9c2 cells to evaluate the colchicine effect on myocardial oxidative stress. Moreover, the mechanism through which colchicine attenuated MVO was examined using flow cytometry, WB, ELISA, immunohistochemistry, bioinformatics analysis, and immunofluorescence.
Multivariate analysis showed that elevated neutrophils were associated with extensive MVO. Colchicine could attenuate MVO and reduce neutrophil recruitment and NETs formation after myocardial I/R. In addition, colchicine inhibited cardiomyocyte apoptosis in vivo and ROS levels in vitro. Furthermore, colchicine inhibited neutrophil proliferation in the bone marrow (BM) by inhibiting the S100A8/A9 inflammatory signaling pathway.
Colchicine attenuated MVO after myocardial I/R injury by inhibiting the proliferation of neutrophils in BM through the neutrophil-derived S100A8/A9 inflammatory signaling pathway.
经皮冠状动脉介入治疗(PCI)实现血流的完全快速再通是ST段抬高型心肌梗死(STEMI)患者最有效的干预措施。然而,心肌缺血/再灌注(I/R)损伤会导致微血管阻塞(MVO),限制了其疗效。秋水仙碱可减轻心肌I/R损伤,但其对MVO的影响尚不清楚。因此,本研究旨在评估秋水仙碱对MVO的作用及机制。
收集接受PCI的STEMI患者的临床资料,并分析与MVO相关的危险因素。建立大鼠心肌I/R模型,通过硫黄素S染色评估MVO。在再灌注时用PBS或秋水仙碱处理小鼠心肌I/R模型。通过TUNEL和裂解的caspase-3表达评估秋水仙碱对I/R后心肌细胞凋亡的影响。在H9c2细胞中检测ROS水平,以评估秋水仙碱对心肌氧化应激的作用。此外,使用流式细胞术、蛋白质免疫印迹法(WB)、酶联免疫吸附测定(ELISA)、免疫组织化学、生物信息学分析和免疫荧光检查秋水仙碱减轻MVO的机制。
多因素分析显示,中性粒细胞升高与广泛的MVO相关。秋水仙碱可减轻MVO,并减少心肌I/R后中性粒细胞募集和中性粒细胞胞外诱捕网(NETs)形成。此外,秋水仙碱在体内抑制心肌细胞凋亡,在体外降低ROS水平。此外,秋水仙碱通过抑制S100A8/A9炎症信号通路抑制骨髓(BM)中中性粒细胞增殖。
秋水仙碱通过中性粒细胞衍生的S100A8/A9炎症信号通路抑制BM中中性粒细胞增殖,减轻心肌I/R损伤后的MVO。