Article(id=1322922806249390967, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.02.023, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793338975727, onlineDateStr=2026-10-30, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793338975727, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793338975727, creator=13701087609, updateTime=1793338975727, updator=13701087609, issue=Issue{id=1322922680609014711, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='2', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793338945772, creator='13701087609', updateTime=1793340618065, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929694785536732, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929694785536733, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322922680609014711, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=100, endPage=104, ext={EN=ArticleExt(id=1322922806459106168, articleId=1322922806249390967, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Electroacupuncture Preconditioning Regulates NLRP3/TRIF/Beclin 1 Signaling Pathway to Improve Myocardial Ischemia-Reperfusion Injury in Rats, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the effects of electroacupuncture(EA)preconditioning on cardiac function,myocardial injury related indexes and autophagy level in rats with myocardial ischemia-reperfusion injury(MIRI),and to explore the possible mechanism of electroacupuncture preconditioning in improving MIRI.

Methods

Sixty male SD rats were randomly divided into five groups:sham operation group,model group,EA group,EA+saline group and EA+agonist group,with 12 rats in each group. The I/R model was established by ligation of left anterior descending coronary artery for 30 min and reperfusion for 4 h in rats. The EA group,EA+saline group and EA+agonist group were treated with EA intervention at Neiguan(PC6)for 20 min,once a day for successive4 days. In EA+agonist group,nigericin(1 mg/kg),an agonist of NLRP3 receptor,was injected intraperitoneally 30 min before each EA. In EA+saline group,saline was injected into abdominal cavity 30 min before each EA,and the dose was the same as that in agonist group. The echocardiography was used to observe left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)of rats 4 hours after modeling to evaluate cardiac function. Serum levels of IL-6 were de-tected by ELISA. HE staining was used to observe the myocardial tissue morphology of rats. The mRNA and protein expressions of NLRP3,Beclin 1,TRIF,Caspase-1,LC3 and IL-18 were detected by RT-qPCR and Western blot.

Results

Compared with those of the sham operation group,the values of LVEF and LVFSin the model group were significantly decreased(P<0.05),and the myocardial fibers were disordered,with vague structure and large inflammatory infiltration. The level of IL-6 and the contents of NLRP3,TRIF,Beclin 1,LC3 mRNA and protein in the myocardial tissue were all increased(P<0.05). Compared with those of the model group,the myocardial fiber breakage was reduced and a small amount of inflammatory cells infiltrated. In the EA group,the values of LVEF and LVFSwere significantly increased(P<0.05),the level of IL-6 and the expressions of NLRP3 mRNA and protein in myocardial tissue were all decreased(P<0.05),while the contents of TRIF,Beclin 1 and LC3 mRNA and protein were all increased(P<0.05). Compared with those of the EA group,the levels of IL-6 and the contents of NLRP3,TRIF,Beclin 1,LC3 mRNA and protein and the values of LVEF and LVFSin the EA+saline group had no obvious changes(P>0.05). In the EA+agonist group,the myocardial structure of rats was abnormal,with obvious tissue fibrosis and inflammatory infiltration,and the values of LVEF and LVFSin rats were obviously decreased(P<0.05). The level of IL-6 and the expressions of NLRP3 mRNA and protein in myocardial tissue decreased(P<0.05),while the contents of TRIF,Beclin 1 and LC3 mRNA and protein increased(P<0.05).

Conclusion

EA preconditioning can alleviate myocardial injury in I/R rats by regulating autophagy level,and its mechanism may be related to activating NLRP3/TRIF/Beclin 1 signal pathway.

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目的

观察电针预处理对心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MIRI)大鼠心功能、心肌损伤相关指标及自噬水平的影响,探讨电针预处理改善心肌缺血再灌注损伤的可能机制,进一步发挥中医“治未病”思想指导临床实践的优势。

方法

将60只雄性SD大鼠随机分为5组:假手术组、模型组、电针组、电针+生理盐水组、电针+激动剂组,每组12只。大鼠结扎左冠状动脉前降支30 min再灌注4 h建立I/R模型。电针组、电针+生理盐水组、电针+激动剂组于“内关”行电针干预,每次20 min,1次/d,连续4 d;电针+激动剂组在每次电针前30 min于腹腔注射NLRP3受体激动剂尼日利亚菌素钠盐Nigericin(1 mg/kg);电针+生理盐水组在每次电针前30 min于腹腔注射生理盐水,剂量同激动剂组。采用超声心动图观察造模后4h后大鼠左心室射血分数(left ventricular ejection fraction,LVEF)、左心室短轴缩短率(left ventricular fractional shortening,LVFS)评估心功能;ELISA法检测血清中炎性因子白细胞介素-6(IL-6)水平;苏木素-伊红(HE)染色法观察大鼠心肌组织形态;实时荧光定量PCR(RT-qPCR)和Western blot法检测NLRP3、Beclin 1、TRIF、Caspase-1、LC3、IL-18 mRNA和蛋白表达。

