Influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury

Objective: To explore the influence of ginkgolide combined with edaravone on the brain function of elderly patients with acute cerebral infarction and its preventive effect on ischemia reperfusion injury. Methods: A total of 126 patients with acute cerebral infarction who were treated in Dazhou Central Hospital between February 2016 and May 2017 were divided into the control group (n=67) and ginkgolide group (n=59) according to different therapies. Control group received routine intravenous thrombolysis + edaravone therapy, and ginkgolide group received routine intravenous thrombolysis + edaravone + ginkgolide therapy. The differences in brain function and nerve ischemia reperfusion injury extent were compared between the two groups. Results: At T1 and T2, serum nerve function indexes NT-proBNP and NSE levels of ginkgolide group were lower than those of control group whereas BDNF levels were higher than those of control group;serum inflammatory mediators MCP-1, NF-κB, CRP and TNF-α levels were lower than those of control group;serum apoptosis molecules caspase-3 and Bax levels were lower than those of control group whereas Bcl-2 levels were higher than those of control group. Conclusion: Ginkgolide combined with edaravone therapy on the basis of intravenous thrombolysis can effectively optimize the brain function and alleviate the ischemia reperfusion injury caused by inflammatory response and apoptosisis in elderly patients with acute cerebral infarction.

The expression of oxidative stress genes related to myocardial ischemia reperfusion injury in patients with ST-elevation myocardial infarction

BACKGROUND:We aimed to investigate the gene expression of myocardial ischemia/reperfusion injury(MIRI)in patients with acute ST-elevation myocardial infarction(STEMI)using stress and toxicity pathway gene chip technology and try to determine the underlying mechanism.METHODS:The mononuclear cells were separated by ficoll centrifugation,and plasma total antioxidant capacity(T-AOC)was determined by the ferric reducing ability of plasma(FRAP)assay.The expression of toxic oxidative stress genes was determined and verified by oligo gene chip and quantitative real-time polymerase chain reaction(qRT-PCR).Additionally,gene ontology(GO)enrichment analysis was performed on DAVID website to analyze the potential mechanism further.RESULTS:The total numbers of white blood cells(WBC)and neutrophils(N)in the peripheral blood of STEMI patients(the AMI group)were significantly higher than those in the control group(WBC:11.67±4.85×10^(9)/L vs.6.41±0.72×10^(9)/L,P<0.05;N:9.27±4.75×10^(9)/L vs.3.89±0.81×10^(9)/L,P<0.05),and WBCs were significantly associated with creatine kinase-myocardial band(CK-MB)on the first day(Y=8.945+0.018X,P<0.05).In addition,the T-AOC was significantly lower in the AMI group comparing to the control group(12.80±1.79 U/mL vs.20.48±2.55 U/mL,P<0.05).According to the gene analysis,eight up-regulated differentially expressed genes(DEGs)included GADD45A,PRDX2,HSPD1,DNAJB1,DNAJB2,RAD50,TNFSF6,and TRADD.Four down-regulated DEGs contained CCNG1,CAT,CYP1A1,and ATM.TNFSF6 and CYP1A1 were detected by polymerase chain reaction(PCR)to verify the expression at different time points,and the results showed that TNFSF6 was up-regulated and CYP1A1 was down-regulated as the total expression.GO and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis suggested that the oxidative stress genes mediate MIRI via various ways such as unfolded protein response(UPR)and apoptosis.CONCLUSIONS:WBCs,especially neutrophils,were the critical cells that mediating reperfusion injury.MIRI was regulated by various genes,including oxidative metabolic stress,heat shock,DNA damage and repair,and apoptosis-related genes.The underlying pathway may be associated with UPR and apoptosis,which may be the novel therapeutic target.

microRNA-455-5p alleviates neuroinflammation in cerebral ischemia/reperfusion injury

