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Liu XS, Zeng J, Yang YX, Qi CL, Xiong T, Wu GZ, Zeng CY, Wang DX. DRD4 Mitigates Myocardial Ischemia/Reperfusion Injury in Association With PI3K/AKT Mediated Glucose Metabolism. Front Pharmacol 2021; 11:619426. [PMID: 33584304 PMCID: PMC7873565 DOI: 10.3389/fphar.2020.619426] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Ischemia-reperfusion (I/R) could cause heart irreversible damage, which is tightly combined with glucose metabolism disorder. It is demonstrated that GLUT4 (glucose transporter 4) translocation is critical for glucose metabolism in the cardiomyocytes under I/R injury. Moreover, DRD4 (dopamine receptor D4) modulate glucose metabolism, and protect neurocytes from anoxia/reoxygenation (A/R) injury. Thus, DRD4 might regulate myocardial I/R injury in association with GLUT4-mediated glucose metabolism. However, the effects and mechanisms are largely unknown. In the present study, the effect of DRD4 in heart I/R injury were studied ex vivo and in vitro. For I/R injury ex vivo, DRD4 agonist (PD168077) was perfused by Langendorff system in the isolated rat heart. DRD4 activated by PD168077 improved cardiac function in the I/R-injured heart as determined by the left ventricular developed pressure (LVDP), +dp/dt, and left ventricular end diastolic pressure (LVEDP), and reduced heart damage evidenced by infarct size, the release of troponin T (TNT) and lactate dehydrogenase (LDH). DRD4 activation diminished I/R injury induced apoptosis and enhanced cell viability impaired by I/R injury in cardiomyocyte, showed by TUNEL staining, flow cytometer and CCK8 assay. Furthermore, DRD4 activation did not change total GULT4 protein expression level but increased the membrane GULT4 localization determined by western blot. In terms of mechanism, DRD4 activation increased pPI3K/p-AKT but not the total PI3K/AKT during anoxia/reoxygenation (A/R) injury in vitro. Interestingly, PI3K inhibitor, Wortmannin, blocked PI3K/AKT pathway and depleted the membrane GULT4, and further promoted apoptosis showed by TUNEL staining, flow cytometer, western blot of cleaved caspase 3, BAX and BCL2 expression. Thus, DRD4 activation exerted a protective effect against I/R injury by promoting GLUT4 translocation depended on PI3K/AKT pathway, which enhanced the ability of glucose uptake, and ultimately reduced the apoptosis in cardiomyocytes.
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Affiliation(s)
- Xue-Song Liu
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jing Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Yu-Xue Yang
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Chun-Lei Qi
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ting Xiong
- Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Geng-Ze Wu
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Chun-Yu Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China
| | - Da-Xin Wang
- The Hospital Affiliated to Medical School of Yangzhou University (Taizhou people's Hospital), Taizhou, China
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Yang P, Du Y, Zeng H, Xing H, Tian C, Zou X. Comparison of Inflammatory Markers Between the Sevoflurane and Isoflurane Anesthesia in a Rat Model of Liver Ischemia/Reperfusion Injury. Transplant Proc 2019; 51:2071-2075. [PMID: 31303406 DOI: 10.1016/j.transproceed.2019.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/17/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Sevoflurane and isoflurane had been reported to improve ischemia/reperfusion injury (I/R) through amelioration of the inflammatory response. We aimed to explore and compare the molecular mechanisms involved in sevoflurane and isoflurane anesthesia in liver ischemia-reperfusion of rat model. METHODS Forty male Wistar rats were randomly divided into 4 groups: sham group, I/R group, sevoflurane group, and isoflurane group. The liver I/R injury model was established to investigate the effect of sevoflurane and isoflurane anesthesia on liver ischemia/reperfusion. The inflammatory markers and complement C3, C5a, and C6 were detected by enzyme-linked immunosorbent assay. Oxidative stress was detected by measuring the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO). RESULTS Our results showed that sevoflurane anesthesia significantly decreased alanine transaminase, aspartate transaminase, and lactate dehydrogenase levels compared with isoflurane and controls. Sevoflurane inhibited I/R injury induced production of tumor necrosis factor α, interleukin 1, interleukin 6, and intercellular cell adhesion molecule-1 and promoted interleukin 10 production more significantly compared with isoflurane. Reduced MDA and NO and elevated SOD release suggested that oxidative stress was attenuated by sevoflurane and isoflurane anesthesia. Both sevoflurane and isoflurane anesthesia significantly decreased plasma C3 levels compared with the I/R injury group without differences. CONCLUSION Sevoflurane anesthesia produced a more significant inhibitive effect on inflammatory cytokines and oxidative stress in liver I/R injury model than isoflurane, suggesting that sevoflurane is more suitable in surgery.
