基于嘌呤信号研究针灸治疗心肌缺血作用机制的现状及思路
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摘要
冠心病为重大疾病之一,心肌缺血是其最基本的病理改变。本文分析近15年的临床及实验研究,发现嘌呤能信号转导分子作用的受体亚型腺苷受体A1、A2A、A2B、A3在心血管系统选择地表达,可能成为心血管疾病防治的新靶点。基于嘌呤受体研究针灸治疗心肌缺血的作用,为针灸治疗心肌缺血作用机制提供新的思路。
Coronary heart disease(CHD)is believed to be one of the major diseases with myocardial ischemia(MI)as basic pathological change.The clinical trials and experimental researches in the last 15 years were analyzed in this paper,and it was found that purinergic signaling could transduce the selective expression of molecular adenosine receptors A1,A2 A,A2B,A3 in cardiovascular system,which had the potential to be a novel target for treating cardiovascular disease.Using purinergic receptors to explore the actions of acupuncture for myocardial ischemia provides new perspectives to elucidate the mechanism of acupuncture for MI.
Coronary heart disease(CHD)is believed to be one of the major diseases with myocardial ischemia(MI)as basic pathological change.The clinical trials and experimental researches in the last 15 years were analyzed in this paper,and it was found that purinergic signaling could transduce the selective expression of molecular adenosine receptors A1,A2 A,A2B,A3 in cardiovascular system,which had the potential to be a novel target for treating cardiovascular disease.Using purinergic receptors to explore the actions of acupuncture for myocardial ischemia provides new perspectives to elucidate the mechanism of acupuncture for MI.
引文
[1]赵冬.北京地区急性冠心病事件发病率研究的启示[J].中国循环杂志,2013,28(2):83-84.
[2]许波华,许立.中药抗心肌缺血作用机制的研究进展[J].中国实验方剂学杂志,2011,17(15):265-269.
[3]熊芳丽,肖亚平,黄慧.针灸治疗冠心病心绞痛130例[J].上海针灸杂志,2000,19(4):18.
[4]林婉娟,陈东风,张少君.针灸治疗冠心病心绞痛30例临床观察[J].中医药导报,2008,14(6):82-83.
[5]梁宪如,席强,李晓梅,等.针刺内关穴对急性心肌缺血大鼠缺血心肌基因表达谱的影响[J].天津中医药,2012,29(4):349-355.
[6]马铁明,任路,梁雪松,等.针刺对急性心肌缺血家兔外周血超氧化物歧化酶和丙二醛影响的实验研究[J].辽宁中医药大学学报,2007,9(1):35-36.
[7]黄伯湘,闫玉生,肖飞,等.腺苷A1受体拮抗剂对LNAME预处理第二窗心肌保护作用的影响[J].热带医学杂志,2010,10(4):390-393.
[8]龚子曦,冉珂,常业恬,等.腺苷A1受体激动剂后处理对兔心肌缺血-再灌注损伤的影响[J].临床麻醉学杂志,2009,25(3):245-247.
[9]冉珂,卢向航,李晋,等.腺苷A1受体激动剂延迟预处理对兔心肌缺血再灌注损伤的保护作用[J].重庆医科大学学报,2010,35(4):535-537.
[10]Chandrasekera PC,McIntosh VJ,Cao FX,et al.Differential effects of adenosine A2aand A2breceptors on cardiac contractility[J].Am J Physiol Heart Circ Physiol,2010,299(6):H2082-H2089.
[11]郦铮铮,郑荣远.腺苷A2a受体在炎症反应中的作用[J].国家免疫学杂志,2009,32(4):313-316.
[12]李妮妮,廉哲勋,葛毅萍,等.腺苷A2a受体激动剂后处理对兔缺血再灌注心肌的保护作用[J].中国心血管杂志,2010,15(1):50-53.
[13]易云,高云.腺苷A2B受体在心血管系统研究新进展[J].中国药理学通报,2014,30(1):21-24.
