Remote preconditioning provides myocardial protection against myocardial ischemia/reperfusion injury through downregulating the expression of calreticulin in rats

AIM: To evaluate the role of calreticulin (CRT) in myocardial protection of remote preconditioning against myocardial ischemia/reperfusion injury. METHODS: Thirty SD rats were randomly divided into 5 groups: ischemia reperfusion group (IR), ischemia preconditioning group (IP), remote preconditioning group Ⅰ (RPI), remote preconditioning group Ⅱ (RPII) and pseudo-operation group (PO). The ischemia/reperfusion model was established in vivo. Hemodynamic changes of heart function were observed. Serum cardiac troponin T (cTnT), superoxide dismutase (SOD), malondialdehyde (MDA) and the expression of calreticulin in myocardium were detected. RESULTS: Hemodynamic data, serum cTnT, DA, SOD and the expression of CRT in RPI and IR group were not statistically different (P>0.05). SOD level in IP and RPII group was higher than that in IR group (P<0.05). Accordingly, cTnT, MDA and the expression of CRT in these two groups were lower than those in IR group (P<0.05). CONCLUSION: Remote preconditioning may mimic the protective effect of ischemic preconditioning. Remote preconditioning attenuates myocardial ischemia/reperfusion injury in vivo possibly through down-regulation of CRT expression in rats.     

Ischemic preconditioning relieves the ischemia/reperfusion injury of neurons in hippocampus by inhibiting the expression of p53

AIM: To examine whether ischemic preconditioning (IPC) can protect against apoptosis in CA1 subfield of hippocampus following reperfusion of a lethal ischemia in rats and explore the role of IPC by inhibiting the expression of p53 in this process. METHODS: Wistar rats were used in the experiment. A global ischemia/reperfusion model was induced by 4-vessel occlusion. The rats were divided into the following three groups randomly: (1) ischemic preconditioning group (IPC group); (2) ischemia/reperfusion group (IR group); (3) control group. The histopathological changes, the percentage of apoptosis and the expression of p53 gene in CA1 region of rat hippocampus were examined by HE staining, FCM, RT-PCR and immunohistochemistry techniques. RESULTS: The neuronal density of CA1 region in IPC group ［(217±9)/0.72 mm²］ was significantly higher than that in IR group ［(29±5)/0.72 mm², P<0.01］. The percentage of apoptotic neurons in IPC group (2.07%±0.21%) was lower than that in IR group (4.26%±0.08%), P<0.01. Compared with IR group, the expression of p53 gene in IPC group was significantly weakened. CONCLUSION: Ischemic preconditioning protects the ischemic neurons in CA1 region of rat hippocampus by inhibiting the expression of p53 gene.     

Effects of heptanol preconditioning on structure,function and Cx43 content of mitochondria in rabbit model of myocardial ischemia/reperfusion injury

AIM: To investigate the effects of heptanol preconditioning on the changes of structure, function and connexin 43 (Cx43) content in mitochondria in a rabbit model of myocardial isehemia-reperfusion (IR) injury. METHODS: In anesthetized open-chest rabbits, the left anterior descending artery (LAD) was occluded for 30 min and reperfused for 4 h. Sixty-four rabbits were randomly divided into 4 groups (n=16 in each group): sham operation group (sham group), ischemia-reperfusion group (IR group), ischemic preconditioning group (IP group) and heptanol preconditioning group (HT group). All rabbits in the 4 groups were killed 4 h after reperfusion. Myocardial infarct size was determined at the end of the experiment. Mitochondria was isolated by centrifugations. The ultrastructural changes of the mitochondria were observed under electronic microscope. The mitochondrial membrane potential, Ca2+ concentration, MDA content and SOD activity of myocardial mitochondria were also examined. The content of mitochondria Cx43 was detected by Western blotting. RESULTS: Compared to IR group, the myocardial infarct size was significantly reduced in IP (18.97%±2.80%) and HT (19.97%±3.80%) groups, the damage of mitoehondrial ultrastructure was milder (P<0.05), mitochondrial membrane potential was significantly higher and Ca2+ concentration was much lower (P<0.01) in IP group and HT group. No significant difference of MDA content and SOD activity in myocardial mitochondria between IR group and HT group was found. However, MDA content were much lower and SOD activity was significantly higher in IP group as compared to IR group (P<0.01). Compared to sham group, the mitochondria Cx43 expression was distinctly decreased compared to IR group (P<0.05) and no significant difference was found between IP group and HT group (P>0.05). CONCLUSION: Heptanol preconditioning protects myocardium from ischemia-reperfusion injury. The mechanism may be related to increasing in mitochondrial membrane potential, alleviating Ca2+ overload in myocardial mitochondria and attenuating the decrease in mitochondria Cx43 expression induced by isehemia-reperfusion.     