Neuroinflammation is a major pathophysiological factor that results in the development of brain injury after cerebral ischemia/reperfusion.Downregulation of microRNA(miR)-455-5p after ischemic stroke has been considered a potential biomarker and therapeutic target for neuronal injury after ischemia.However,the role of miR-455-5p in the post-ischemia/reperfusion inflammatory response and the underlying mechanism have not been evaluated.In this study,mouse models of cerebral ischemia/reperfusion injury were established by transient occlusion of the middle cerebral artery for 1 hour followed by reperfusion.Agomir-455-5p,antagomir-455-5p,and their negative controls were injected intracerebroventricularly 2 hours before or 0 and 1 hour after middle cerebral artery occlusion(MCAO).The results showed that cerebral ischemia/reperfusion decreased miR-455-5p expression in the brain tissue and the peripheral blood.Agomir-455-5p pretreatment increased miR-455-5p expression in the brain tissue,reduced the cerebral infarct volume,and improved neurological function.Furthermore,primary cultured microglia were exposed to oxygen-glucose deprivation for 3 hours followed by 21 hours of reoxygenation to mimic cerebral ischemia/reperfusion.miR-455-5p reduced C-C chemokine receptor type 5 mRNA and protein levels,inhibited microglia activation,and reduced the production of the inflammatory factors tumor necrosis factor-αand interleukin-1β.These results suggest that miR-455-5p is a potential biomarker and therapeutic target for the treatment of cerebral ischemia/reperfusion injury and that it alleviates cerebral ischemia/reperfusion injury by inhibiting C-C chemokine receptor type 5 expression and reducing the neuroinflammatory response.

Update on ischemia-reperfusion injury in kidney transplantation: Pathogenesis and treatment

Ischemia/reperfusion injury is an unavoidable relevant consequence after kidney transplantation and influences short term as well as long-term graft outcome. Clinically ischemia/reperfusion injury is associated with delayed graft function, graft rejection, chronic rejection and chronic graft dysfunction. Ischemia/reperfusion affects many regulatory systems at the cellular level as well as in the renal tissue that result in a distinct inflammatory reaction of the kidney graft. Underlying factors of ischemia reperfusion include energy metabolism, cellular changes of the mitochondria and cellular membranes, initiation of different forms of cell death-like apoptosis and necrosis together with a recently discovered mixed form termed necroptosis. Chemokines and cytokines together with other factors promote the inflammatory response leading to activation of the innate immune system as well as the adaptive immune system. If the inflammatory reaction continues within the graft tissue, a progressive interstitial fibrosis develops that impacts long-term graft outcome. It is of particular importance in kidney transplantation to understand the underlying mechanisms and effects of ischemia/reperfusion on the graft as this knowledge also opens strategies to prevent or treat ischemia/reperfusion injury after transplantation in order to improve graft outcome.

Myocardial ischemia-reperfusion injury:Possible role of melatonin

Our knowledge and understanding of the pathophysiology of coronary atherosclerosis has increased enormously over the last 20 years.Reperfusion through thrombolysis or percutaneous coronary angioplasty is the standard treatment for preventing acute myocardial infarction.Early reperfusion is an absolute prerequisite for survival of the ischemic myocardium,but reperfusion itself may lead to accelerated and additional myocardial injury beyond that generated by ischemia alone.These outcomes,in a range of reperfusion-associated pathologies,are collectively termed "reperfusion injuries".Reactive oxygen species are known to be produced in large quantities in the first few minutes of the post-ischemia reperfusion process.Similarly,scientific evidence from the last 15 years has suggested that melatonin has beneficial effects on the cardiovascular system.The presence of vascular melatoninergic receptor binding sites has been demonstrated;these receptors are functionally linked to vasoconstrictor or vasodilatory effects of melatonin.It has been shown that patients with coronary heart disease have a low melatonin production rate,especially those with higher risk of cardiac infarction and/or sudden death.Melatonin attenuates molecular and cellular damage resulting from cardiac ischemia-reperfusion in which destructive free radicals are involved.

Differential expression of 114 oxidative stress-related genes in peripheral blood mononuclear cells of acute cerebral infarction patients A gene microarray experiment

Previous studies have focused on the analysis of single or several function-related genes in oxidative stress; however, little information is available regarding altered expression of oxidative stress-related genes in the process of ischemia-reperfusion injury from microarray experiments. The aim of the present study was to investigate the changes in cell oxidative stress- and toxicity-related gene expression utilizing microarray screening in patients with acute cerebral infarction during cerebral ischemia-reperfusion injury. Of the included 114 genes, expression was significantly upregulated in eight genes, including three heat shock protein-related genes, one oxidative and metabolic stress-related gene, one cell growth arrest/senescence related gene, two apoptosis signal-related genes, and one DNA damage and repair related gene. Expression was significantly downregulated in four genes, including one cell proliferation/cancer related gene, two oxidative and metabolic stress-related genes and one DNA damage and repair related gene. The results demonstrated that cerebral ischemia-reperfusion injury in patients with acute cerebral infarction was affected by many genes including oxidative stress-, heat shock-, DNA damage and repair-, and apoptosis signal-related genes. Therefore, it could be suggested that cerebral ischemia-reperfusion injury may be subjected to complex genetic regulation mechanisms.

