Which Distant Organ is Most Affected by Lower Extremity Ischemia-Reperfusion?

Effects of Ulinastatin on Myocardial Ischemia-Reperfusion Injury, Cardiac Function, and Serum TNF-α and IL-10 Levels in Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass

Background

Myocardial ischemia-reperfusion injury (MIRI) is a very common adverse reaction after cardiac valve replacement (CVR) under cardiopulmonary bypass, which seriously affects the rehabilitation and prognosis of patients.

Objective

The prevention and treatment of MIRI are a hotspot of modern medical research, and this study is aimed at providing reliable reference and guidance for future clinical prevention and treatment of MIRI by analyzing the effects of ulinastatin (UL) on cardiac function and MIRI of patients after CVR.

Methods

A total of 104 patients undergoing CVR under cardiopulmonary bypass in our hospital were selected as research participants. Among them, 52 patients treated with UL were assigned to the observation group, and the rest 52 patients given the same amount of normal saline were assigned to the control group. The cardiopulmonary bypass status, postoperative status, cardiac function, inflammatory response, oxidative stress response, and hemodynamics were observed and compared between the two groups. In addition, clinical efficacy and safety and patient prognosis were compared.

Results

Through experimental analysis, we found that UL had no significant effect on the clinical efficacy, safety, and prognosis of patients after surgery (P > 0.05) but had obvious protective effects on cardiopulmonary bypass status, cardiac function, inflammation, oxidative stress, and hemodynamics (P < 0.05).

Conclusion

UL can effectively prevent the occurrence of MIRI after CVR under cardiopulmonary bypass, which is worthy of clinical application.

LncRNA Rian reduces cardiomyocyte pyroptosis and alleviates myocardial ischemia-reperfusion injury by regulating by the miR-17-5p/CCND1 axis

Myocardial ischemia-reperfusion injury (MIRI) is a pathological process characterized by cardiomyocyte death. Long noncoding RNAs (lncRNAs) have been shown to be dysregulated in the course of MIRI. Accordingly, the current study investigated the mechanism of lncRNA Rian in MIRI-induced cardiomyocyte pyroptosis. First, a murine model of MIRI was established by using the left anterior descending (LAD) coronary artery ligation method. Cardiac function and myocardial histopathological changes were evaluated by echocardiography and hematoxylin and eosin staining. Then, a cell model of MIRI was established by oxygen-glucose deprivation/reoxygenation (OGD/R), followed by analysis of NLRP3, cleaved caspase-1, and GSDMD-N levels by western blotting. The levels of IL-1β, IL-18, TNF-α, and IL-10 were measured using ELISA. LncRNA Rian, miR-17-5p, and CCND1 expression in myocardial tissues and OGD/R cells were examined using RT-qPCR. Finally, the binding relationships between Rian and miR-17-5p and miR-17-5p and CCND1 were validated with the help of dual-luciferase and RNA pull-down assays. Rian was poorly expressed in MIRI mice and OGD/R cells. LncRNA Rian overexpression reduced cardiomyocyte pyroptosis in vivo and in vitro, as indicated by decreased NLRP3, cleaved caspase-1, GSDMD-N, IL-1β, IL-18, and TNF-α levels and increased IL-10 levels. Furthermore, Rian bound to miR-17-5p and promoted CCND1 transcription. Notably, miR-17-5p overexpression or CCND1 silencing reversed the inhibitory effect of Rian overexpression on cardiomyocyte pyroptosis. Collectively, our findings indicate that Rian overexpression reduces cardiomyocyte pyroptosis and alleviates MIRI through the miR-17-5p/CCND1 axis.