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Affiliation(s)
- Peng Yang
- Department of Anesthesiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China
| | - Ying Du
- Department of Orthopaedics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China
| | - Haibo Zeng
- Department of Anesthesiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China
| | - Haoran Xing
- Department of Anesthesiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China
| | - Chunlin Tian
- Department of Anesthesiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China
| | - Xuejun Zou
- Department of Anesthesiology, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China.
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Sevoflurane relieves hepatic ischemia-reperfusion injury by inhibiting the expression of Grp78. Biosci Rep 2018; 38:BSR20180549. [PMID: 30217942 PMCID: PMC6172422 DOI: 10.1042/bsr20180549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/07/2018] [Accepted: 09/03/2018] [Indexed: 12/30/2022] Open
Abstract
Purpose: This article aimed to study the role of sevoflurane pre-conditioning in hepatic ischemia–reperfusion and its potential mechanism. Methods: Rat liver ischemia–reperfusion model was constructed. Serum TNF-α, IL-1β, IL-10, and IL-6 concentrations were detected by ELISA. Malondialdehyde (MDA), superoxide dismutase (SOD), and nitric oxide (NO) in liver homogenate were determined. Hematoxylin–Eosin (HE) staining, Tunel, and immunohistochemistry were performed. Ischemia–reperfusion hepatocyte model was established. Cells transfection was conducted. Apoptosis was observed by flow cytometry. Quantitative real-time PCR (qRT-PCR) and Western blotting analysis were used. Results: Compared with I/R group, liver damage degree, liver cell apoptosis, and glucose regulatory protein 78 (Grp78) expression was obviously reduced in rats of SEV group. TNF-α, IL-1β, and IL-6 concentrations were also significantly increased (P<0.01). MDA and NO concentrations were dramatically lower (P<0.01) and SOD concentration was significantly higher (P<0.01). Apoptosis rate, Grp78, PERK, eIF2α, and p-c-JNK/JNK expression was also significantly decreased (P<0.01). Sevoflurane significantly reduced apoptosis and expression of PERK, eIF2α, p-c-JNK/JNK by inhibiting the expression of Grp78 (P<0.01). Conclusion: Sevoflurane relieves hepatic ischemia–reperfusion injury by inhibiting the expression of Grp78.
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Høyer KF, Nielsen TS, Risis S, Treebak JT, Jessen N. Sevoflurane Impairs Insulin Secretion and Tissue-Specific Glucose Uptake In Vivo. Basic Clin Pharmacol Toxicol 2018; 123:732-738. [PMID: 29956485 DOI: 10.1111/bcpt.13087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/21/2018] [Indexed: 01/08/2023]
Abstract
The use of anaesthetics severely influences substrate metabolism. This poses challenges for patients in clinical settings and for the use of animals in diabetes research. Sevoflurane can affect regulation of glucose homoeostasis at several steps, but the tissue-specific response remains to be determined. The aim of the study was to investigate the pharmacological effect of sevoflurane anaesthesia on glucose homoeostasis during hyperinsulinaemic clamp conditions, the gold standard method for assessment of whole-body insulin sensitivity. Conscious mice (n = 6) and mice under sevoflurane anaesthesia (n = 8) underwent a hyperinsulinaemic clamp where constant infusion of insulin and donor blood was administered during variable glucose infusion to maintain isoglycaemia. 2-[1-14 C]-deoxy-D-glucose was infused to determine tissue-specific uptake of glucose in adipose tissue, heart, brain and skeletal muscle. Sevoflurane anaesthesia severely impaired insulin-stimulated whole-body glucose uptake demonstrated by a 50% lower glucose infusion rate (GIR). This was associated with decreased glucose uptake in brain, soleus, triceps and gastrocnemius muscles in sevoflurane-anaesthetized mice compared to conscious mice. Plasma-free fatty acids (FFA), a potent inducer of insulin resistance, increased by 42% in mice during sevoflurane anaesthesia. In addition, insulin secretion from pancreatic β-cell was lower in fasted, anaesthetized mice. Sevoflurane anaesthesia impairs insulin secretion, induces insulin resistance in mice and reduces glucose uptake in non-insulin-sensitive tissue like the brain. The underlying mechanisms may involve sevoflurane-induced mobilization of FFA.