结果

与假手术组相比,模型组大鼠LVEF、LVFS值明显降低(P<0.05),心肌纤维排列紊乱、结构模糊、有大片炎性浸润,心肌组织中IL-6水平及NLRP3、TRIF、Beclin 1、LC3 mRNA和蛋白等指标含量均升高(P<0.05);与模型组相比,电针组大鼠LVEF、LVFS明显升高(P<0.05),心肌纤维断裂减轻,少量炎性细胞浸润,心肌组织中IL-6水平、NLRP3 mRNA及蛋白表达均降低(P<0.05),TRIF、Beclin 1、LC3 mRNA和蛋白含量均升高(P<0.05);与电针组相比,电针+生理盐水组LVEF、LVFS及心肌组织中IL-6水平及NLRP3、TRIF、Beclin 1、LC3 mRNA和蛋白含量均无明显变化(P>0.05),而电针+激动剂组大鼠LVEF、LVFS明显降低(P<0.05),心肌结构异常,有明显的组织纤维化和炎性浸润,心肌组织中IL-6水平、NLRP3 mRNA及蛋白表达均升高(P<0.05),TRIF、Beclin 1、LC3 mRNA和蛋白含量均降低(P<0.05)。

结论

电针预处理可通过调控自噬水平减轻I/R大鼠心肌损伤,其机制可能与NLRP3/TRIF/Beclin 1信号通路有关,对中医疗法防治心肌缺血再灌注损伤有一定指导意义。

, authors=贺丽丽, 姜春宏, 刘顺畅, 白桦, 顾一煌, 李开平, authorsList=贺丽丽, 姜春宏, 刘顺畅, 白桦, 顾一煌, 李开平, authorCompany=null, correspAuthors=李开平, authorNote=

贺丽丽(1999-),女,陕西商洛人,医师,硕士,研究方向:中医养生治未病的基础与研究。

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李开平(1967-),男,安徽马鞍山人,副教授,硕士研究生导师,博士,研究方向:中医养生治未病的基础与研究。E-mail:。
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贺丽丽(1999-),女,陕西商洛人,医师,硕士,研究方向:中医养生治未病的基础与研究。

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贺丽丽(1999-),女,陕西商洛人,医师,硕士,研究方向:中医养生治未病的基础与研究。

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Bioorg Chem,2022,127:105971., articleTitle=Dehydromevalonolactone ameliorates liver fibrosis and inflammation by repressing activation of NLRP3 inflammasome, refAbstract=null)], funds=[Fund(id=1322922816181502909, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, awardId=81974583, language=CN, fundingSource=国家自然科学基金面上项目(81974583), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322922809730663302, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, xref=null, ext=[AuthorCompanyExt(id=1322922809739051911, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, companyId=1322922809730663302, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu,China), AuthorCompanyExt(id=1322922809751634824, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, companyId=1322922809730663302, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=南京中医药大学,江苏 南京 210000)])], figs=[ArticleFig(id=1322922814881268657, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=ankyC8Yhx8ESOE86+aczKg==, figureFileBig=54dbVcpZh7RRdXaSCnFopw==, tableContent=null), ArticleFig(id=1322922814969349042, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=图1, caption=各组大鼠超声心动图LVEF、LVFS比较(n=6)

注:*与假手术组比较,P<0.05;**与假手术组比较,P<0.01;#与模型组比较,P<0.05;##与模型组比较,P<0.01;▲与电针组比较,P<0.05;▲▲与电针组比较,P<0.01。

, figureFileSmall=ankyC8Yhx8ESOE86+aczKg==, figureFileBig=54dbVcpZh7RRdXaSCnFopw==, tableContent=null), ArticleFig(id=1322922815229395891, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=OZRb8PYwUEVjb3/EwQ/NIQ==, figureFileBig=OM74BRLCkY1j0j41Q6hZfg==, tableContent=null), ArticleFig(id=1322922815300699060, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=图2, caption=各组大鼠心肌组织病理变化(n=5), figureFileSmall=OZRb8PYwUEVjb3/EwQ/NIQ==, figureFileBig=OM74BRLCkY1j0j41Q6hZfg==, tableContent=null), ArticleFig(id=1322922815531385781, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=wJQvT4Meu93VFP2mzzz8zw==, figureFileBig=jmr7OIrZmhjzZXrke9g1fA==, tableContent=null), ArticleFig(id=1322922815590106038, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=图3, caption=各组大鼠心肌组织IL-6水平比较(n=5)