Effects of Fufang Shenhua Tablet(复方肾华片) on the Expression of Toll-Like Receptors during Acute Kidney Injury Induced by Ischemia-Reperfusion in Rats

Objective： To investigate the impact of a traditional Chinese medicinal compound known as Fufang Shenhua Tablet （复方肾华片, SHP） on the expression of Toll-like receptors （TLRs） during renal ischemia-reperfusion injury （IRI）-induced acute kidney injury （AKI） in rats. Methods： A total of 28 Wistar rats were randomly divided into five groups： （1） pseudo-operation control group, （2） ischemia-reperfusion model group, （3） Astragaloside group, （4） high-dose SHP group, and （5） low-dose SHP group. There were four rats in the pseudo-operation group and six rats in each of the other groups. The accepted ischemia-reperfusion model was established after a 7-day gavage intervention, and pathological changes and renal function were observed, using an enzyme-linked immunosorbent assay （ELISA） to detect interleukin 8 （IL-8） and interferon gamma （IFN-r） levels, as well as immunohistochemical staining to detect altered levels of TLR2 and TLR4 expression in renal tissue. Results： After 24 h, renal pathological damage and the expression levels of serum creatinine （Scr）, IL-8, IFN- r, TLR2, and TLR4 were significantly higher in the model group as compared with the pseudo-operation group （P〈0.05）. In addition, at 24 h the above indicators decreased significantly in the Astragaloside group, high- dose SHP group and low-dose SHP group as compared with the ischemia-reperfusion model group （P〈0.05）. TLR2 and TLR4 expression levels were significantly reduced in the SHP treatment and Astragaloside group as compared with the pseudo-operation group （P〈0.05）. Further, the high-dose SHP group showed significantly less renal damage score and decreased levels of TLR expression than those of low-dose SHP group and Astragaloside group （all P〈0.05）. Conclusion： SHP can alleviate the renal structural and functional damage caused by IRI-induced AKI in rats by reducing the damage of renal pathology, which may reduce inflammatory cytokine levels by downregulating the expression of TLRs in renal tissue in a dose-dependent manner.

ACI溶栓患者miR-379-5p表达水平与缺血再灌注损伤的相关性

目的探讨急性脑梗死(ACI)溶栓患者miR-379-5p表达水平与缺血再灌注损伤的相关性。方法选取2018年12月至2022年12月于新疆维吾尔自治区人民医院接受治疗的患者148例为观察组,同时健康体检正常者148例为对照组,均采用实时荧光定量PCR法检测血清miR-379-5p表达水平并对比。根据血清miR-379-5p表达水平情况将观察组进行亚分组,根据中位数分为高表达组和低表达组,对比观察组中高表达组和低表达组一般资料、缺血再灌注损伤水平,采用Pearson分析ACI溶栓患者miR-379-5p表达水平与缺血再灌注损伤的相关性。结果观察组miR-379-5p表达水平(1.09±0.24)较对照组miR-379-5p表达水平(1.88±0.21)低(t=30.137,P<0.01)。根据观察组miR-379-5p表达水平中位数分组分为高表达组74例(miR-379-5p表达水平≥1.10)和低表达组74例(miR-379-5p表达水平<1.10);高表达组溶栓后NIHSS评分、血清晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、单核细胞趋化蛋白-1(MCP-1)水平较低表达组低,血清过氧化物歧化酶(SOD)水平较低表达组高(P<0.05);Pearson相关性分析显示:miR-379-5p表达水平与溶栓后NIHSS评分、血清AOPP、MDA、TNF-α、CRP及MCP-1水平(r=-0.465,P<0.05;r=-0.273,P<0.05;r=-0.429,P<0.05;r=-0.486,P<0.05;r=-0.320,P<0.05;r=-0.273,P<0.05)呈负相关,与血清SOD水平呈正相关(r=-0.465,P<0.05)。结论ACI溶栓患者miR-379-5p表达水平与缺血再灌注损伤的相关性,上调miR-379-5p水平有助于减轻ACI静脉溶栓后缺血再灌注损伤。