[14]Ryzhov S,Sung BH,Zhang Q,et al.Role of adenosine A2B receptor signaling in contribution of cardiac mesenchymal stem-like cells to myocardial scar formation[J].Purinergic Signal,2014,10(3):477-486.
[15]McIntosh VJ,Lasley RD.Adenosine receptor-mediated cardioprotection are all 4subtypes required or redundant?[J].J Cardiovasc Pharmacol Ther,2012,17(1):21-33.
[16]Safran N,Shneyvays V,Balas N,et al.Cardioprotective effects of adenosine A1and A3receptor activation during hypoxia in isolated rat cardiac myocytes[J].Mol Cell Biochem,2001,217(1-2):143-152.
[17]周荣,刘良明,胡德耀,等.腺苷A3受体调控低氧血管反应性的实验研究[J].解放军药学学报,2008,24(4):291-295.
[18]聂永莉,张玉芹.P2嘌呤受体亚型与冠心病的关系[J].基础医学与临床,2010,30(4):434-436.
[19]李桂林,戴群,梁尚栋,等.P2X受体拮抗剂对大鼠心肌缺血心电图的影响[J].基础医学与临床,2007,27(5):571-572.
[20]吴炳,李桂林,涂桂花,等.亮蓝G对颈上神经节P2X7受体介导心肌缺血损伤的作用研究[J].中国药理学通报,2013,29(10):1413-1417.
[21]Yitzhaki S,Shainberg A,Cheporko Y,et al.Uridine-5'-triphosphate(UTP)reduces infarct size and improves rat heart function after myocardial infarct[J].Biochem Pharmacol,2006,72(8):949-955.
[22]Hochhauser E,Cohen R,Waldman M,et al.P2Y2receptor agonist with enhanced stability protects the heart from ischemic damage in vitro and in vivo[J].Purinergic Signal,2013,9(4):633-642.
[23]汪克明,周逸平,周美启,等.电针心经、小肠经对急性心肌缺血大鼠心功能的影响[J].安徽中医学院学报,2003,22(4):24-25.
[24]胡玲,何璐,蔡荣林,等.电针不同单穴与原络配穴对急性心肌缺血家兔心功能及心肌酶的影响[J].针刺研究,2010,35(5):363-367.
[25]周美启,周逸平,汪克明,等.电针心经、小肠经对心肌缺血损伤大鼠心电图和心肌酶学的影响[J].中医药临床杂志,2005,17(6):572-573.
[26]汪克明,刘婧,吴子建,等.针刺不同经穴干预心肌缺血模型大鼠下丘脑内单胺类递质的相对特异性[J].针刺研究,2011,36(3):205-208,235.
[27]孙国杰,黄娥梅,吴绪平,等.针刺“内关”穴对急性心肌缺血家兔延髓中cAMP和cGMP的影响[J].湖北中医杂志,1995,17(6):46-47.
[28]张田宁.针刺心经对急性心肌缺血模型大鼠海马神经元放电及c-fos表达的影响[D].合肥:安徽中医药大学,2014.
[29]李明磊,王华,陈泽斌.电针内关穴对急性心肌缺血大鼠心电图及超微结构的影响[J].中西医结合心脑血管病杂志,2007,5(8):708-710.
[30]谢芳,梁勋厂,吴红金,等.电针“内关"对急性心肌缺血大鼠心肌c-fos基因表达的影响[J].中国针灸,2005,25(5):355-358.
[31]李强,吴绪平.电针内关穴对急性心肌缺血家兔一氧化氮及血小板活性物质的影响[J].湖北中医学院学报,2006,8(2):3-5.
[32]管义红.电针内关对急性心肌缺血家兔内皮源性血管活性物质影响的研究[D].武汉:湖北中医学院,2005.
[33]田岳凤,李雷勇,王军,等.针刺手厥阴心包经穴对大鼠缺血再灌注损伤心肌组织ATP、ADP和AMP的影响[J].中国中医药科技,2007,14(1):1-2,5.