注:*与假手术组比较,P<0.05;**与假手术组比较,P<0.01;#与模型组比较,P<0.05;##与模型组比较,P<0.01;▲与电针组比较,P<0.05;▲▲与电针组比较,P<0.01。

, figureFileSmall=wJQvT4Meu93VFP2mzzz8zw==, figureFileBig=jmr7OIrZmhjzZXrke9g1fA==, tableContent=null), ArticleFig(id=1322922815673992119, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=WmGnUMKlPXRXvSDyRruCSQ==, figureFileBig=Kj3+4bUAw6sgznlHBE9Nsg==, tableContent=null), ArticleFig(id=1322922815766266808, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=图4, caption=各组大鼠心肌组织NLRP3、Beclin 1、Caspase-1、LC3、IL-18 mRNA表达比较(n=3)

注:*与假手术组比较,P<0.05;**与假手术组比较,P<0.01;#与模型组比较,P<0.05;##与模型组比较,P<0.01;▲与电针组比较,P<0.05;▲▲与电针组比较,P<0.01。

, figureFileSmall=WmGnUMKlPXRXvSDyRruCSQ==, figureFileBig=Kj3+4bUAw6sgznlHBE9Nsg==, tableContent=null), ArticleFig(id=1322922815892095929, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=5QbIleSD9e/UvcZtS8xWFQ==, figureFileBig=+NqZpsxXnxOqPbM5d/D3Hw==, tableContent=null), ArticleFig(id=1322922815955010490, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=图5, caption=各组大鼠心肌组织NLRP3、TRIF、Beclin 1、LC3蛋白表达比较(n=3)

注:*与假手术组比较,P<0.05;**与假手术组比较,P<0.01;#与模型组比较,P<0.05;##与模型组比较,P<0.01;▲与电针组比较,P<0.05;▲▲与电针组比较,P<0.01。

, figureFileSmall=5QbIleSD9e/UvcZtS8xWFQ==, figureFileBig=+NqZpsxXnxOqPbM5d/D3Hw==, tableContent=null), ArticleFig(id=1322922816009536443, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
基因名称引物序列(5-3)
NLRP3F:TGTTGTCAGGATCTCGCA
R:AGTGAAGTAAGGCCGGAAT
Beclin 1F:GGCGGCTCCTATTCCATCAA
R:TGAGGACACCCAAGCAAGAC
Caspase-1F:CAGATGCCAACCACTGAA
R:CATGATTCCCAACACAGGT
LC3F:TCCAAAAGGCTCTGGCT
R:GCTGAATCCTGGGGTGT
IL-18F:AACGAATCCCAGACCAGAC
R:AGAGGGTAGACATCCTTCCAT
GAPDHF:GTTACCAGGGCTGCCTTCTC
R:GATGGTGATGGGTTTCCCGT
), ArticleFig(id=1322922816072451004, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322922806249390967, language=CN, label=表1, caption=

引物序列

, figureFileSmall=null, figureFileBig=null, tableContent=
基因名称引物序列(5-3)
NLRP3F:TGTTGTCAGGATCTCGCA
R:AGTGAAGTAAGGCCGGAAT
Beclin 1F:GGCGGCTCCTATTCCATCAA
R:TGAGGACACCCAAGCAAGAC
Caspase-1F:CAGATGCCAACCACTGAA
R:CATGATTCCCAACACAGGT
LC3F:TCCAAAAGGCTCTGGCT
R:GCTGAATCCTGGGGTGT
IL-18F:AACGAATCCCAGACCAGAC
R:AGAGGGTAGACATCCTTCCAT
GAPDHF:GTTACCAGGGCTGCCTTCTC
R:GATGGTGATGGGTTTCCCGT
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电针预处理调控NLRP3/TRIF/Beclin 1信号通路改善大鼠心肌缺血再灌注损伤
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贺丽丽 , 姜春宏 , 刘顺畅 , 白桦 , 顾一煌 , 李开平
中华中医药学刊 | 国家项目点击 2025,43(2): 100-104
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中华中医药学刊 |国家项目点击 2025 , 43 (2) : 100 -104
电针预处理调控NLRP3/TRIF/Beclin 1信号通路改善大鼠心肌缺血再灌注损伤
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贺丽丽, 姜春宏, 刘顺畅, 白桦, 顾一煌, 李开平
作者信息
  • 南京中医药大学,江苏 南京 210000
通讯作者:
李开平(1967-),男,安徽马鞍山人,副教授,硕士研究生导师,博士,研究方向:中医养生治未病的基础与研究。E-mail:。
作者简介:

贺丽丽(1999-),女,陕西商洛人,医师,硕士,研究方向:中医养生治未病的基础与研究。

Electroacupuncture Preconditioning Regulates NLRP3/TRIF/Beclin 1 Signaling Pathway to Improve Myocardial Ischemia-Reperfusion Injury in Rats
Lili HE, Chunhong JIANG, Shunchang LIU, Hua BAI, Yihuang GU, Kaiping LI
Affiliations
  • Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu,China
出版时间: 2025-02-10 doi: 10.13193/j.issn.1673-7717.2025.02.023
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目的

观察电针预处理对心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MIRI)大鼠心功能、心肌损伤相关指标及自噬水平的影响,探讨电针预处理改善心肌缺血再灌注损伤的可能机制,进一步发挥中医“治未病”思想指导临床实践的优势。

方法

将60只雄性SD大鼠随机分为5组:假手术组、模型组、电针组、电针+生理盐水组、电针+激动剂组,每组12只。大鼠结扎左冠状动脉前降支30 min再灌注4 h建立I/R模型。电针组、电针+生理盐水组、电针+激动剂组于“内关”行电针干预,每次20 min,1次/d,连续4 d;电针+激动剂组在每次电针前30 min于腹腔注射NLRP3受体激动剂尼日利亚菌素钠盐Nigericin(1 mg/kg);电针+生理盐水组在每次电针前30 min于腹腔注射生理盐水,剂量同激动剂组。采用超声心动图观察造模后4h后大鼠左心室射血分数(left ventricular ejection fraction,LVEF)、左心室短轴缩短率(left ventricular fractional shortening,LVFS)评估心功能;ELISA法检测血清中炎性因子白细胞介素-6(IL-6)水平;苏木素-伊红(HE)染色法观察大鼠心肌组织形态;实时荧光定量PCR(RT-qPCR)和Western blot法检测NLRP3、Beclin 1、TRIF、Caspase-1、LC3、IL-18 mRNA和蛋白表达。

结果

与假手术组相比,模型组大鼠LVEF、LVFS值明显降低(P<0.05),心肌纤维排列紊乱、结构模糊、有大片炎性浸润,心肌组织中IL-6水平及NLRP3、TRIF、Beclin 1、LC3 mRNA和蛋白等指标含量均升高(P<0.05);与模型组相比,电针组大鼠LVEF、LVFS明显升高(P<0.05),心肌纤维断裂减轻,少量炎性细胞浸润,心肌组织中IL-6水平、NLRP3 mRNA及蛋白表达均降低(P<0.05),TRIF、Beclin 1、LC3 mRNA和蛋白含量均升高(P<0.05);与电针组相比,电针+生理盐水组LVEF、LVFS及心肌组织中IL-6水平及NLRP3、TRIF、Beclin 1、LC3 mRNA和蛋白含量均无明显变化(P>0.05),而电针+激动剂组大鼠LVEF、LVFS明显降低(P<0.05),心肌结构异常,有明显的组织纤维化和炎性浸润,心肌组织中IL-6水平、NLRP3 mRNA及蛋白表达均升高(P<0.05),TRIF、Beclin 1、LC3 mRNA和蛋白含量均降低(P<0.05)。

结论

电针预处理可通过调控自噬水平减轻I/R大鼠心肌损伤,其机制可能与NLRP3/TRIF/Beclin 1信号通路有关,对中医疗法防治心肌缺血再灌注损伤有一定指导意义。

电针预处理  /  心肌缺血再灌注损伤  /  自噬  /  NLRP3  /  Beclin 1
Objective

To observe the effects of electroacupuncture(EA)preconditioning on cardiac function,myocardial injury related indexes and autophagy level in rats with myocardial ischemia-reperfusion injury(MIRI),and to explore the possible mechanism of electroacupuncture preconditioning in improving MIRI.

Methods

Sixty male SD rats were randomly divided into five groups:sham operation group,model group,EA group,EA+saline group and EA+agonist group,with 12 rats in each group. The I/R model was established by ligation of left anterior descending coronary artery for 30 min and reperfusion for 4 h in rats. The EA group,EA+saline group and EA+agonist group were treated with EA intervention at Neiguan(PC6)for 20 min,once a day for successive4 days. In EA+agonist group,nigericin(1 mg/kg),an agonist of NLRP3 receptor,was injected intraperitoneally 30 min before each EA. In EA+saline group,saline was injected into abdominal cavity 30 min before each EA,and the dose was the same as that in agonist group. The echocardiography was used to observe left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)of rats 4 hours after modeling to evaluate cardiac function. Serum levels of IL-6 were de-tected by ELISA. HE staining was used to observe the myocardial tissue morphology of rats. The mRNA and protein expressions of NLRP3,Beclin 1,TRIF,Caspase-1,LC3 and IL-18 were detected by RT-qPCR and Western blot.