Relationship between plasma D(-)-lactate and intestinal damage after severe injuries in rats

AIM To explore the kinetic changes in plasma D(-)- lactate and lipopolyssccharide(LPS)levels,and investigate whether D(-)-lactate could be used as a marker of intestinal injury in rats following gut ischemia/ reperfusion,burn,and acute necrotizing pancreatitis (ANP). METHODS Three models were developed in rats:① gut ischemia/ reperfusion obtained by one hour of superior mesenteric artery occlusion followed by reperfusion;② severe burn injury created by 30% of total body surface area(TBSA)full-thickness scald burn;and ③ ANP induced by continuous inverse infusion of sodium taurocholate and trypsin into main pancreatic duct. Plasma levels of D(-)-lactate in systemic circulation and LPS in portal circulation were measured by enzymatic- spectrophotometric method and limulus amebocyte lysate (LAL)test kit,respectively.Tissue samples of intestine were taken for histological analysis. RESULTS One hour gut ischemia followed by reperfusion injuries resulted in a significant elevation in plasma D(-)- lactate and LPS levels,and there was a significant correlation between the plasma D(-)-lactate and LPS(r =0.719,P<0.05).The plasma concentrations of D(-)- lactate and LPS increased significantly at 6h postburn, and there was also a remarkable correlation between them (r = 0.877,P < 0.01).D(-)-lactate and LPS levels elevated significantly at 2h after ANP,with a similar significant correlation between the two levels(r = 0.798, P < 0.01 ).The desquamation of intestine villi and infiltration of inflammatory cells in the lamina propria were observed in all groups. CONCLUSION The changes of plasma D(-)-lactate levels in systemic blood paralleled with LPS levels in the portal vein blood.The measurement of plasma D(-)-lactate level may be a useful marker to assess the intestinal injury and to monitor an increase of intestinal permeability and endotoxemia following severe injuries in early stage.

Intestinal injury can be reduced by intra-arterial postischemic perfusion with hypertonic saline

AIM:To investigate the effect of local intestinal perfusion with hypertonic saline(HTS) on intestinal ischemia-reperfusion injury(IRI) in bothex vivo andin vivo rat models.METHODS:All experiments were performed on male Wistar rats anesthetized with pentobarbital sodium given intraperitoneally at a dose of 60 mg/kg.Ex vivo vascularly perfused rat intestine was subjected to 60-min ischemia and either 30-min reperfusion with isotonic buffer(controls),or 5 min with HTS of 365 or 415 mOsm/L osmolarity(HTS 365mOsm or HTS 415mOsm,respectively) followed by 25-min reperfusion with isotonic buffer.The vascular intestinal perfusate flow(IPF) rate was determined by collection of the effluent from the portal vein in a calibrated tube.Spontaneous intestinal contraction rate was monitored throughout.Irreversible intestinal injury or area of necrosis(AN) was evaluated histochemically using 2.3.5-triphenyltetrazolium chloride staining.In vivo,30-min ischemia was followed by either 30-min blood perfusion or 5-min reperfusion with HTS 365mOsm through the superior mesenteric artery(SMA) followed by 25-min blood perfusion.Arterial blood pressure(BP) was measured in the common carotid artery using a miniature pressure transducer.Histological injury was evaluated in both preparations using the Chui score.RESULTS:Ex vivo,intestinal IRI resulted in a reduction in the IPF rate during reperfusion(P < 0.05 vs sham).The postischemic recovery of the IPF rate did not differ between the controls and the HTS 365mOsm group.In the HTS 415mOsm group,postischemic IPF rates were lower than in the controls and the HTS 365mOsm group(P < 0.05).The intestinal contraction rate was similar at baseline in all groups.An increase in this parameter was observed during the first 10 min of reperfusion in the control group as compared to the sham-treated group,but no such increase was seen in the HTS 365mOsm group.In controls,AN averaged 14.8% ± 5.07% of the total tissue volume.Administration of HTS 365mOsm for 5 min after 60-min ischemia resulted in decrease in AN(5.1% ± 1.20% vs controls,P < 0.01).However,perfusion of the intestine with the HTS of greater osmolarity(HTS 415mOsm) failed to protect the intestine from irreversible injury.The Chiu score was lower in the HTS 365mOsm group in comparison with controls(2.4 ± 0.54 vs 3.2 ± 0.44,P = 0.042),while intestinal perfusion with HTS 415mOsm failed to improve the Chiu score.Intestinal reperfusion with HTS 365mOsm in the in vivo series secured rapid recovery of BP after its transient fall,whereas in the controls no recovery was seen.The Chiu score was lower in the HTS 365mOsm group vs controls(3.1 ± 0.26 and 3.8 ± 0.22,P = 0.0079 respectively,),although the magnitude of the effect was lower than in the ex vivo series.CONCLUSION:Brief intestinal postischemic perfusion with HTS 365mOsm through the SMA followed by blood flow restoration is a protective procedure that could be used for the prevention of intestinal IRI.