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Affiliation(s)
- Kasper F Høyer
- Department of Biomedicine, Health, Aarhus University, Aarhus C, Denmark.,Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus C, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Integrative Physiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas S Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Integrative Physiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steve Risis
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Integrative Physiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jonas T Treebak
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Integrative Physiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jessen
- Department of Biomedicine, Health, Aarhus University, Aarhus C, Denmark.,Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University Hospital, Aarhus C, Denmark.,Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus C, Denmark
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Jiang X, Ma H, Li C, Cao Y, Wang Y, Zhang Y, Liu Y. Effects of neonatal dexamethasone administration on cardiac recovery ability under ischemia-reperfusion in 24-wk-old rats. Pediatr Res 2016; 80:128-35. [PMID: 26991264 DOI: 10.1038/pr.2016.54] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Evaluations of stress-induced cardiac functional alterations in adults after neonatal glucocorticoid (GC) treatment have been limited. In the present study, we evaluated adult cardiac functional recovery during postischemic reperfusion and measured cardiac gene expression involved energy metabolism in rats neonatally treated with dexamethasone (DEX). METHOD Male Wistar rats were injected DEX in first 3 d after birth and controls were received saline (SAL). At 24 wk of age, insulin tolerance tests were performed, plasma lipid levels were measured, and left ventricular function and myocardial infarct size were evaluated. Expressions of genes involved in cardiac energy metabolism were measured by quantitative real-time polymerase chain reaction (PCR) and western blot. RESULTS In 24-wk-old rats, neonatal DEX administration caused dyslipidemia, impaired cardiac recovery function and increased size of infarction, decreased cardiac expression of glucose transporter 4(GLUT4), peroxisome proliferative-activated receptor gamma coactivator 1α (PGC-1α) and ratios of phospho-forkhead box O1/forkhead box O1 (p-FoxO1/FoxO1) and phospho AMP-activated protein kinase/AMP-activated protein kinase (p-AMPK/AMPK) but increased pyruvate dehydrogenase kinase isoenzyme 4 (PDK4) expression compared with controls. CONCLUSION Neonatal DEX administration impairs cardiac functional recovery during reperfusion following ischemia in 24-wk-old rats. Reduced cardiac glucose utilization may contribute to the long-term detrimental effects caused by neonatal DEX treatment.
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Affiliation(s)
- Xinli Jiang
- Department of Ophthalmology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huijie Ma
- Department of Physiology, Hebei Medical University, Shijiazhuang, China
| | - Chunguang Li
- Department of Endocrinology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yue Cao
- Department of Endocrinology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yan Wang
- Department of Endocrinology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yi Zhang
- Department of Physiology, Hebei Medical University, Shijiazhuang, China
| | - Yan Liu
- Department of Endocrinology, the Third Hospital of Hebei Medical University, Shijiazhuang, China
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Li X, Liu Y, Ma H, Guan Y, Cao Y, Tian Y, Zhang Y. Enhancement of Glucose Metabolism via PGC-1α Participates in the Cardioprotection of Chronic Intermittent Hypobaric Hypoxia. Front Physiol 2016; 7:219. [PMID: 27375497 PMCID: PMC4896962 DOI: 10.3389/fphys.2016.00219] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 05/26/2016] [Indexed: 11/21/2022] Open
Abstract
Background and Aims: Previous studies demonstrated that energy metabolism disturbance impairs cardiac function and chronic intermittent hypobaric hypoxia (CIHH) protects heart against ischemia/reperfusion injury. The present study aimed to test the hypothesis that CIHH protects the heart against ischemia/reperfusion (I/R) injury via improvement of cardiac glucose metabolism. Methods: Male Sprague-Dawley rats received CIHH treatment simulating 5000-m altitude for 28 days, 6 h per day in a hypobaric chamber or no treatment (control). Body weight, fasting blood glucose, blood lipid and glucose tolerance were measured. The left ventricular function of isolated hearts was evaluated during 30 min of ischemia and 60 min of reperfusion using Langendorff method. The mRNA and protein expression involved in cardiac energy metabolism was determined using quantitative PCR and Western blot techniques. Results: 1. There was no difference of body weight, fast blood glucose, blood lipid and glucose tolerance between control and CIHH rats under baseline condition (p > 0.05). 2. The recovery of left ventricular function after I/R was improved significantly in CIHH rats compared to control rats (p < 0.05). 3. The expression of cardiac GLUT4 and PGC-1α was increased but PDK4 gene expression was decreased by CIHH treatment at both mRNA and protein level. Also p-AMPK/AMPK ratio was increased in CIHH rats (p < 0.05). Conclusion: CIHH ameliorates I/R injury through improving cardiac glucose metabolism via upregulation of GLUT4, p-AMPK, and PGC-1α expressions, but downregulation of cardiacPDK4 expression.