Results

Compared with those of the sham operation group,the values of LVEF and LVFSin the model group were significantly decreased(P<0.05),and the myocardial fibers were disordered,with vague structure and large inflammatory infiltration. The level of IL-6 and the contents of NLRP3,TRIF,Beclin 1,LC3 mRNA and protein in the myocardial tissue were all increased(P<0.05). Compared with those of the model group,the myocardial fiber breakage was reduced and a small amount of inflammatory cells infiltrated. In the EA group,the values of LVEF and LVFSwere significantly increased(P<0.05),the level of IL-6 and the expressions of NLRP3 mRNA and protein in myocardial tissue were all decreased(P<0.05),while the contents of TRIF,Beclin 1 and LC3 mRNA and protein were all increased(P<0.05). Compared with those of the EA group,the levels of IL-6 and the contents of NLRP3,TRIF,Beclin 1,LC3 mRNA and protein and the values of LVEF and LVFSin the EA+saline group had no obvious changes(P>0.05). In the EA+agonist group,the myocardial structure of rats was abnormal,with obvious tissue fibrosis and inflammatory infiltration,and the values of LVEF and LVFSin rats were obviously decreased(P<0.05). The level of IL-6 and the expressions of NLRP3 mRNA and protein in myocardial tissue decreased(P<0.05),while the contents of TRIF,Beclin 1 and LC3 mRNA and protein increased(P<0.05).

Conclusion

EA preconditioning can alleviate myocardial injury in I/R rats by regulating autophagy level,and its mechanism may be related to activating NLRP3/TRIF/Beclin 1 signal pathway.