Rac1 relieves neuronal injury induced by oxygen-glucose deprivation and re-oxygenation via regulation of mitochondrial biogenesis and function

Certain microRNAs(miRNAs)can function as neuroprotective factors after reperfusion/ischemia brain injury.miRNA-142-3p can participate in the occurrence and development of tumors and myocardial ischemic injury by negatively regulating the activity of Rac1,but it remains unclear whether miRNA-142-3p also participates in cerebral ischemia/reperfusion injury.In this study,a model of oxygen-glucose deprivation/re-oxygenation in primary cortical neurons was established and the neurons were transfected with miR-142-3p agomirs or miR-142-3p antagomirs.miR-142-3p expression was down-regulated in neurons when exposed to oxygen-glucose deprivation/re-oxygenation.Over-expression of miR-142-3p using its agomir remarkably promoted cell death and apoptosis induced by oxygen-glucose deprivation/re-oxygenation and improved mitochondrial biogenesis and function,including the expression of peroxisome proliferator-activated receptor-γcoactivator-1α,mitochondrial transcription factor A,and nuclear respiratory factor 1.However,the opposite effects were produced if miR-142-3p was inhibited.Luciferase reporter assays verified that Rac Family Small GTPase 1(Rac1)was a target gene of miR-142-3p.Over-expressed miR-142-3p inhibited NOX2 activity and expression of Rac1 and Rac1-GTPase(its activated form).miR-142-3p antagomirs had opposite effects after oxygen-glucose deprivation/re-oxygenation.Our results indicate that miR-142-3p down-regulates the expression and activation of Rac1,regulates mitochondrial biogenesis and function,and inhibits oxygen-glucose deprivation damage,thus exerting a neuroprotective effect.The experiments were approved by the Committee of Experimental Animal Use and Care of Central South University,China(approval No.201703346)on March 7,2017.

铁死亡在缺血-再灌注急性肾损伤中的研究进展

缺血-再灌注(I/R)是急性肾损伤(AKI)的常见原因,常见于肾移植、休克、创伤、泌尿外科和心血管外科手术,对此尚无有效的治疗方法。铁死亡是一种新发现的调节性细胞死亡模式,其特征是铁依赖性脂质过氧化物的致命积累。已有大量研究表明,铁死亡参与I/R AKI的发生发展,其病理生理机制及治疗靶点逐渐成为研究的热点。本文概述了近年来关于I/R AKI中铁死亡的相关研究进展,旨在为I/R AKI的预防及治疗提供新的思路和策略。

高甘油三酯血症对急性心梗PCI后缺血-再灌注损伤的影响

目的探究高甘油三酯血症对急性心肌梗死(acute myocardial infarction,AMI)经皮冠脉介入术(percutaneous coronary intervention,PCI)缺血-再灌注损伤的影响。方法回顾性分析2021年10月至2022年12月收治的AMI行急诊PCI的患者共132例,其中47例存在高甘油三酯血症的患者纳入高甘油三酯血症组,85例甘油三酯正常的患者纳入对照组。检测并记录患者一般临床资料,心肌酶检测包括肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶CK-MB、心肌肌钙蛋白T(cardiac troponin T,cTnT),氨基末端脑钠肽前体(NT-proBNP),超声心动图,氧化应激指标包括超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malondialdehyde,MDA),炎症指标白介素-6(interleukin 6,IL-6)水平。结果与对照组相比,高甘油三酯血症患者BMI和甘油三酯水平显著增高(P<0.05),其他指标差异无统计意;CK和CKMB水平显著升高(P<0.05),而cTnT差异不显著;左室射血分数显著降低(P<0.05),NT-proBNP显著增高(P<0.05),左室舒张末期内径差异不显著;SOD显著降低,MDA和IL-6水平显著增高(P<0.05)。结论高甘油三酯血症可显著加重急性心梗PCI术后的缺血再灌注损伤,及时纠正甘油三酯紊乱对改善PCI术后临床结局具有重要意义。