Effect of pretreatment with 11,12-EET on myocardial ischemia/reperfusion injury in rats

AIM: To examine the effect of pretreatment with low-concentration of 11, 12-epoxyeicosatrienoic acid(EET) on myocardial ischemia/reperfusion injury in rats. METHODS: After tracheotomy, myocardial ischemia/reperfusion was produced by occlusion and release of the left anterior descending artery(LAD) of the rats. Ischemic preconditioning(IP) was made by two times of ischemia(5 min)/reperfusion(5 min). The experiment was conducted in three groups: control,IP and pretreatment with 11,12-EET(6.24×10^-8 mol/L), and each group was subdivided into two subgroups:A,the rats were subjected to ischemia(10 min)/reperfusion(10 min) and arrhythmias during the whole periods were monitored; The rats in B were subjected to ischemia(60 min)/reperfusion(30 min) and arrhythmias, cardiac funtion and myocardial infarction size were documented. RESULTS: Both IP and pretreatment with 11,12-EET could protect the heart against arrhythmias, cardiac disfunction and myocardial infarction. CONCLUSION: Pretreatment with 11,12-EET had protective effect on myocardium in case of ischemia/reperfusion, which was similar to ischemic preconditioning.     

Effect of preconditioning with pioglitazone on ischemia reperfusion/hypoxia reoxygenation-induced mitochondrial structure and membrane potential in rats

AIM: To observe the effect of preconditioning with pioglitazone on ischemia reperfusion/hypoxia reoxygenation-induced mitochondrial ultramicro-structure and membrane potential in rats. METHODS: Sprague-Dawley rats were randomly divided into four groups: sham-operated (SO) group, ischemia reperfusion (IR) group, pioglitazone preconditioning group (Pio-P) and 5-HD+pioglitazone (5-HD+Pio) group. Apart from the SO group, IR, Pio-P and 5-HD+Pio groups were subjected to 30 min ischemia and 4 h reperfusion. The heart was quickly removed for observing the structure of mitochondria and measurement of the apoptosis index (AI) by TUNEL. Primary cultured cardiomyocytes of Sprague-Dawley rats were divided into control, hypoxic reoxygenation (HR) and different concentrations of Pio-P group. JC-1 staining flowcytometry was adopted to examine mitochondrial membrane potential (ΔΨm). RESULTS: The injury of mitochondrial structure in IR group was severer than that in Pio-P group, while the difference between 5-HD+Pio group and IR group was not evident. Flameng score in Pio-P group(1.62±0.60) was significantly lower than that in IR group (2.75±1.09), P<0.01. AI in Pio-P group (28.19%±4.93%) was lower than that in IR group (55.44%±6.63%),P<0.05. The rates of low ΔΨm cells in (5 μmol/L,10 μmol/L and 15 μmol/L) Pio-P group were (45.89±3.63)%, (17.13±1.37)% and (18.43±2.44)%, significantly lower than that in HR group (56.52%±2.87%),P<0.05, while the difference between 10 μmol/L group and 15 μmol/L group was not significant (P>0.05). CONCLUSION: Pioglitazone protects the heart from ischemia reperfusion/ hypoxia reoxygenation injury evidenced by improving mitochondrial ultrastructure and lessening the loss of mitochondrial membrane potential, and decreasing apoptosis. The cardioprotective effects can be inhibited by the blocker of mitochondrial ATP-sensitive potassium channels.     