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Affiliation(s)
- Xuyi Li
- Department of Physiology, Hebei Medical UniversityShijiazhuang, China; Hebei Collaborative Innovation Center for Cardio-Cerebrovascular DiseaseShijiazhuang, China
| | - Yan Liu
- Department of Endocrinology, The Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Huijie Ma
- Department of Physiology, Hebei Medical UniversityShijiazhuang, China; Hebei Collaborative Innovation Center for Cardio-Cerebrovascular DiseaseShijiazhuang, China
| | - Yue Guan
- Department of Physiology, Hebei Medical UniversityShijiazhuang, China; Hebei Collaborative Innovation Center for Cardio-Cerebrovascular DiseaseShijiazhuang, China
| | - Yue Cao
- Department of Endocrinology, The Third Hospital of Hebei Medical University Shijiazhuang, China
| | - Yanming Tian
- Department of Physiology, Hebei Medical UniversityShijiazhuang, China; Hebei Collaborative Innovation Center for Cardio-Cerebrovascular DiseaseShijiazhuang, China
| | - Yi Zhang
- Department of Physiology, Hebei Medical UniversityShijiazhuang, China; Hebei Collaborative Innovation Center for Cardio-Cerebrovascular DiseaseShijiazhuang, China
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Lou PH, Lucchinetti E, Zhang L, Affolter A, Schaub MC, Gandhi M, Hersberger M, Warren BE, Lemieux H, Sobhi HF, Clanachan AS, Zaugg M. The mechanism of Intralipid®-mediated cardioprotection complex IV inhibition by the active metabolite, palmitoylcarnitine, generates reactive oxygen species and activates reperfusion injury salvage kinases. PLoS One 2014; 9:e87205. [PMID: 24498043 PMCID: PMC3907505 DOI: 10.1371/journal.pone.0087205] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/23/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Intralipid® administration at reperfusion elicits protection against myocardial ischemia-reperfusion injury. However, the underlying mechanisms are not fully understood. METHODS Sprague-Dawley rat hearts were exposed to 15 min of ischemia and 30 min of reperfusion in the absence or presence of Intralipid® 1% administered at the onset of reperfusion. In separate experiments, the reactive oxygen species (ROS) scavenger N-(2-mercaptopropionyl)-glycine was added either alone or with Intralipid®. Left ventricular work and activation of Akt, STAT3, and ERK1/2 were used to evaluate cardioprotection. ROS production was assessed by measuring the loss of aconitase activity and the release of hydrogen peroxide using Amplex Red. Electron transport chain complex activities and proton leak were measured by high-resolution respirometry in permeabilized cardiac fibers. Titration experiments using the fatty acid intermediates of Intralipid® palmitoyl-, oleoyl- and linoleoylcarnitine served to determine concentration-dependent inhibition of complex IV activity and mitochondrial ROS release. RESULTS Intralipid® enhanced postischemic recovery and activated Akt and Erk1/2, effects that were abolished by the ROS scavenger N-(2-mercaptopropionyl)glycine. Palmitoylcarnitine and linoleoylcarnitine, but not oleoylcarnitine concentration-dependently inhibited complex IV. Only palmitoylcarnitine reached high tissue concentrations during early reperfusion and generated significant ROS by complex IV inhibition. Palmitoylcarnitine (1 µM), administered at reperfusion, also fully mimicked Intralipid®-mediated protection in an N-(2-mercaptopropionyl)-glycine -dependent manner. CONCLUSIONS Our data describe a new mechanism of postconditioning cardioprotection by the clinically available fat emulsion, Intralipid®. Protection is elicited by the fatty acid intermediate palmitoylcarnitine, and involves inhibition of complex IV, an increase in ROS production and activation of the RISK pathway.