electroacupuncture pretreatment  /  myocardial ischemia-reperfusion injury  /  autophagy  /  NLRP3  /  Beclin 1
贺丽丽, 姜春宏, 刘顺畅, 白桦, 顾一煌, 李开平. 电针预处理调控NLRP3/TRIF/Beclin 1信号通路改善大鼠心肌缺血再灌注损伤. 中华中医药学刊, 2025 , 43 (2) : 100 -104 . DOI: 10.13193/j.issn.1673-7717.2025.02.023
Lili HE, Chunhong JIANG, Shunchang LIU, Hua BAI, Yihuang GU, Kaiping LI. Electroacupuncture Preconditioning Regulates NLRP3/TRIF/Beclin 1 Signaling Pathway to Improve Myocardial Ischemia-Reperfusion Injury in Rats[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (2) : 100 -104 . DOI: 10.13193/j.issn.1673-7717.2025.02.023
急性心肌梗死(acute myocardial infarction,AMI)是世界范围内心血管疾病的主要死亡原因之一[1]。目前,临床上最有效的治疗策略是通过经皮冠状动脉介入治疗或者溶栓疗法以重建血运,但再灌注会对心肌造成巨大损伤,即心肌缺血再灌注损伤(myocardial ischemia-reperfusion injury,MIRI)[2]。MIRI发生的主要病理机制多且复杂,主要有自噬、氧化应激、炎症、凋亡和线粒体功能障碍等因素[3],其中自噬途径至关重要。自噬在MIRI中具有双面作用,适度活化的自噬可以清除或再次利用缺血缺氧后受损的细胞器,但若过度激活,可能会引发细胞凋亡,从而加剧细胞损伤[4]。因此心肌再灌注期间适度激活自噬可能成为减轻细胞损伤潜在的治疗靶点。课题组前期研究显示,针灸可上调缺血期自噬水平而抑制再灌注期的自噬水平,但具体机制仍需进一步探讨。
有研究显示,炎症在调控自噬水平中发挥重要作用。NLRP3炎症小体是目前NOD样受体家族研究最成熟的一员,含TIR结构域的转接蛋白(TIR-domain-contains adapteror protein include IFN-β,TRIF)是触发自噬反应的重要蛋白之一[5-6]。NLRP3/TRIF/Beclin 1信号通路是调控细胞自噬水平的重要通路之一,在维持细胞稳态中发挥着重要作用[7]。本研究通过建立I/R大鼠模型,探讨电针预处理通过NLRP3/TRIF/Beclin 1信号通路对I/R大鼠心肌自噬水平的调控作用及心肌损伤的保护作用,以期为临床治疗I/R心肌损伤提供一定参考。
清洁级雄性SD大鼠60只,购自上海必凯科翼生物科技有限公司,体质量(240±10)g,生产许可证号:SCXK(沪)2018-0006,饲养于南京中医药大学SPF级实验动物中心,昼夜节律为12 h光照/12 h黑暗,自由饮食,室温(25±2)℃,湿度(50±5)%,适应性饲养1周。按照随机数字表法将其分为假手术组、模型组、电针组、电针加生理盐水组、电针加激动剂组,每组12只。实验过程中对动物的处置符合《关于善待实验动物的指导性意见》中相关规定。
主要仪器:小动物呼吸机、异氟烷麻醉机(深圳市瑞沃德生命科技有限公司);MYLAB多普勒超声仪(意大利ESAOTE);显微镜(日本OLYMPUS);病理切片机(德国LEICA);电泳仪、电泳槽(美国BIO-RAD);电子天平(瑞士METTERAE100);韩氏电针仪(南京济生医疗科技有限公司);华佗牌一次性不锈钢针灸针(苏州医疗用品厂有限公司);实时荧光定量PCR仪(美国StrataGene公司),高速离心机(德国Eppendorf公司),酶标仪(美国BIOTEK),化学发光成像系统(上海天能),PowerPac电泳仪(美国Bio-rad)。
主要试剂:异氟烷(深圳市瑞沃德生命科技有限公司),RIPA裂解液(上海碧云天生物技术有限公司),BCA蛋白定量试剂盒(上海碧云天生物技术有限公司),NLRP3抗体(武汉三鹰生物技术有限公司),Beclin 1抗体(武汉三鹰生物技术有限公司),TRIF抗体(武汉三鹰生物技术有限公司),LC3Ⅰ/Ⅱ抗体(武汉三鹰生物技术有限公司),NLRP3受体激动剂尼日利亚菌素钠盐(美国MedChemExpress公司)。
使用目前较为成熟的在体MIRI模型[8]:采用冠状动脉左前降支结扎法复制MIRI大鼠模型:5%异氟烷快速麻醉大鼠后,1%~2%的浓度维持,使其仰卧位于加热实验板[(37±3)℃]上,气管插管后接呼吸机机械通气(呼吸频率为65~70次/min,潮气量为1.0 mL/100 mg)。打开胸腔暴露心脏,用6-0的丝线将冠状动脉左前降支与一软管共同结扎,缺血30 min后剪开,行再灌注。逐层缝合,关闭胸腔,关闭呼吸机并拔掉气管插管,清除呼吸道分泌物。以结扎线下端心脏表面变紫绀或灰白为造模成功标志,心电图显示ST段弓背向上抬高为造模成功标志。假手术组仅穿线不结扎。
电针组:于造模前进行4 d的电针预处理,“内关”定位参照《实验针灸学》[9]大鼠穴位图谱。采用0.18 mm×13 mm一次性不锈钢毫针,双侧“内关”直刺2~3mm,接韩氏电针仪,采用疏密波,频率2 Hz/100 Hz,强度2 mA,电针20 min,1次/d,连续4 d,电针干预4 d结束后,第5天进行MIRI模型制备。