Role of heme oxygenase-1 in the ischemic preconditioning of isolated rat heart

AIM: To investigate the influence of ischemic preconditioning on heart function, the activities of lactate dehydrogenase (LDH), malondialdehyde (MDA), and heme oxygenase-1 (HO-1) after ischemia/reperfusion in isolated rat heart. METHODS: The model of Langendorff was used in isolated rat heart perfusion. Ischemic preconditioning protocol: stopping perfusion for 5 minutes and reperfusion for 5 minutes, repeating three times. Ischemia protocol: stopping perfusion for 40 minutes and reperfusion for 20 minutes. Indexes of heart function were recorded in control M8, ischemia and reperfusion group (IR), and ischemic preconditioning group (IPC). The content of LDH of coronary effluent was measured. Moreover, the content of MDA and activity of HO-1 in myocardium were also measured. RESULTS: The recovery percentage of heart function in IPC group was significantly higher than that in IR group (P<0.01) and the activity of heme oxygenase-1 also increased significantly (P<0.05). CONCLUSION: The contents of LDH and MDA significantly decreased in IPC group compared with IR group. The increase in heme oxygenase-1 activity might be involved in the protective effect of ischemic preconditioning on ischemic/reperfused rat heart.     

Significance and changes of serum interleukin-8 and 10 in human myocardium ischemic preconditioning

AIM: To explore the mechanism of myocardium protection after ischemia/reperfusion (I/R) injury by preconditioning with ischemia in human. METHODS: Thirty-six patients underwent valve replacement were divided into ischemic preconditioning group (IP group, 20 cases) and non-ischemic preconditioning group (control group, 16 cases) according to whether they were given single cycle reperfusion before cardioplegia or not. Serum levels of interleukin-8 and 10 were measured with ELISA. Expressions of myocardial Bcl-2 and caspase-3 were analyzed. RESULTS: The inflammatory factors IL-8 and IL-10 increased to the highest level in serum at 6 h after declamping and recovered to normal level on 5 d after declamping. On 6 h, 1 d and 2 d after declamping, serum level of IL-8 was significantly lower in IP group than that in control group (P<0.05), but serum level of IL-10 was higher in IP group (P<0.05). Expression of myocardial Bcl-2 and caspase-3 increased in both groups after reperfusion, and Bcl-2 was lower in the control group than that in IP group while the level of caspase-3 was higher (P<0.05). Expression of myocardial Bcl-2 had positive correlation with IL-10 and negative correlation with IL-8. CONCLUSION: Ischemic preconditioning has the effect of protection of human myocardial cells after ischemia/reperfusion injury through decreasing systemic inflammatory response following ischemia reperfusion injury.     

Effect of apelin on isoproterenol-induced myocardium injury in rats

AIM: To explore the change and significance of vasoactive peptide apelin and its receptor APJ during myocardial ischemia, and the therapeutic effects of apelin on myocardial ischemia injury. METHODS: The myocardial ischemia injury was induced by subcutaneous injection of high dose isoproterenol (ISO). Radioimmunoassay was used to measure the apelin contents. Semi-Quantitative RT-PCR was used to measure the mRNA levels of apelin and APJ in myocardium. Apelin (10 nmol/kg) was administered through femoral vein to observe the effect of apelin on ischemic heart induced by ISO. The hemodynamic parameters were recorded by Powerlab. RESULTS: In ISO-treated rat, histological sections showed severe myocardial ischemic injury. The apelin contents in plasma, atrial and ventricular myocardium were markedly decreased (all P<0.01), respectively. The mRNA levels of apelin and APJ in myocardium were also markedly reduced. However, therapy with apelin significantly ameliorated myocardial injury and heart failure induced by ISO. Compared with ISO alone, in the low dose apelin (200 ng·kg-1·d-1) group, the LV±dp/dtmax values were 39% and 66% higher, and the LVEDP was 29% lower (P<0.01). In the high dose (apelin 10 nmol/kg) group these parameters were superior to low dose group. Interestingly, it was found that when bolus injection of apelin (10 nmol/kg), its inotropic effect was more potent in ISO-treated rat than that in control. CONCLUSION: The data show that the myocardial injury induced by ISO leads to a hypoexpression of apelin and of its receptor APJ. Administration of exogenous apelin ameliorates heart failure and myocardial ischemia injury induced by ISO. These results suggest that apelin has a cardioprotective effect and apelin/APJ system may be a new therapeutic target for myocardial ischemia and heart failure.     

