Ono K, Matsumori A, Shioi T, Furukawa Y, Sasayama S
Department of Cardiovascular Medicine, Kyoto University, Graduate School of Medicine, Japan.
Circulation. 1998 Jul 14;98(2):149-56. doi: 10.1161/01.cir.98.2.149.
A large transmural myocardial infarction may initiate structural and geometric changes in the left ventricle that are commonly referred to as remodeling. Progressive, adverse remodeling of the myocardium may lead to ventricular dilatation and congestive heart failure. Recent studies have highlighted the effects of some cytokines on immune-mediated myocyte injury, postischemic myocardial inflammation, and cardiac function. However, studies of the involvement of cytokines in remodeling of the heart are few.
In a rat model of myocardial infarction, progressive dilatation of the left ventricular cavity and lack of appropriate hypertrophy of the surviving myocardium were confirmed by transthoracic echocardiography. The relative expression of mRNA for tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6 in the infarcted and noninfarcted myocardium of these rats, as well as in a group of sham-operated animals, was assessed by the technique of quantitative polymerase chain reaction amplification. In the infarcted region, TNF-alpha, IL-1beta, and IL-6 gene expression peaked at 1 week after infarction and decreased rapidly thereafter. In contrast, at 20 weeks after infarction, the gene expression levels of these cytokines remained significantly higher in the noninfarcted than in the infarcted zone or in the myocardium of sham-operated animals. Furthermore, the levels of these cytokines in the noninfarcted region correlated with the left ventricular end-diastolic diameter measured at 8 and 20 weeks after infarction. Among these cytokines, IL-1beta expression was highest, and its level correlated well with collagen deposition in the noninfarcted myocardium at 8 and 20 weeks after surgery. At 20 weeks after infarction, immunohistochemical analysis revealed the presence of IL-1beta in macrophages, endothelial cells, and vascular smooth muscle cells in the noninfarcted region, whereas no such immunoreactivity was found in the myocardium of sham-operated animals.
These findings suggest the possible involvement of cytokines during the remodeling process of the noninfarcted left ventricular myocardium.
大面积透壁性心肌梗死可能引发左心室结构和几何形状的改变,这通常被称为重塑。心肌进行性的不良重塑可能导致心室扩张和充血性心力衰竭。最近的研究强调了一些细胞因子对免疫介导的心肌细胞损伤、缺血后心肌炎症和心脏功能的影响。然而,关于细胞因子参与心脏重塑的研究较少。
在大鼠心肌梗死模型中,经胸超声心动图证实左心室腔逐渐扩张,存活心肌无适当肥厚。通过定量聚合酶链反应扩增技术评估这些大鼠梗死和未梗死心肌以及一组假手术动物中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β和IL-6的mRNA相对表达。在梗死区域,TNF-α、IL-1β和IL-6基因表达在梗死后1周达到峰值,此后迅速下降。相比之下,梗死后20周,这些细胞因子的基因表达水平在未梗死区域仍显著高于梗死区域或假手术动物的心肌。此外,这些细胞因子在未梗死区域的水平与梗死后8周和20周测量的左心室舒张末期直径相关。在这些细胞因子中,IL-1β表达最高,其水平与术后8周和20周未梗死心肌中的胶原沉积密切相关。梗死后20周,免疫组织化学分析显示未梗死区域的巨噬细胞、内皮细胞和血管平滑肌细胞中有IL-1β存在,而假手术动物的心肌中未发现这种免疫反应性。
这些发现提示细胞因子可能参与了未梗死左心室心肌的重塑过程。