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Affiliation(s)
- Phing-How Lou
- Postdoctoral Fellow, Cardiovascular Research Centre, University of Alberta, Edmonton, AB, Canada
| | - Eliana Lucchinetti
- Research Associate, Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - Liyan Zhang
- Research Associate, Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - Andreas Affolter
- Research Associate, Department of Clinical Chemistry, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Marcus C. Schaub
- Professor, Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Manoj Gandhi
- Research Associate, Department of Pharmacology, University of Alberta, Edmonton, AB, Canada
| | - Martin Hersberger
- Head of the Department of Clinical Chemistry, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Blair E. Warren
- Undergraduate student, Campus Saint-Jean, University of Alberta, Edmonton, AB, Canada
| | - Hélène Lemieux
- Assistant Professor, Campus Saint-Jean, University of Alberta, Edmonton, AB, Canada
| | - Hany F. Sobhi
- Assistant Professor and Director of Coppin Center for Organic Synthesis, Coppin State University, Baltimore, Maryland, United States of America
| | | | - Michael Zaugg
- Professor, Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, AB, Canada
- * E-mail:
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Ischemia-reperfusion injury and volatile anesthetics. BIOMED RESEARCH INTERNATIONAL 2014; 2014:526301. [PMID: 24524079 PMCID: PMC3909964 DOI: 10.1155/2014/526301] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/18/2013] [Indexed: 01/06/2023]
Abstract
Ischemia-reperfusion injury (IRI) is induced as a result of reentry of the blood and oxygen to ischemic tissue. Antioxidant and some other drugs have protective effect on IRI. In many surgeries and clinical conditions IRI is counteract inevitable. Some anesthetic agents may have a protective role in this procedure. It is known that inhalational anesthetics possess protective effects against IRI. In this review the mechanism of preventive effects of volatile anesthetics and different ischemia-reperfusion models are discussed.
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van den Brom CE, Bulte CS, Loer SA, Bouwman RA, Boer C. Diabetes, perioperative ischaemia and volatile anaesthetics: consequences of derangements in myocardial substrate metabolism. Cardiovasc Diabetol 2013; 12:42. [PMID: 23452502 PMCID: PMC3599199 DOI: 10.1186/1475-2840-12-42] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/21/2013] [Indexed: 12/18/2022] Open
Abstract
Volatile anaesthetics exert protective effects on the heart against perioperative ischaemic injury. However, there is growing evidence that these cardioprotective properties are reduced in case of type 2 diabetes mellitus. A strong predictor of postoperative cardiac function is myocardial substrate metabolism. In the type 2 diabetic heart, substrate metabolism is shifted from glucose utilisation to fatty acid oxidation, resulting in metabolic inflexibility and cardiac dysfunction. The ischaemic heart also loses its metabolic flexibility and can switch to glucose or fatty acid oxidation as its preferential state, which may deteriorate cardiac function even further in case of type 2 diabetes mellitus.Recent experimental studies suggest that the cardioprotective properties of volatile anaesthetics partly rely on changing myocardial substrate metabolism. Interventions that target at restoration of metabolic derangements, like lifestyle and pharmacological interventions, may therefore be an interesting candidate to reduce perioperative complications. This review will focus on the current knowledge regarding myocardial substrate metabolism during volatile anaesthesia in the obese and type 2 diabetic heart during perioperative ischaemia.
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Affiliation(s)
- Charissa E van den Brom
- Department of Anesthesiology, Experimental Laboratory for VItal Signs, VU University Medical Center, De Boelelaan 1117, Amsterdam, the Netherlands.