Effects of non-wounded ischemic preconditioning on ischemia-reperfusion injury in isolated rat hearts

AIM:To observe the protective effect of non-wounded ischemic preconditioning on ischemic/reperfusion injury in isolated rat hearts. METHODS: 25 male SD rats, weighting (250±30) g, were randomly divided into three groups: control group (C,n=8), anoxia/reoxygenation group (A,n=8) and non-wounded legs ischemic preconditioning group (N-WIP,n=9).Hearts were isolated from rats and perfused on a Langendorff apparatus with a normal Krebs-Henseleit buffer (saturation 95% O₂+5% CO₂) at a constant pressure (8.33 kPa) and temperature (37 ℃) in C group; Following 15 min equilibration, hearts were subjected to 15 min of global ischemia and 15 min reperfusion (37℃) in A group; Rats were subjected to non-wounded leg repeated-brief ischemic preconditioning, and then treated in procedure similar to A group in N-WIP group.The activities of superoxide dismutase (SOD) and Ca²⁺-Mg²⁺-ATPase, malondialdehyde (MDA) content of efflux from coronary vessel and myocardium, myocardium monophasic action potential and contractile force were measured before ischemia, 15 minutes after ischemia and 5, 15 minutes after reperfusion. RESULTS:Compared with A group, non-wounded legs ischemic preconditioning reduced the incidence of reperfusion arrhythmias (P＜0.05), decreased the content of MDA of myocardium (P＜0.01), enhanced the activities of SOD (P＜0.01) and stabilized myocardial membranous potential,the activity of Ca²⁺-Mg²⁺-ATPase and contractile function. CONCLUSION:These results indicate that non-wounded leg ischemic preconditioning has a protective effect on ischemia-reperfusion injury in isolated rat hearts. The mechanism may be related to the strength of antioxidation, the stability of Ca²⁺-Mg²⁺-ATPase activity and membranous structure in myocardium.     

Protective role of ornithine decarboxylase (ODC)/polyamines system in the myocardium induced by ischemic preconditioning in rats

AIM: To explore the protective role of ornithine decarboxylase (ODC)/polyamines system in the myocardium induced by ischemic preconditioning in rats.METHODS: The experiment model of simulating myocardial ischemia-reperfusion was replicated by Langendorff perfused rat heart. The hearts were randomly divided into six groups: control group, ischemic-reperfusion group (IR), weak ischemic preconditioning group (IPCw), strong ischemic preconditioning groups (IPCs) and inhibitor groups (DF-EG-IPCw and DF-EG-IPCs). The expression of ODC was quantified by Western blotting analysis. The contents of polyamines (putrescine, spermidine, spermine) in cardiac tissue were detected with high performance liquid chromatography. The hemodynamics was obtained using the PowerLab 8/SP TM data acquisition system. The infarct size was measured using triphenyltetrazolium chloride (TTC) staining and the apoptosis cardiomyocytes were observed under optic microscope after TUNEL method treatment. RESULTS: In contrast with control group, in IR group the putrescine contents increased, the expression of ODC was down-regulated, the contents of spermine and the total polyamine pool decreased (P<0.05). At the same time, the cardiac function declined, with an increase in myocardium infarct size and the apoptosis rate of cardiomyocytes (P<0.05). When compared with IR group in terms of LVDP, HR and CF, both IPCw and IPCs groups had significant improvements in cardiac functions (P<0.05). These two groups also had smaller myocardium infarct size (P<0.01) and apoptosis rate of cardiomyocytes (P<0.01). When compared with IR group, the expression of ODC, the contents of spermine and the total polyamine pool increased in both IPCw (P<0.05) and IPCs groups (P<0.01), but the putrescine contents declined. In the respective inhibitor groups of the weak and ischemic preconditioning, the expression of ODC and the levels of putrescine, spermidine, spermine and the total polyamine pool decreased remarkably (DF-EG-IPCw vs IPCw, P<0.05; DF-EG-IPCs vs IPCs, P<0.01), while the myocardium infarct size and apoptosis rate of cardiomyocyte were relatively bigger in both inhibitor groups (P<0.05). Also, the heart function decreased significantly in terms of LVDP, HR and CF compared to their matched ischemic preconditioning group (P<0.05).CONCLUSION: Ischemic preconditioning significantly up-regulates the ODC / polyamines system in Langendorff perfused rat hearts and provides protective effects on myocardium with ischemia/reperfusion injury. Inhibition of bio-synthesis of polyamine abolishes the cardiac function improvement and the decreases the infarct size and apoptosis rate induced by ischemic preconditioning. It reveals that the ornithine decarboxylase (ODC) /polyamines system may be involved in the protection of myocardium induced by IPC in rats.     

