Nishida T, Morita S, Masuda M, Tominaga R, Kawachi Y, Yasui H
Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ann Thorac Surg. 1998 Nov;66(5):1647-52. doi: 10.1016/s0003-4975(98)00774-7.
Lazaroid, a series of 21-aminosteroids, has been shown to reduce free-radical-mediated injury after ischemia and reperfusion. Recent in vitro studies have demonstrated that, among the various compounds studied, the most efficient agent was U74500A. The question is whether these findings apply to the whole heart experiencing ischemia-reperfusion injury. In this study we compared the myocardial protective effects of U74006F, the only clinical candidate, and U74500A.
An isolated rabbit heart preparation perfused with the blood from a support rabbit was used. All hearts were divided into three groups according to the administration of U74500A (4 mg/kg, group A; n = 7), U74006F (4 mg/kg, group F; n = 7), or solvent (group S; n = 7) to the donor rabbit before preservation. After 24 hours of preservation with University of Wisconsin solution at 0 degrees C, all hearts were perfused with cross-circulated blood for 60 minutes with the Langendorff mode followed by 40 minutes in the working mode.
After 10 minutes of reperfusion the serum lipid peroxide levels were significantly (p < 0.05) lower in group A (0.62+/-0.31 nmol/mL) than those in group S (2.1+/-1.3 nmol/mL) and group F (1.0+/-0.6 nmol/mL). The aortic flow rate at 10 mm Hg of left atrial pressure was significantly higher in group A (164+/-37 mL/min) than that of other groups (71+/-28 mL/min in group S and 97+/-28 mL/min in group F). There were no significant differences in high-energy phosphate levels after reperfusion among the three groups.
These data imply that U74500A inhibits lipid peroxidation and prevents ischemia-reperfusion injury more efficiently than U74006F.
拉扎罗类化合物,即一系列21 -氨基类固醇,已被证明可减轻缺血再灌注后自由基介导的损伤。最近的体外研究表明,在所研究的各种化合物中,最有效的药物是U74500A。问题在于这些发现是否适用于经历缺血再灌注损伤的整个心脏。在本研究中,我们比较了唯一的临床候选药物U74006F和U74500A的心肌保护作用。
采用用供血兔的血液灌注的离体兔心制备方法。根据在保存前给供体兔施用U74500A(4mg/kg,A组;n = 7)、U74006F(4mg/kg,F组;n = 7)或溶剂(S组;n = 7),将所有心脏分为三组。在0℃用威斯康星大学溶液保存24小时后,所有心脏先用Langendorff模式进行60分钟的交叉循环血液灌注,然后在工作模式下灌注40分钟。
再灌注10分钟后,A组(0.62±0.31nmol/mL)的血清脂质过氧化物水平显著低于(p < 0.05)S组(2.1±1.3nmol/mL)和F组(1.0±0.6nmol/mL)。左心房压力为10mmHg时,A组的主动脉血流速度(164±37mL/min)显著高于其他组(S组为71±28mL/min,F组为97±28mL/min)。再灌注后三组之间的高能磷酸水平无显著差异。
这些数据表明,U74500A比U74006F更有效地抑制脂质过氧化并预防缺血再灌注损伤。