缺血后适应对急性ST段抬高型心肌梗死患者PCI介入术后缺血-再灌注损伤的预后影响

目的:观察缺血后适应(IPoC)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后缺血-再灌注损伤(IRI)预后影响。方法:将90例STMEI患者按照不同治疗方式分为对照组(常规方法行PCI)和观察组(再灌注开始1 min内行IPoC),每组各45例。比较两组患者ST段回落情况,心肌再灌注评价,心肌坏死标志物,心功能指标,外周血氨基末端B型钠尿肽原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、内皮素1(ET-1)和主要心脏不良事件。结果:观察组患者术后6 h完全回落高于术后2 h(P<0.05);术后心肌再灌注评价指标CTFC和WMSI,心肌坏死标志物c-TnI、CK和CK-MB,外周血NT-proBNP、hs-CRP和ET-1水平均低于对照组(P<0.05);主要心脏不良事件发生率低于对照组(P<0.05)。结论:IPoC能有效改善STMEI患者PCI介入后IRI,能降低心肌酶和NT-proBNP、hs-CRP和ET-1水平,改善预后,值得临床应用推广。

纤维蛋白原Bβ15-42肽在细胞水平对缺血再灌注急性肾损伤线粒体自噬的影响

目的探讨纤维蛋白原Bβ15-42肽(fibrin-derived peptide Bβ15-42,FgBβ15-42)在细胞水平对缺血再灌注急性肾损伤(acute kidney injury,AKI)线粒体自噬的影响。方法体外培养人肾小管上皮细胞,随机分为5组,即正常对照组(Control组)、缺氧复氧(hypoxia/reoxygenation,H/R)模型组(H/R组)、H/R模型+9μmol/L FgBβ15-42肽组(Fg组)、H/R模型+20μmol/L氯喹组(CQ组)、H/R模型+9μmol/L FgBβ15-42肽+20μmol/L氯喹组(Fg+CQ组)。Control组:将同质化细胞置于完全培养基中,在有氧(5%CO_(2),21%O_(2))条件下培养28h。H/R组:细胞用无糖、无血清DMEM/F12培养基在缺氧(5%CO_(2),1%O_(2)和94%N 2)条件下培养24h,再更换含血清的DMEM/F12培养基置于有氧(5%CO_(2),21%O_(2))环境中4h。Fg组:在复氧时加入FgBβ15-42肽9μmol/L进行干预。CQ组:在进行同质化处理时加入氯喹进行预处理(20μmol/L),后序步骤同H/R组。Fg+CQ组:按照上述CQ组及FgBβ15-42组在不同时间段的加药顺序、剂量,及H/R组的造模时间进行干预。干预结束后采用CCK-8法检测HK2细胞活力;电子显微镜观察线粒体形态、线粒体自噬体结构及数量;Western blot法检测自噬相关蛋白p62、LC3的表达水平。结果与Control组比较,H/R组细胞的存活率下降(P<0.01);线粒体损伤明显,出现了肿胀、棘断裂等,且线粒体自噬体的数目增多;自噬标志性蛋白LC-3Ⅱ/Ⅰ表达上调(P<0.05),自噬底物蛋白p62表达下调(P<0.01)。与H/R组比较,Fg组、CQ组、Fg+CQ组细胞的存活率回升(P<0.01),线粒体自噬体减少,LC-3Ⅱ/Ⅰ表达下调(P<0.01),p62表达上调(P<0.05),细胞自噬被抑制。结论FgBβ15-42肽干预后可降低H/R-AKI细胞中自噬及线粒体自噬水平,对HK2细胞H/R损伤有保护作用。