Role of nitric oxide in ischemia/reperfusion injury and ischemic preconditioning

AIM: To clarify the role of nitric oxide(NO) in ischemic preconditioning(IP) and its effects on apoptosis. METHODS: Seventy-two male Wistar rats were divided into the following six groups:ischemia/reperfusion (IR) group,IP group,IR+L-arg group,IP+L-arg group,IR+L-NAME group and IP+L-NAME group,The following changes were measured:cardiac hemodynamic parameters,infarct size,PMNs counting myocardial MPO activity and TUNEL staining.RESULTS: ①L-arg significantly attenuated ischemia/reperfusion-induced heart injury,reduced PMNs infiltration and cardiomyocyte apoptosis.②L-NAME also significantly reduced infarct size,PMNs infiltration and cardiomyocyte apoptosis compared with IR group,however,L-NAME aggravated ischemia/reperfusions-induced cardiac functional injury.③L-arg or L-NAME did not significantly alter the protective effect of ischemic preconditioning. CONCLUSION: Increased production of endogenous NO before prolonged ischemic period can protect hearts and inhibit apoptosis.L-NAME can inhibit iNOS activity and ONOO^- production in reperfusion period to protect heart.     

Effects of atorvastatin on nitric oxide,endothelin-1 and myocardial function in a rabbit model of acute myocardial infarction and reperfusion

AIM: To evaluate the effects of atorvastatin on nitric oxide(NO), endothelin-1(ET-1)and myocardial no-reflow in a rabbit model of acute myocardial infarction and reperfusion(AMI/R). METHODS: Twenty-four rabbits were randomized into 3 groups: 8 in AMI/R group, 8 in atorvastatin-treated group(5 mg·kg-1·d-1)and 8 in sham-operated group. Animals in the former two groups were subjected to 60 min of coronary occlusion followed by 120 min of reperfusion. Data on haemodynamics were collected. NO in blood sample, and in normal, and in infarcted reflow and no-reflow myocardium were evaluated respectively by nitrate reductase method. The levels of ET-1 in blood sample, and in normal, infarcted reflow and no-reflow myocardium were determined by radioimmunoassay. RESULTS: (1)Compared to the baselines, the heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), left ventricular systolic pressure(LVSP), maximal rate of increase and decline in left ventricular pressure(±dp/dtmax)and cardiac output(CO)in AMI/R and atorvastatin-treated groups were significantly declined, whereas left ventricular end-diastolic pressure(LVEDP)was increased after 60 min of coronary occlusion and 120 min of reperfusion(P<0.05 or P<0.01). However, in atorvastatin-treated group, LVSP, LVEDP, ±dp/dtmax and CO at the time point of 120 min of reperfusion recovered more significantly than those at the time point of 60 min of coronary occlusion(P<0.01), which was more significant than those in AMI/R group(P<0.05 or P<0.01). Compared to AMI/R group, the SBP and DBP were significantly heigher in atorvastatin-treated group(P<0.01).(2)In atorvastatin-treated group, the levels of ET-1 in blood sample were significantly lower than those in AMI/R group(P<0.01), and the levels of NO were significantly higher(P<0.01). Moreover, the levels of NO or ET-1 in infarcted reflow myocardium were significantly lower than that in AMI/R group(P<0.05 or P<0.01).(3)Atorvastatin could ameliorate myocardial function. CONCLUSION: Atorvastatin is effective in increasing NO and reducing ET-1 in blood plasma and local myocardium, and in protection of endothelial cells. Atorvastatin also has a beneficial effect on improving left ventricular function during acute myocardial infarction and reperfusion in rabbits.     

Effects of 11, 12-EET and ischemic preconditioning on phosphorylated ERK and p38 MAPK during ischemia and reperfusion in rat myocardium

