首页|脓毒症大鼠血小板受体CD62P的表达及替格瑞洛的心脏保护作用

脓毒症大鼠血小板受体CD62P的表达及替格瑞洛的心脏保护作用

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目的 探讨脓毒症大鼠血小板受体CD62P表达情况以及替格瑞洛的抗炎作用及其对脓毒症大鼠心肌损伤的保护作用.方法 采用SD雄性大鼠32只,以随机数字表法将大鼠分为4组:假手术组(sham)、脓毒症组(cecal ligation and puncture,CLP)、低剂量给药组(low dose,LD):给药剂量为10 mg/kg、高剂量给药组(high dose,HD):给药剂量为50 mg/kg,每组8只.假手术组大鼠仅进行开关腹并剥离盲肠处理,脓毒症组、低剂量给药组和高剂量给药组的大鼠采用CLP法构建脓毒症大鼠模型,给药组分别按照10 mg/kg及50 mg/kg用量进行替格瑞洛灌胃给药,假手术组及脓毒症组则按照1 mL/kg进行生理盐水灌胃处理.分别于手术前12 h及手术后12 h两次对大鼠进行灌胃给药.各组大鼠造模后24 h经腹主动脉取血并采集病理标本.应用流式细胞术检测各组大鼠血小板表面受体CD62P的表达情况;采用酶联免疫吸附试验(ELISA)法检测IL-6、TNF-α水平;检测心肌损伤标志物:CKMB、LDH水平;并检测转氨酶、肌酐、白细胞水平;对心肌组织进行HE染色观察病理形态;通过TUNEL法观察心肌细胞凋亡情况.结果 ①流式结果可见与sham组相比,CLP组的CD62P表达水平明显增加(P<0.01),两组给药组与CLP组相比CD62P的表达水平均明显降低,HD组更为显著(P<0.01).②ELISA结果显示与sham组相比CLP组的IL-6、TNF-α水平显著升高(P<0.01),HD组较CLP组显著降低(P<0.05),LD组IL-6水平下降不明显.CLP组的TNF-α水平与sham组相比明显升高(P<0.01).③CLP组和两组替格瑞洛干预组与sham组相比,CKMB和LDH的表达水平均有显著增加(P<0.01),给药组与CLP组相比CKMB、LDH均有明显下降(P<0.05),HD组下降更明显(P<0.01).;④与sham组相比,CLP组大鼠血WBC,ALT,CR值升高明显,而使用替格瑞洛进行干预后,大鼠的WBC、ALT、CR值下降明显(P<0.05),且差异与剂量明显相关.⑤病理结果显示:sham组心肌细胞形态正常,CLP组心肌细胞损伤最重,LD组及HD组心肌细胞损伤较CLP组明显减轻.⑥Tunel染色显示与Sham组可见的少量阳性细胞比较,CLP组可见大量被染色的阳性细胞,LD组和HD组心肌细胞凋亡与CLP组相比明显减少.结论 脓毒症激活血小板,刺激CD62P的过度表达,进而诱导炎症反应的过度激活,引起心肌细胞的凋亡和损伤,导致脓毒性心肌损伤;替格瑞洛的心脏保护作用可能与抑制血小板活化后CD62P表达的减少有关,且CD62P的表达与替格瑞洛之间存在剂量依赖关系.
Expression of platelet receptor CD62P in septic rats and the cardioprotective effect of ticagrelor
Objective To investigate the expression of platelet receptor CD62P in septic rats and the anti-inflammatory effect of ticagrelor and its protective effect on myocardial injury in septic rats.Methods Thirty-two male SD rats were randomly(random number)divided into 4 groups:sham group,cecal ligation and puncture group(CLP),low dose group:the dose of 10 mg/kg,high dose group:the dose was 50 mg/kg,8 rats in each group.The rats in the sham operation group were only treated with abdominal switch and cecum stripping,and the rats in the sepsis group,the low dose group and the high dose group were treated with CLP method to establish the sepsis model.The rats in the ticagrelor administration group were treated with ticagrelor at a dose of 10 mg/kg and 50mg/kg by gavage,respectively.The sham operation group and the sepsis group were treated with normal saline(1 mL/kg)by gavage.The rats were administrated twice by gavage 12 hours before and 12 hours after surgery.Blood samples were collected from the abdominal aorta 24 hours after modeling and then pathological specimens were collected.The expression of platelet surface receptor CD62P was detected by flow cytometry.The levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay(ELISA).The levels of myocardial injury markers including CKMB and LDH were detected.The levels of transaminase,creatinine and white blood cell were detected.HE staining was used to observe the pathological morphology of myocardial tissue.Cardiomyocyte apoptosis was observed by TUNEL assay.Results ① Compared with sham group,the expression of CD62P in CLP group significantly increased(P<0.01).Compared with the CLP group,the expression levels of CD62P in the two treatment groups significantly decreased,and the HD group was more significant(P<0.01).②ELISA results showed that compared with sham group,the level of IL-6 in CLP group was significantly increased(P<0.05).Compared with the CLP group,the HD group significantly decreased(P<0.05).There was no significant decrease in IL-6 level in the LD group.The level of TNF-α in CLP group was significantly higher than that in sham group(P<0.01).③Compared with sham group,the expression levels of CKMB and LDH in CLP group and two ticagrelor intervention groups significantly increased(P<0.01).Compared with the CLP group,CKMB and LDH in the treatment group significantly decreased(P<0.05),and the HD group decreased more significantly(P<0.01).④Compared with sham group,WBC,ALT,CR values in CLP group significantly increased,while after the intervention with ticagrelor,WBC,ALT,CR values in rats significantly decreased(P<0.05),and the difference significantly related to the dose.⑤ The pathological results showed that the morphology of myocardial cells in sham group was normal.The CLP group most myocardial cell injury.LD and HD group the CLP group obviously reduce myocardial cell injury.⑥Tunel staining showed that compared with a small number of positive cells in Sham group,a large number of positive cells were stained in CLP group.The apoptosis of myocardial cells in LD and HD groups significantly reduced compared with CLP group.Conclusions Sepsis activates platelets and stimulates the overexpression of CD62P,which induces excessive activation of inflammatory response,induces apoptosis and damage of cardiomyocytes,and leads to septic myocardial injury.The cardioprotective effect of ticagrelor may be related to the inhibition of the reduction of CD62p expression after platelet activation,and the expression level of CD62p has a dose-dependent relationship with ticagrelor.

SepsisCD62PP selectionTicagrelorMyocardial injuryBlood plateletsPlatelet receptorSepsis-induced cardiomyopathy

郭沛雨、郭飞、黄海、单亮

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青岛大学附属医院重症医学科,青岛 266061

青岛大学医学部,青岛 266061

脓毒症 CD62P P选择素 替格瑞洛 心肌损伤 血小板 血小板受体 脓毒性心肌病

山东省自然科学基金青岛大学附属医院临床医学+X项目

ZR2021MH093

2024

中华急诊医学杂志
中华医学会

中华急诊医学杂志

CSTPCD北大核心
影响因子:1.556
ISSN:1671-0282
年,卷(期):2024.33(2)
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