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Lou PH, Zhang L, Lucchinetti E, Heck M, Affolter A, Gandhi M, Kienesberger PC, Hersberger M, Clanachan AS, Zaugg M. Infarct-remodelled hearts with limited oxidative capacity boost fatty acid oxidation after conditioning against ischaemia/reperfusion injury. Cardiovasc Res 2012; 97:251-61. [PMID: 23097573 DOI: 10.1093/cvr/cvs323] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIMS Infarct-remodelled hearts are less amenable to protection against ischaemia/reperfusion. Understanding preservation of energy metabolism in diseased vs. healthy hearts may help to develop anti-ischaemic strategies effective also in jeopardized myocardium. METHODS AND RESULTS Isolated infarct-remodelled/sham Sprague-Dawley rat hearts were perfused in the working mode and subjected to 15 min of ischaemia and 30 min of reperfusion. Protection of post-ischaemic ventricular work was achieved by pharmacological conditioning with sevoflurane. Oxidative metabolism was measured by substrate flux in fatty acid and glucose oxidation using [(3)H]palmitate and [(14)C]glucose. Mitochondrial oxygen consumption was measured in saponin-permeabilized left ventricular muscle fibres. Activity assays of citric acid synthase, hydroxyacyl-CoA dehydrogenase, and pyruvate dehydrogenase and mass spectrometry for acylcarnitine profiling were also performed. Six weeks after coronary artery ligation, the hearts exhibited macroscopic and molecular signs of hypertrophy consistent with remodelling and limited respiratory chain and citric acid cycle capacity. Unprotected remodelled hearts showed a marked decline in palmitate oxidation and acetyl-CoA energy production after ischaemia/reperfusion, which normalized in sevoflurane-protected remodelled hearts. Protected remodelled hearts also showed higher β-oxidation flux as determined by increased oxygen consumption with palmitoylcarnitine/malate in isolated fibres and a lower ratio of C16:1+C16OH/C14 carnitine species, indicative of a higher long-chain hydroxyacyl-CoA dehydrogenase activity. Remodelled hearts exhibited higher PPARα-PGC-1α but defective HIF-1α signalling, and conditioning enabled them to mobilize fatty acids from endogenous triglyceride stores, which closely correlated with improved recovery. CONCLUSIONS Protected infarct-remodelled hearts secure post-ischaemic energy production by activation of β-oxidation and mobilization of fatty acids from endogenous triglyceride stores.
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Affiliation(s)
- Phing-How Lou
- Cardiovascular Research Centre, University of Alberta, Edmonton, Canada
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Kojima A, Kitagawa H, Omatsu-Kanbe M, Matsuura H, Nosaka S. Presence of store-operated Ca2+ entry in C57BL/6J mouse ventricular myocytes and its suppression by sevoflurane. Br J Anaesth 2012; 109:352-60. [PMID: 22777657 DOI: 10.1093/bja/aes212] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Store-operated Ca(2+) entry (SOCE) has been implicated in various pathological conditions of the heart including ischaemia/reperfusion and ventricular hypertrophy. This study investigated the effects of sevoflurane on SOCE. METHODS Fluorescence imaging was performed on fluo-3- and mag-fluo-4-loaded mouse ventricular myocytes to measure the cytosolic and intraluminal sarcoplasmic reticulum (SR) Ca(2+) levels, respectively, using a confocal laser scanning microscope. Whole-cell membrane currents were recorded using the patch-clamp technique. Ventricular myocytes were exposed to thapsigargin and angiotensin II to deplete SR Ca(2+) stores and thereby activate SOCE. RESULTS The combined application of thapsigargin and angiotensin II to the Ca(2+)-free medium evoked a significant decrease in the SR Ca(2+) levels, which was followed by the elevation of cytosolic Ca(2+) and the development of cellular hypercontracture upon subsequent addition of extracellular Ca(2+). This cytosolic Ca(2+) elevation was inhibited by 2-aminoethoxydiphenyl borate but not by verapamil and KB-R7943, which indicates that SOCE was present in mouse ventricular myocytes. Sevoflurane concentration-dependently inhibited the SOCE-mediated Ca(2+) overload (IC(50) of 137 μM, which corresponds to 0.96%) with a significant reduction occurring at concentrations of ≥2%. Patch-clamp experiments revealed that the SOCE current was also concentration-dependently blocked by sevoflurane (IC(50) of 144 μM, which corresponds to 1.0%). CONCLUSIONS Sevoflurane at concentrations of ≥2% significantly inhibits the SOCE activity and prevents the resultant cellular Ca(2+) overload that leads to hypercontracture in ventricular myocytes. This inhibitory action may be involved in the cardioprotective effect of sevoflurane against Ca(2+) overload-mediated injury.
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Affiliation(s)
- A Kojima
- Department of Anesthesiology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
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The effect of sevoflurane postconditioning on cardioprotection against ischemia-reperfusion injury in rabbits. Mol Biol Rep 2012; 39:6049-57. [DOI: 10.1007/s11033-011-1419-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 12/19/2011] [Indexed: 10/14/2022]
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