AIM: In order to study the relationship between the ERK and p38 MAPK activation and the protection of 11, 12-epoxyeicosatrienoic acid (11, 12-EET) and ischemia preconditioning (IP), the effects of 11, 12-EET and ischemic preconditioning on phosphorylated ERK and p38 MAPK during ischemia and reperfusion in rat myocardium were examined. METHODS: The rat heart was subjected to ischemia for 5 min by ligating the left anterior descending coronary artery followed by reperfusion for 5 min (two times) to undergo ischemia preconditioning. The rats were divided into 5 groups: (1) control; (2) sham group; (3) ischemia/reperfusion (I/R) group, in which the rat heart suffered from 60 min ischemia followed by 30 min reperfusion; (4) IP plus I/R group; (5) EET plus I/R group, in which 6.28×10^-8 mol/L 11, 12-EET was injected intravenously 20 min before I/R. The heart function was examined, and phosphorylated ERK and p38 MAPK were detected by Western blot. RESULTS: At 30 min reperfusion, +dp/dt_max, -dp/dt_max and LVDP decreased significantly in I/R group compared with sham group, IP plus I/R group and EET plus I/R group; Phosphorylated ERK1/2 level was higher in I/R group than sham group, but was lower in I/R group than IP plus I/R group and EET plus I/R group; Phosphorylated p38 MAPK level was lower in control, sham, IP plus I/R and EET plus I/R group than I/R group. CONCLUSION: 11,12-EET protects rat heart against ischemia/reperfusion injury, the mechanism may be related to activation of ERK1/2 and inhibition of p38 MAPK.     

Protective effect of rapid ischemic preconditioning against spinal cord ischemic injury in rabbits

AIM: To evaluate the protective effect of rapid phase of ischemic preconditioning against spinal cord ischemic injury in rabbits. METHODS: Thirty six male New Zealands white rabbits were randomly assigned to 3 groups (12 in each group): ischemia and reperfusion injury group (IR group), ischemic preconditioning + IR group (IPC+IR group) and sham operation group (sham). In IR group, spinal cord ischemia was induced by an infrarenal aorta clamping for 20 min; The rabbits in IPC+IR group underwent a 6 min ischemic preconditioning followed by 30 min of reperfusion before the 20 min clamping; The rabbits in sham group underwent the same procedures as the IR group except for infrarental aortic unclamping. Neurologic status was scored at 8, 12, 24 and 48 h after reperfusion. All animals were sacrificed at 48 h after reperfusion and the spinal cords (L_5-7) were removed for histopathologic study and determination of the activity of Na⁺, K⁺-ATPase. RESULTS: The neurologic function scores in sham group and IPC+IR group at each observation interval were higher than those in IR group (P＜0.01). Compared to IR group, there were more normal neurons in anterior horn of spinal cord in sham group and IPC+IR group (P＜0.01); the activity of Na⁺, K⁺-ATPase in sham group and IPC+IR group were higher than those in IR group (P＜0.01). CONCLUSION: The rapid phase of ischemic preconditioning has a protective effect against spinal cord ischemic injury in rabbits, and this neuroprotection may be related to the maintenance of Na⁺, K⁺-ATPase activity.     

Dexamethasone pretreatment attenuates reperfusion arrhythmia in rats

AIM: To investigate the effect of dexamethasone (DEX) preconditioning on reperfusion arrhythmia. METHODS: 46 Sprague-Dawley rats were divided randomly into DEX and control (CON) group, the rats were pretreated with DEX or sodium chloride before their hearts were separated for Langendorff perfusion and for ischemia/reperfusion. The reperfusion arrhythmias were observed dynamically after 60 min reperfusion following 30 min ischemia. The expression of HSP72 in myocardium was examined by Western blotting and immunohistochemistry at reperfusion 60 min. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and the activities of Na+-K+-ATP ase, Ca2+-Mg2+-ATPase on myocardial plasma membrane were detected. RESULTS: Compared with control group, the accumulated points and persistence time of ventricular arrhythmia were reduced significantly in DEX group (P<0.05), the expression of HSP72 was significant upregulated (P<0.05), the level of MDA was reduced significantly, the activities of SOD, CAT, GSH-Px and Na+-K+-ATPase were significantly higher (P<0.05). CONCLUSION: Dexamethasone pretreatment markedly reduces the reperfusion ventricular arrhythmias in rats, which may be attributed to upregulation of HSP72, SOD, CAT, GSH-Px , Na+-K+-ATPase and inhibition of lipid peroxidation.     

