Yu Zongying, Wu Yanjun, Liu Dadong
Department of Electrocardiograph, Zhenjiang Fourth People's Hospital, Zhenjiang 212001, Jiangsu, China.
Department of Cardiology, Zhenjiang Fourth People's Hospital, Zhenjiang 212001, Jiangsu, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Jan;36(1):44-49. doi: 10.3760/cma.j.cn121430-20230703-00002.
To investigate the correlation between 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3) and the inflammatory activation of polymorphonuclear myeloid-derived suppressor cell (PMN-MDSC) in acute myocardial infarction (AMI), and to evaluate the effect of intervention targeting PFKFB3 on the inflammatory activation of PMN-MDSC during AMI.
(1) Clinical trial section: a observational study was conducted. The patients with acute coronary syndrome (ACS) admitted to Zhenjiang Fourth People's Hospital were enrolled, and they were divided into AMI group and non-AMI group according to clinical diagnosis. The peripheral venous blood of the two groups was collected to detect the proportion of PMN-MDSC, and the expression of PFKFB3 gene in mononuclear cells was detected by real-time quantitative polymerase chain reaction (RT-qPCR). (2) Basic experiment section: a total of 30 male C57 mice (aged 6-8 weeks) were divided into normal control group (n = 5), Sham group (n = 5), AMI model group (n = 10) and PFKFB3 inhibitor PKF-15 intervention group (n = 10) according to random number table method. The AMI model of mice was reproduced by left anterior descending coronary artery (LADCA) ligation, and the mice in the Sham group did not attach the artery after thoracotomy. The PKF-15 intervention group was intraperitoneally injected with PKF-15 (20 μg/g) at the same time of LADCA ligation. Normal control mice did not receive any treatment. Peripheral venous blood and myocardial tissue of mice were collected 24 hours after modeling. Both the circulating PMN-MDSC ratio and the infiltration of PMN-MDSC in myocardial tissue were detected. After staining with hematoxylin-eosin (HE), the degree of inflammatory damage in mouse myocardial tissue was observed under light microscopy. PMN-MDSC were isolated from mice with flow cytometry, and the gene expressions of PFKFB3 and inflammatory factors were measured by RT-qPCR.
(1) Clinical trial section: the circulating PMN-MDSC ratio of patients in the AMI group (n = 25) was significantly higher than that in the non-AMI group [n = 20; (8.53±0.96)% vs. (1.13±0.39)%, P < 0.01], and PFKFB3 gene expression in the peripheral blood mononuclear cells was also increased (2: 1.18±0.19 vs. 0.96±0.16, P < 0.01). Pearson correlation analysis showed that circulating PMN-MDSC ratio was positively correlated with PFKFB3 gene expression in mononuclear cells in AMI patients (r = 0.608, P = 0.001). (2) Basic experimental section: the circulating PMN-MDSC ratio and the infiltration of PMN-MDSC in myocardial tissue of AMI mice were significantly higher than those in the normal control group and Sham group. PFK-15 intervention could reduce the ratio of PMN-MDSC in the peripheral blood and myocardial tissue of AMI mice [(26.33±5.27)% vs. (75.12±5.02)% in peripheral blood, (20.87±2.97)% vs. (35.28±4.36)% in myocardial tissue, both P < 0.01]. Under light microscopy, the myocardial cells in the AMI modal group were disordered and a large number of inflammatory cells infiltrated. PFK-15 intervention could maintain a normal arrangement of cardiomyocytes and reduce the infiltration of inflammatory cells. The gene expression levels of PFKFB3 in the peripheral blood and myocardial tissue as well as the inflammatory factors in the myocardial tissue of AMI mice were significantly higher than those in the normal control group and Sham group. PKF-15 intervention could effectively reduce the gene expression levels of PFKFB3 in the peripheral blood and myocardial tissue as well as the inflammatory factors in the myocardial tissue of AMI mice [PFKFB3 mRNA (2): 1.01±0.09 vs. 1.40±0.12 in peripheral blood, 0.95±0.09 vs. 1.47±0.10 in myocardial tissue; myocardial tissue tumor necrosis factor-α (TNF-α) mRNA (2) was 14.55±3.99 vs. 29.66±3.90, interleukin-1β (IL-1β) mRNA (2) was 8.72±1.35 vs. 18.53±2.43, IL-6 mRNA (2) was 11.87±2.97 vs. 19.82±4.32, all P < 0.01].
The activation of PFKFB3 is closely related to the inflammatory activation of PMN-MDSC during AMI. Inhibition of PFKFB3 activity can inhibit the inflammatory activation of PMN-MDSC and reduce myocardial inflammatory injury.
探讨急性心肌梗死(AMI)中6-磷酸果糖-2-激酶/果糖-2,6-二磷酸酶3(PFKFB3)与多形核髓源性抑制细胞(PMN-MDSC)炎症激活之间的相关性,并评估靶向PFKFB3干预对AMI期间PMN-MDSC炎症激活的影响。
(1)临床试验部分:进行一项观察性研究。纳入镇江市第四人民医院收治的急性冠状动脉综合征(ACS)患者,根据临床诊断分为AMI组和非AMI组。采集两组患者外周静脉血,检测PMN-MDSC比例,采用实时定量聚合酶链反应(RT-qPCR)检测单核细胞中PFKFB3基因表达。(2)基础实验部分:将30只6-8周龄雄性C57小鼠按随机数字表法分为正常对照组(n = 5)、假手术组(n = 5)、AMI模型组(n = 10)和PFKFB3抑制剂PKF-15干预组(n = 10)。通过结扎左冠状动脉前降支(LADCA)建立小鼠AMI模型,假手术组小鼠开胸后不结扎动脉。PKF-15干预组在LADCA结扎同时腹腔注射PKF-15(20μg/g)。正常对照小鼠不接受任何处理。造模后24小时采集小鼠外周静脉血和心肌组织。检测循环中PMN-MDSC比例及心肌组织中PMN-MDSC浸润情况。苏木精-伊红(HE)染色后,光镜下观察小鼠心肌组织炎症损伤程度。采用流式细胞术从小鼠中分离PMN-MDSC,通过RT-qPCR检测PFKFB3及炎症因子基因表达。
(1)临床试验部分:AMI组(n = 25)患者循环中PMN-MDSC比例显著高于非AMI组[n = 20;(8.53±0.96)%对(1.13±0.39)%,P < 0.01],外周血单核细胞中PFKFB基因表达也升高(2:1.18±0.19对0.96±0.16,P < 0.01)。Pearson相关性分析显示,AMI患者循环中PMN-MDSC比例与单核细胞中PFKFB3基因表达呈正相关(r = 0.608,P = 0.001)。(2)基础实验部分:AMI小鼠循环中PMN-MDSC比例及心肌组织中PMN-MDSC浸润显著高于正常对照组和假手术组。PKF-15干预可降低AMI小鼠外周血和心肌组织中PMN-MDSC比例[外周血中(26.33±5.27)%对(75.12±5.02)%,心肌组织中(20.87±2.97)%对(35.28±4.36)%,均P < 0.