miR-124与心肌缺血再灌注损伤的相关性研究及其靶基因分析

目的探讨血清miR-124对急性ST段抬高型心肌梗死(STEMI)患者心肌缺血再灌注损伤(MIRI)的预测价值,并分析其可能作用的靶基因。方法选取2020年1月—2020年6月于武汉市第三医院首次诊断为STEMI并行急诊经皮冠状动脉介入(PCI)治疗的患者168例为研究对象,采用实时定量PCR技术测定其入院即刻的血清miR-124表达水平。根据患者PCI治疗后是否发生MIRI将其分为MIRI组(n=76)和对照组(n=92),分析两组患者的临床资料和miR-124水平。利用生物信息学方法分析miR-124可能作用的靶基因。结果MIRI组患者的血清miR-124水平(2.26±0.79)显著高于对照组(1.48±0.45),差异具有统计学意义(P<0.001)。多因素Logistic回归分析表明,血清miR-124水平是预测STEMI患者发生MIRI的独立因素(OR=1.37,95%CI=1.06~1.78;P=0.017)。ROC曲线分析结果提示,miR-124预测MIRI的曲线下面积为0.81(95%CI=0.74~0.88,P<0.001),其预测最佳截点的敏感性为76.3%,特异性为75.0%。通过生物信息学的方法共预测到326个miR-124的靶基因,而其中22个与MIRI相关,这些基因可能参与视黄醇代谢、胶原纤维重构和炎症反应。结论血清miR-124水平与STEMI患者发生MIRI有关,可能涉及视黄醇代谢、胶原纤维重构和炎症反应等生物学过程。

Exosomal transfer of microRNA-590-3p between renal tubular epithelial cells after renal ischemia-reperfusion injury regulates autophagy by targeting TRAF6

Background:Acute kidney injury(AKI)is a common complication in patients,especially elderly patients,who undergo cardiac surgery with cardiopulmonary bypass.Studies have indicated a protective role of autophagy in AKI.However,the mechanisms underlying the regulatory effect of autophagy in AKI among patients undergoing cardiac surgeries are poorly understood.In this study,we aimed to test the hypothesis that exosomal microRNAs(miRNAs)regulate autophagy in tubular epithelial cells after AKI.Methods:Plasma exosomal RNA was extracted from young and elderly AKI patients undergoing cardiac surgery,and the miRNAs expression during the perioperative period were analyzed using next-generation sequencing.The screened miRNAs and their target genes were subjected to gene oncology function and Kyoto Encyclopedia of Genes and Genome enrichment analyses.Renal tubular epithelial cell line(HK-2 cells)was cultured and hypoxia/reoxygenation(H/R)model was established,which is an in vitro renal ischemia/reperfusion(I/R)model.We used Western blot analysis,cell viability assay,transfection,luciferase assay to investigate the mechanisms underlying the observed increases in the levels of renal I/R injury-mediated exosomal miRNAs and their roles in regulating HK-2 cells autophagy.Results:miR-590-3p was highly enriched in the plasma exosomes of young AKI patients after cardiac surgery.Increased levels of miR-590-3p led to the increases in the expression of autophagy marker proteins,including Beclin-1 and microtubule associated protein 1 light chain 3 beta(LC3II),and prolonged the autophagic response in HK-2 cells after H/R treatment.These effects were achieved mainly via increases in the exosomal miR-590-3p levels,and the tumor necrosis factor receptor-associated factor 6 protein was shown to play a key role in I/R injury-mediated autophagy induction.Conclusion:Exosomes released from HK-2 cells after renal I/R injury regulate autophagy by transferring miR-590-3p in a paracrine manner,which suggests that increasing the miR-590-3p levels in HK-2 cell-derived exosomes may increase autophagy and protect against kidney injury after renal I/R injury.

麝香、冰片对大鼠脑缺血-再灌注急性期和恢复早期炎性损伤的保护作用及机制研究

目的:探讨麝香、冰片对脑缺血-再灌注损伤大鼠急性期及恢复早期的保护作用及机制。方法:将180只大鼠随机分为假手术组,模型组,麝香高、低剂量组(50、25 mg/kg),冰片高、低剂量组(50、25 mg/kg),醒脑静10m L/kg组。各组大鼠灌胃给药4 d,线栓法复制脑缺血-再灌注模型,观察麝香、冰片对脑缺血-再灌注炎性损伤急性期及恢复早期神经功能缺损评分、脑组织匀浆环氧酶(COX-2)和5脂氧酶(5-LOX)活性变化及海马组织Cys LT2蛋白及mRNA表达的影响。结果:麝香、冰片能显著提高脑缺血-再灌注损伤大鼠神经功能缺损评分,改善其脑组织病理形态,降低脑内COX-2和5-LOX的活性,抑制脑海马组织Cys LT2蛋白表达。结论:麝香、冰片能对抗大鼠脑缺血-再灌注急性期炎性损伤,其机制可能与抑制脑内COX-2与5-LOX的活性有关。