Effect of ischemic preconditioning on myoelectricity and the structure of myocardial gap junction during heart valve replacement surgery

AIM: To investigate the cardio-protective mechanism of ischemic preconditioning (IP) during heart valve replacement of the perspective of architectural changes of myocardial gap junction. METHODS: Fifty-four patients were prospectively randomized to receive or not ischemic preconditioning before cold cardioplegic arrest. The IP protocol in IP patients (n=22) consisted of a single 2-minute ischemia followed by 3-minute reperfusion just before aortic clamping and cold crystalloid cardioplegia for myocardial protection. The control group (n=32) received no ischemic preconditioning prior to cold cardioplegic arrest. The parameters including arrhythmias occurrence, Cx43 expression (immunohistochemistry SABC method) and myocardial structure and intercalated discs observed under electronic microscope were recorded before and after surgery in each group. RESULTS: In IP group, one case (4.55%) of ventricular arrhythmia (sporadic ventricular premature beat), 11 cases (50.00%) of supraventricular arrhythmia (atrial fibrillation, atrial flutter, supraventricular tachycardia, atrioventricular block) and 10 cases (45.50%) of ischemic ST-T changes were observed. In control group, there were 14 cases (43.75%) of ventricular arrhythmia (ventricular premature beat, tachycardia), 18 cases (56.25%) of supraventricular tachycardia and 28 cases (87.50%) of ischemic ST-T changes. No statistical difference in preoperative positive unit of Cx43 expression between the two groups was found (P>0.05). Postoperatively, the positive unit of Cx43 expression in IP group was 16.15±4.40, but the difference was not significant compared to the preoperative value (P>0.05). In control group, Cx43 expression was 11.92±1.26, significantly lower than that of the preoperative value (P<0.05). Cx43 expression between the two postoperative groups showed a significant difference (P<0.05). In control group, electronic microscopic observation revealed disrupted intercalated discs, with some partially or even totally ruptured and disintegrated. Enormous necrotic structural changes of myocardial fibers were also observed, including swelling, dissolution and disorganization of myofilaments and fibers, widening of the Z striae and disorganization. However in IP group, the intercalated discs appeared intact, continuous with normal myocardial structure. CONCLUSION: IP maintains normal expression of the myocardial junctional gap protein Cx43, which preserves a seamless intercellular gap junction and a normal myocardial electric conduction activity.     

Effects of Radix Angelicae Sinensis on changes of IL-6, TNF-α and bFGF in renal ischemia/reperfusion injury in rabbits

AIM: To determine the effect of Radix Angelicae Sinensis(RAS) on renal ischemia/reperfusion injury in rabbits and to explore its mechanism. METHODS: Twenty-five rabbits were divided randomly into the sham operated group(Control group), renal ischemia/reperfusion injury group(IR group) and RAS+IR group. At the time point of reperfusion 48 h after renal ischemia 1 h, the renal tissue were observed by electron-microscope and the contents of creatinine(Cr) in serum, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)and basic fibroblast growth factor(bFGF) in the renal tissue were measured. RESULTS: A remarkably degenerative changes in renal tissue were showed under electronmicroscope in IR group, but the changes in RAS+IR group were slight. The contents of Cr, TNF-α and IL-6 in IR group were higher than those in Control group, these parameters in RAS+IR group were lower than those in IR group, the difference between these groups was significant(P< 0.05 or P< 0.01). At the same time, the content of bFGF in IR group was lower than that in Control group(P< 0.01), while the content of bFGF in RAS+IR group was higher than that in IR group(P< 0.01) and Control group(P< 0.05). CONCLUSION: RAS has an effect of alleviating the renal ischemia/reperfusion injury by modulating the production or release of TNF-α, IL-6 and bFGF.     

Effects of adiponectin on expression of connexin 43 in rat myocardium during ischemia-reperfusion

