Hassoun Sidi Mohammed, Marechal Xavier, Montaigne David, Bouazza Youcef, Decoster Brigitte, Lancel Steve, Neviere Remi
Department of Physiology (EA 2689), University of Lille 2, IFR 114 (IMPRT), Lille, France.
Crit Care Med. 2008 Sep;36(9):2590-6. doi: 10.1097/CCM.0b013e3181844276.
Growing evidence suggests that mitochondria function is impaired in sepsis. Here, we tested the hypothesis that lipopolysaccharide would induce mitochondrial Ca2+ overload and oxygen utilization abnormalities as consequences of sarcoplasmic reticulum Ca2+ handling derangements that are typically observed in sepsis. As lipopolysaccharide-induced sarcoplasmic reticulum dysfunction was mainly characterized by reduced sarcoplasmic reticulum Ca2+ uptake and Ca2+ leak, we tested whether dantrolene, a sarco(endo)plasmic reticulum calcium ATPase leak inhibitor, would prevent mitochondrial and cardiac contractile dysfunction.
Randomized controlled trial.
Experimental laboratory.
Male Sprague Dawley rats.
Sepsis was induced by injection of endotoxin lipopolysaccharide (10 mg/kg/intravenously). Assessment of contractile function and Ca2+ handling was performed 4 hr after lipopolysaccharide. The relative contribution of the different Ca2+ transporters to relaxation in intact cardiomyocytes was studied during successive electrically evoked twitches and caffeine stimulation. Sarcoplasmic reticulum vesicles and mitochondria from ventricles of rats treated or not with lipopolysaccharide were prepared to evaluate Ca2+ uptake-release and oxygen fluxes, respectively. Effects of dantrolene (10 mg/kg) treatment in rats were evaluated in sarcoplasmic reticulum vesicles, mitochondria, and isolated hearts.
Lipopolysaccharide challenge elicited cardiac contractile dysfunction that was accompanied by severe derangements in sarcoplasmic reticulum function, i.e., reduced Ca2+ uptake and increased sarcoplasmic reticulum Ca2+ leak. Functional sarcoplasmic reticulum changes were associated with modification in the status of phospholamban phosphorylation whereas SERCA was unchanged. Rises in mitochondrial Ca2+ content observed in lipopolysaccharide-treated rats coincided with derangements in mitochondrial oxygen efficacy, i.e., reduced respiratory control ratio. Administration of dantrolene in lipopolysaccharide-treated rats prevented mitochondrial Ca2+ overload and mitochondrial oxygen utilization abnormalities. Moreover, dantrolene treatment in lipopolysaccharide rats improved heart mitochondrial redox state and myocardial dysfunction.
These experiments suggest that sarcoplasmic reticulum Ca2+ handling dysfunction is an early event during endotoxemia that could be responsible for, or contribute to, mitochondrial Ca2+ overload, metabolic failure, and cardiac dysfunction.
越来越多的证据表明脓毒症中线粒体功能受损。在此,我们验证了以下假设:脂多糖会因脓毒症中常见的肌浆网钙处理紊乱而导致线粒体钙超载和氧利用异常。由于脂多糖诱导的肌浆网功能障碍主要表现为肌浆网钙摄取减少和钙泄漏,我们测试了丹曲林(一种肌浆网钙ATP酶泄漏抑制剂)是否能预防线粒体和心脏收缩功能障碍。
随机对照试验。
实验实验室。
雄性Sprague Dawley大鼠。
通过静脉注射内毒素脂多糖(10 mg/kg)诱导脓毒症。脂多糖注射4小时后评估收缩功能和钙处理情况。在连续的电诱发抽搐和咖啡因刺激过程中,研究完整心肌细胞中不同钙转运体对舒张的相对贡献。制备用或未用脂多糖处理的大鼠心室的肌浆网囊泡和线粒体,分别评估钙摄取-释放和氧通量。在肌浆网囊泡、线粒体和离体心脏中评估丹曲林(10 mg/kg)对大鼠的治疗效果。
脂多糖攻击引发心脏收缩功能障碍,同时伴有肌浆网功能严重紊乱,即钙摄取减少和肌浆网钙泄漏增加。肌浆网功能的改变与受磷蛋白磷酸化状态的改变有关,而肌浆网钙ATP酶未发生变化。在脂多糖处理的大鼠中观察到线粒体钙含量升高,同时线粒体氧效能紊乱,即呼吸控制率降低。给脂多糖处理的大鼠注射丹曲林可预防线粒体钙超载和线粒体氧利用异常。此外,对脂多糖处理的大鼠进行丹曲林治疗可改善心脏线粒体氧化还原状态和心肌功能障碍。
这些实验表明,肌浆网钙处理功能障碍是内毒素血症期间的早期事件,可能是线粒体钙超载、代谢衰竭和心脏功能障碍的原因或促成因素。