基于PERK/ATF4信号通路探讨保元汤对慢性心力衰竭模型大鼠的影响

Effect of Baoyuan Decoction on Chronic Heart Failure Model Rats Based on PERK/ATF4 Signaling Pathway

【目的】观察保元汤对慢性心力衰竭模型大鼠的治疗作用及机制。【方法】将SD大鼠随机分为空白组、模型组、保元汤组、卡托普利组、保元汤+CCT020312[蛋白激酶R样内质网激酶(PERK)激活剂]组,每组15只。除空白组,其他各组大鼠采用阿霉素诱导构建慢性心力衰竭模型。给予相应的药物干预后,检测各组大鼠心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)及脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)],炎症相关因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)],氧化应激因子[丙二醛(MDA)、超氧化物歧化酶(SOD)],细胞凋亡相关指标[B细胞淋巴瘤2(Bcl-2)、B细胞淋巴瘤2相关X蛋白(Bax)、半胱天冬酶3(Caspase-3)]及PERK/转录激活因子4(ATF4)信号通路相关蛋白葡萄糖调节蛋白78(GRP78)、PERK、ATF4、C/EBP同源蛋白(CHOP)水平变化。【结果】与空白组比较,模型组大鼠LVEDD,BNP、cTnI,TNF-α、IL-1β,MDA水平,Bax、Caspase-3,GRP78、PERK、ATF4、CHOP蛋白表达水平显著升高,LVEF、LVFS,SOD及Bcl-2蛋白表达水平显著降低(均P<0.05)。与模型组和保元汤+CCT020312组比较,保元汤组、卡托普利组大鼠LVEDD,BNP、cTnI,TNF-α、IL-1β,MDA水平,Bax、Caspase-3,GRP78、PERK、ATF4、CHOP蛋白表达水平显著降低,LVEF、LVFS,SOD及Bcl-2蛋白表达水平显著升高(均P<0.05)。与卡托普利组比较,保元汤组大鼠上述指标(除CHOP蛋白表达水平外)均无显著变化(P>0.05)。【结论】保元汤可以延缓慢性心力衰竭大鼠进展,其机制可能与抑制PERK/ATF4信号传导通路缓解心肌细胞凋亡,进而减轻炎症反应和氧化应激程度,从而促进心功能及心肌损伤的修复有关。

Objective To observe the therapeutic effect and mechanism of Baoyuan Decoction for chronic heart failure model rat.Methods SD rats were randomly divided into blank group,model group,Baoyuan Decoction group,Captopril group,Baoyuan Decoction+CCT020312 [protein kinase R-like endoplasmic reticulum kinase(PERK) activator] group,15 rats in each group.Except for the blank group,the rats in the other groups were induced by Adriamycin to construct a chronic heart failure model.After corresponding drug intervention,cardiac function indexes [left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),brain natriuretic peptide(BNP),cardiac troponin I(cTnI)],inflammation-related factors [tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)],oxidative stress factors [malondialdehyde(MDA),superoxide dismutase(SOD)] were detected in each group.Changes in apoptosisrelated indicators [B-cell lymphoma 2(Bcl-2),B-cell lymphoma 2-associated X protein(Bax),Caspase-3] and PERK/transcription activator 4(ATF4) signaling pathway-related proteins glucose-regulated protein 78(GRP78),PERK,ATF4,C/EBP homologous protein(CHOP) levels.Results Compared with the blank group,LVEDD,BNP,cTnI,TNF-α,IL-1β,MDA levels,protein expression levels of Bax,Caspase-3,GRP78,PERK,ATF4,CHOP in the model group were significantly increased,LVEF,LVFS,SOD levels and Bcl-2 protein expression level were significantly decreased(all P<0.05).Compared with the model group and Baoyuan Decoction+CCT020312 group,LVEDD,BNP,cTnI,TNF-α,IL-1β,MDA levels,protein expression levels of Bax,Caspase-3,GRP78,PERK,ATF4,CHOP in Baoyuan Decoction group and Captopril group were significantly decreased,LVEF,LVFS,SOD levels and Bcl-2 protein expression level were significantly increased(all P<0.05).Compared with the Captopril group,there was no significant change in the above indexes(except CHOP protein expression level) in the Baoyuan Decoction group(P>0.05).Conclusion Baoyuan Decoction can delay the progression of chronic heart failure rats,and its mechanism may be related to inhibiting the PERK/ATF4 signaling pathway to alleviate cardiomyocyte apoptosis,further reducing the degree of inflammatory response and oxidative stress,thereby promoting the repair of cardiac function and myocardial injury.