AIM: To observe the effects of adiponectin(APN) on the expression of connexin 43 (Cx43) in rat myocardium during ischemia-induced arrhythmias. METHODS: The SD rats were randomly divided into 4 groups (n=12): sham operation group (SM group), ischemia and reperfusion group (I/R group), I/R+adiponectin(APN1) group: pre-ischemia with 3.5 μg/kg of APN; I/R+APN2 group: post-ischemia with 3.5 μg/kg of APN. The incidence of ventricular arrhythmias and ventricular arrhythmia score (VAS) were determined. The expression of Cx43 in the ischemic myocardium was studied by the techniques of immunohistochemistry and RT-PCR. The levels of malondialdehyde(MDA) and superoxide dismutase(SOD) were measured by the methods of xanthine oxidase and thiobarbituric acid. The expression of endothelial nitric oxide synthase (eNOS) at mRNA and protein levels was determined by RT-PCR and Western blotting,respectively.The morphological changes of the myocardial tissues were observed under electronic microscope. RESULTS: The VAS and concentration of MDA increased obviously and the activity of SOD was decreased in I/R group as compared with SM group (P<0.01). The expression of Cx43 was evidently decreased and the distribution of Cx43 in the myocardium was disturbed. The expression of eNOS at mRNA and protein levels was decreased in I/R group (P<0.05). The ultrastructure of ventricular myocardium was abnormal in I/R group. Compared with I/R group, APN obviously decreased the VAS caused by ischemia and reperfusion (P<0.01) no matter the drug was given before or after ischemia. APN increased the activity of SOD, inhibited the MDA content in serum, and resulted in normal distribution of Cx43 and increased the expression of Cx43 and eNOS. Compared with I/R group, the changes of heart ultrastructure attenuated greatly in APN group, but didn't recover to normal state. CONCLUSION: Adiponectin antagonizes the arrhythmias during myocardial ischemia and reperfusion via inhibiting oxidative stress and regulating Cx43.     

Cardiac protective effect of granulocyte colony-stimulating factor combined with ischemic postconditioning on acute myocardial infarction in rabbits

AIM: To investigate the protective effect of granulocyte colony-stimulating factor (G-CSF) combined with ischemic postconditioning (IP) on acute myocardial infarction (AMI). METHODS: Male New Zealand rabbits were randomly divided into 4 groups (n=15) after 30 min of left ventricular artery (LVA) occlusion: the rabbits in ischemia-reperfusion (IR) group were directly given reperfusion|the rabbits in G-CSF group were subsequently treated with G-CSF (10 μg·kg^-1·d^-1) by subcutaneous injection after direct reperfusion|the rabbits in IP group received 4 episodes of 30 s reperfusion and 30 s occlusion before total reperfusion|the rabbits in IP combined with G-CSF (IP+G-CSF) group were treated with both IP and G-CSF. Electrocardiogram (ECG) monitoring was performed during the operation. Blood was drawn to evaluate white blood cell count (WBC) and cardiac troponin I (cTnI) before operation and 7 d later. Ultrasound cardiography was performed to evaluate left ventricular remodeling and functions 4 weeks after operation. The sizes of infarcted myocardium were determined by triphenyltetrazolium chloride (TTC) staining. Apoptosis of cardiomyocytes was measured by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end labeling (TUNEL) staining. RESULTS: ST-segment resolutions were significantly decreased in IP group and IP+G-CSF group compared with direct reperfusion groups (P<0.05). WBC significantly increased in the groups treated with G-CSF for 1 week. The values of cTnI after operation were significantly lowered in G-CSF group, IP group and IP+G-CSF group as compared with IR group (P<0.05). Left ventricular ejection fraction, the size of infarcted myocardium and apoptosis of cardiomyocytes were better in IP group, G-CSF group and IP+G-CSF group than those in IR group. CONCLUSION: G-CSF combined with IP is a promising strategy against cardiac reperfusion injury and accelerates cardiac repair in AMI.     

Effects of ganoderma spores on apelin expression in rats with myocardial ischemia injury induced by isoproterenol

AIM: To investigate the changes of apelin in blood and myocardium, and the protective mechanisms of ganoderma spores on myocardial ischemia injury induced by isoproterenol in rats. METHODS: The model of myocardial ischemia injury was induced by subcutaneous injection of high dose isoproterenol. Enzyme linked immunosorbent assay (ELISA) was used to measure the apelin contents in blood and myocardium. Semi-quantitative RT-PCR was used to measure the apelin mRNA level in myocardium. Electron microscope was used to observe the pathomorphological changes of myocardium. Ganoderma spores was administered i.g. for 7 weeks. RESULTS: Compared with the normal control group, the apelin contents in blood and myocardium and the apelin mRNA level in myocardium were significantly decreased in the model group (P＜0.01). Compared with the model group, the apelin contents in blood and myocardium and the apelin mRNA level in myocardium were obviously elevated in the ganoderma spores groups (P＜0.01 or P＜0.05). Meanwhile, the NO contents in blood and myocardium were also obviously elevated. The pathological damage of myocardium was obviously relieved. CONCLUSION: The results suggest that the protective mechanisms of ganoderma spores on myocardial ischemia injury may be related to the elevation of apelin contents and the mRNA level.