α7nAChR激动剂和乌司他丁对大鼠肠缺血再灌注后肺组织IL-1β、IL-6和TNF-α作用的比较

目的:比较α7nAChR激动剂(PNU-282987)和乌司他丁对大鼠肠缺血再灌注后肺组织IL-1β、IL-6和TNF-α的影响。方法:32只健康清洁级SD大鼠(200～250g)随机分为4组(n=8):S组(假手术组)、M组(缺血/再灌注组)、PM组(模型+PNU-282987组)、UM组(模型+乌司他丁组)。建立肠缺血75min再灌注2h损伤模型。所有大鼠均于肠系膜上动脉开放后2h处死,取标本进行肺组织的病理学检查;采用ELISA法测定肺组织中IL-1β、IL-6、TNF-α的浓度。结果:与S组比较,M组肺组织损伤明显加重,IL-1β、IL-6和TNF-α的浓度均升高,且有统计学意义(P<0.05);与M组比较,PM组和UM组肺组织损伤明显减轻,IL-1β、IL-6和TNF-α的浓度均下降,且有统计学意义(P<0.05);PM组和UM组之间无明显差异。结论:α7nAChR激动剂(PNU-282987)和乌司他丁对大鼠肠缺血再灌注后肺组织中炎症因子IL-1β、IL-6和TNF-α的产生具有相似的抑制作用。

舒芬太尼通过上调microRNA-145促进自噬和改善缺血再灌注诱导的急性肾损伤

目的:舒芬太尼对缺血再灌注(ischemia reperfusion,IR)引起的心肌和肝损伤具有良好的保护作用,但其对肾的保护作用尚不清楚。本研究旨在探讨舒芬太尼是否可以预防IR引起的急性肾损伤(acute kidney injury,AKI),并确定其疗效是否与miR-145介导的自噬有关。方法:40只大鼠随机分为5组(每组8只):假手术组、IR组、舒芬太尼组、舒芬太尼+miR-145抑制剂对照组(舒芬太尼+anti-NC组)和舒芬太尼+miR-145抑制剂组(舒芬太尼+antimiR-145组)。除假手术组外,其余组均建立了由IR诱导的大鼠AKI模型。舒芬太尼组、舒芬太尼+anti-NC组和舒芬太尼+anti-miR-145组在IR处理前30 min通过股静脉注射舒芬太尼(剂量为1μg/kg),后两组大鼠在舒芬太尼预处理前通过尾静脉注射miR-145抑制剂对照或anti-miR-145(剂量为80 mg/kg)。评估大鼠肾的结构和功能,并测量自噬相关蛋白的蛋白水平、氧化应激水平和细胞凋亡水平。结果:与IR组相比,舒芬太尼组改善了肾结构和功能,并且血尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、尿肾损伤分子1(kidney injury molecule 1,KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase related lipid transporter,NGAL)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(interleukin,IL)-1β、IL-6和ROS水平均显著降低(均P<0.05)。此外,与IR组相比,舒芬太尼组肾组织肌球蛋白样BCL2结合蛋白(coiled-coil, myosin-like BCL2 interacting protein,Beclin-1)和微管相关蛋白1轻链3(microtubule-associated protein 1 light chain 3,LC3)水平均显著增加(均P<0.05),并且肾组织中的细胞凋亡显著减少(P<0.05)。与舒芬太尼+anti-NC组相比,舒芬太尼+anti-miR-145组BUN、Cr、KIM-1、NGAL、TNF-α、IL-1β、IL-6和ROS水平均显著增加(均P<0.05),肾组织Beclin-1和LC3水平均显著降低(均P<0.05),并且肾组织中的细胞凋亡显著增加(P<0.05)。结论:舒芬太尼可预防IR引起的AKI,其作用机制与上调miR-145介导的自噬有关。