电针加激动剂组:在每次电针干预前30 min于腹腔注射NLRP3受体激动剂尼日利亚菌素钠盐(1 mg/kg)[10],大鼠麻醉及电针干预方法、时间同电针组,第5天进行MIRI模型制备。
电针加生理盐水组:给予与电针组相同浓度、时间的异氟烷维持麻醉和固定,在每次电针干预前30 min予生理盐水,剂量同激动剂组,大鼠麻醉及电针干预方法、时间同电针组,第5天进行MIRI模型制备。
假手术组、模型组常规饲养,予等时长和方式的抓取、固定。
超声心动检测大鼠心功能变化情况:大鼠麻醉后仰卧位固定于手术台,连接超声心动图机,测量大鼠左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(left ventricular fractional shortening,LVFS)。
ELISA法检测各组大鼠心肌组织白细胞介素-6(IL-6)含量:严格按照ELISA试剂盒使用说明进行标准品的制备、加样及孵育,经酶标仪测得吸光度值,依据样品标准曲线图计算各组大鼠心肌组织IL-6含量。
苏木素-伊红(HE)染色法观察大鼠心肌组织形态:心肌组织切片经二甲苯脱蜡,梯度乙醇水化,苏木素-伊红染色后,梯度乙醇脱水,二甲苯透明,中性树胶封片,在光学显微镜下观察记录大鼠心肌组织形态变化,并采集图像。
Western blot法测定梗死区心肌组织中NLRP3、TRIF、Beclin 1、LC3蛋白表达:根据蛋白提取试剂盒提取总蛋白并用BCA法将蛋白定量。然后将等量的蛋白质经SDS-聚丙烯酰胺凝胶电泳后电转移到PVDF膜上。然后加入一抗NLRP3(1∶2000),TRIF(1∶2000),Beclin 1(1∶2000),LC3(1∶2000),GAPDH(1∶5000),4℃孵育过夜。孵育结束后用TBST将膜清洗5次×5 min。加入二抗,摇床常温孵育2 h,TBST洗膜5次×5 min。化学发光试剂显影,以GAPDH蛋白作为内参。以条带灰度值作为蛋白表达量的定量标准,采用Image-J软件分析目的蛋白与内参蛋白条带灰度值的比值并得出相对表达量。
RT-qPCR法检测心肌组织中NLRP3、Beclin 1、Caspase-1、LC3、IL-18基因表达:取-80℃冻存的组织标本剪碎,将TRIzol试剂加入放有组织的试管中进行组织匀浆后加入200 μL氯仿快速震荡30s室温孵育离心,取水相,异丙醇沉淀,乙醇清洗,弃上清,晾干沉淀后溶解。用超微紫外可见分光光度计测定浓度和纯度,反转录后进行PCR扩增,以GAPDH作为内参对照。PCR引物序列见下表1。
数据使用SPSS 26.0软件分析,计量资料以均数±标准差()表示。当数据符合正态分布及方差齐性检验时,组间比较使用单因素方差分析,两两比较采用LSD法。以P≤0.05作为差异有统计学意义的标准。
再灌注4 h后心超结果显示,与假手术组比较,模型组LVEF、LVFS均降低(P<0.01)。与模型组比较,电针组、电针+生理盐水组LVEF、LVFS均升高(P<0.01)电针+激动剂组LVEF、LVFS均升高(P<0.01)。与电针组相比,电针+激动剂组LVEF、LVFS均降低(P<0.01),电针+生理盐水组LVEF、LVFS均升高,但差异无统计学意义(P>0.05)。见插页Ⅹ图1。
光镜下假手术组心肌结构正常,未见水肿、组织纤维化及炎性浸润;模型组心肌结构整体异常,心肌纤维排列紊乱,可见明显炎症细胞浸润;电针组、电针+生理盐水组心肌结构基本正常,未见明显心肌纤维肿胀断裂,少量炎症细胞浸润;电针+激动剂组心肌结构整体异常,心肌纤维排列紊乱,大量炎症细胞浸润。见插页Ⅺ图2。
再灌注4 h后,与假手术组相比,模型组IL-6水平显著升高(P<0.01)。与模型组比较,电针组、电针+生理盐水组IL-6水平均下降(P<0.01)。与电针组相比,电针+激动剂组IL-6水平降低(P<0.01)。见插页Ⅹ图3。
由插页Ⅻ图4可知,与假手术组比较,模型组大鼠心肌组织NLRP3、Beclin 1、Caspase-1、LC3、IL-18 mRNA表达均显著上升(P<0.05);与模型组比较,电针组心肌组织NLRP3、Caspase-1、IL-18 mRNA表达均明显下降(P<0.05),Beclin 1、LC3 mRNA表达均明显上升(P<0.05);与电针组相比,电针+生理盐水组心肌组织NLRP3、Beclin 1、Caspase-1、LC3、IL-18 mRNA表达差异无统计学意义(P>0.05),电针+激动剂组心肌组织NLRP3、Caspase-1、IL-18 mRNA表达明显上升(P<0.05),Beclin 1、LC3 mRNA表达明显下降(P<0.05)。
与假手术组比较,模型组大鼠心肌组织NLRP3、TRIF、Beclin 1、LC3蛋白表达均显著上升(P<0.05);与模型组比较,电针组心肌组织NLRP3蛋白表达明显下降(P<0.01),TRIF、Beclin 1、LC3蛋白表达均明显上升(P<0.01);与电针组相比,电针+生理盐水组心肌组织NLRP3、TRIF、Beclin 1、LC3蛋白表达无显著性差异(P>0.05),电针+激动剂组心肌组织NLRP3蛋白表达明显上升(P<0.05),TRIF、Beclin 1、LC3蛋白表达均明显下降(P<0.05)。见插页ⅩⅢ图5。
中医学中MIRI属“胸痹”“厥心痛”等范畴,其主要病机是心脉痹阻[11]。古代医家最多选用针刺疗法治疗心胸疾病。早在《灵枢》有云:“上工,刺其未生者也;其次,刺其未盛者也;其次,刺其已衰者也”。针刺预处理便是源于中医治未病思想。治未病思想提倡以疾病为参照,因人制宜,选择合适的干预治疗方法,重在“防治结合”,预防疾病发生,促进疾病康复[12]。针刺疗法作为中国传统医学特色疗法之一,更侧重于治未病思想中防微杜渐和既病防变这两方面,因其安全、无创伤、无不良反应、可操作性强等优点[13]成为现代医学的研究热点。大量研究表明针刺可以减轻冠心病症状,增强心肌缺血耐受性,阻止冠状动脉粥样硬化,以及减轻缺血再灌注损伤,保护缺血心肌[14]。依据“经脉所过,主治所及”的理论,内关穴是手厥阴心包经之络穴,主要有宁心安神,理气止痛之效,是预防和治疗心胸疾病的常用穴位[15]。目前现代大量的临床研究结果也显示:电针内关穴可明显降低LDH/CK-MB含量,减少心肌梗死面积,降低大鼠TLR4、MyD88及NF-KB mRNA的表达,抑制细胞凋亡,保护心肌[16]。本研究超声心动图结果表明,电针预处理后大鼠LVEF、LVFS水平升高,表明电针预处理能够增强左室舒张及收缩能力,改善大鼠心功能。IL-6水平和HE染色结果反映了心肌炎性反应及受损程度,结果发现电针预处理后IL-6、IL-18含量降低,提示电针预处理可以抑制再灌注后心肌炎性反应的扩大,对保护心肌有一定作用。
心肌I/R损伤的特征是复杂信号和分子级联的动态变化。再灌注会引发大量凋亡细胞的积累,破坏心肌的稳态,造成恶性循环,加剧心肌损伤[17]。自噬作为一种高度保守的分解代谢过程,是清除凋亡细胞和受损细胞器的重要途径,在维持细胞内环境稳态方面起着重要作用[18]。有研究表明[19],通过抑制miR-490-3p可促进LC3的表达,增加自噬体,缩小梗死范围。此外,虫草素可通过AMPK-mTOR途径诱导自噬,减少心肌梗死面积和细胞凋亡,改善心功能[20]。本课题组前期研究发现,电针预处理内关穴可减轻心肌组织中线粒体损伤,调控自噬水平,保护心肌,其机制主要与促进MIRI后急性促炎期向抗炎修复期平衡和快速转化有关,以及与减轻MIRI大鼠心肌细胞的焦亡程度有关[21-23]。本实验结果表明,相较于模型组,电针组大鼠心肌组织中Beclin 1和LC3的表达显著升高,提示电针预处理可以上调心肌组织中的自噬水平,从而减轻MIRI损伤。因此,自噬也可能是I/R损伤中的一种保护机制,I/R期诱导一定水平的自噬可发挥心肌保护作用。
自噬的调节是复杂的,由许多受体介导,包括Toll样受体(TLRS)和NOD样受体(NLR)家族成员[24]。与自噬密切相关的还有酵母自噬基因6(ATG6)的同源物Beclin1,它可以和TRIF相互作用,介导自噬体的形成。LC3作为线粒体外膜上的自噬标记蛋白,在外界刺激下,LC3I变为LC3Ⅱ,自噬被激活,标志着自噬体形成[25]。因此,LC3Ⅱ是衡量自噬水平的重要指标。JABIR M S等[26]发现NLRP3炎症小体能够抑制自噬的原因是通过NLRP3炎症小体激活的caspase-1对信号分子TRIF的切割,TRIF信号分子的减少导致NLRP3/TRIF信号通路诱导的自噬减少。上述证实TLR衔接分子TRIF的裂解是自噬和炎症小体之间负调控的分子机制,TRIF起自噬激动剂的作用,TLR信号增强复合体中Beclin 1的表达相应升高,从而促进自噬。此外,在神经炎症巨噬细胞和小胶质细胞中,长链非编码RNA(lnc RNAs)诱导TRIF裂解以抑制自噬[27]。LincRNA-Cox2的敲除减弱了NLRP3炎症小体中Caspase-1的激活,增加了TRIF介导的自噬,促进了自噬蛋白Beclin1和LC3的表达[28]。为了验证激活NLRP3通路对自噬的影响,本研究设立了电针+激动剂组,通过查阅相关文献[29],选择了认可度较高的NLRP3激动剂(Nigericin),实验结果显示,电针+激动剂组中NLRP3、Caspase-1表达显著升高,相应的TRIF、Beclin1和LC3的表达下降,自噬水平下调,表明在I/R期间自噬水平受NLRP3炎症小体的影响。
综上所述,本研究提示电针预处理内关穴可以上调I/R期自噬水平,减少心肌梗死面积,改善心功能,其机制可能是通过调节NLRP3/TRIF/Beclin 1通路,降低NLRP3炎症小体表达,上调TRIF、Beclin1、LC3Ⅱ表达,进而促进细胞自噬实现心肌保护作用。但是目前尚不明确心肌再灌注期发挥保护效应的自噬水平区间,仍有待进一步研究。
  • 国家自然科学基金面上项目(81974583)
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doi: 10.13193/j.issn.1673-7717.2025.02.023
  • 首发时间:2026-10-30
  • 出版时间:2025-02-10
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国家自然科学基金面上项目(81974583)
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    南京中医药大学,江苏 南京 210000

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李开平(1967-),男,安徽马鞍山人,副教授,硕士研究生导师,博士,研究方向:中医养生治未病的基础与研究。E-mail:。
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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栓菌属 Trametes 5 2.39
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