[34]Zhan E,McIntosh VJ,Lasley RD.Adenosine A2Aand A2Breceptors are both required for adenosine A1receptor-mediated cardioprotection[J].Am J Physiol Heart Circ Physiol,2011,301(3):H1183-H1189.
[2]许波华,许立.中药抗心肌缺血作用机制的研究进展[J].中国实验方剂学杂志,2011,17(15):265-269.
[3]熊芳丽,肖亚平,黄慧.针灸治疗冠心病心绞痛130例[J].上海针灸杂志,2000,19(4):18.
[4]林婉娟,陈东风,张少君.针灸治疗冠心病心绞痛30例临床观察[J].中医药导报,2008,14(6):82-83.
[5]梁宪如,席强,李晓梅,等.针刺内关穴对急性心肌缺血大鼠缺血心肌基因表达谱的影响[J].天津中医药,2012,29(4):349-355.
[6]马铁明,任路,梁雪松,等.针刺对急性心肌缺血家兔外周血超氧化物歧化酶和丙二醛影响的实验研究[J].辽宁中医药大学学报,2007,9(1):35-36.
[7]黄伯湘,闫玉生,肖飞,等.腺苷A1受体拮抗剂对LNAME预处理第二窗心肌保护作用的影响[J].热带医学杂志,2010,10(4):390-393.
[8]龚子曦,冉珂,常业恬,等.腺苷A1受体激动剂后处理对兔心肌缺血-再灌注损伤的影响[J].临床麻醉学杂志,2009,25(3):245-247.
[9]冉珂,卢向航,李晋,等.腺苷A1受体激动剂延迟预处理对兔心肌缺血再灌注损伤的保护作用[J].重庆医科大学学报,2010,35(4):535-537.
[10]Chandrasekera PC,McIntosh VJ,Cao FX,et al.Differential effects of adenosine A2aand A2breceptors on cardiac contractility[J].Am J Physiol Heart Circ Physiol,2010,299(6):H2082-H2089.
[11]郦铮铮,郑荣远.腺苷A2a受体在炎症反应中的作用[J].国家免疫学杂志,2009,32(4):313-316.
[12]李妮妮,廉哲勋,葛毅萍,等.腺苷A2a受体激动剂后处理对兔缺血再灌注心肌的保护作用[J].中国心血管杂志,2010,15(1):50-53.
[13]易云,高云.腺苷A2B受体在心血管系统研究新进展[J].中国药理学通报,2014,30(1):21-24.
[14]Ryzhov S,Sung BH,Zhang Q,et al.Role of adenosine A2B receptor signaling in contribution of cardiac mesenchymal stem-like cells to myocardial scar formation[J].Purinergic Signal,2014,10(3):477-486.
[15]McIntosh VJ,Lasley RD.Adenosine receptor-mediated cardioprotection are all 4subtypes required or redundant?[J].J Cardiovasc Pharmacol Ther,2012,17(1):21-33.
[16]Safran N,Shneyvays V,Balas N,et al.Cardioprotective effects of adenosine A1and A3receptor activation during hypoxia in isolated rat cardiac myocytes[J].Mol Cell Biochem,2001,217(1-2):143-152.
[17]周荣,刘良明,胡德耀,等.腺苷A3受体调控低氧血管反应性的实验研究[J].解放军药学学报,2008,24(4):291-295.
[18]聂永莉,张玉芹.P2嘌呤受体亚型与冠心病的关系[J].基础医学与临床,2010,30(4):434-436.
[19]李桂林,戴群,梁尚栋,等.P2X受体拮抗剂对大鼠心肌缺血心电图的影响[J].基础医学与临床,2007,27(5):571-572.
[20]吴炳,李桂林,涂桂花,等.亮蓝G对颈上神经节P2X7受体介导心肌缺血损伤的作用研究[J].中国药理学通报,2013,29(10):1413-1417.
[21]Yitzhaki S,Shainberg A,Cheporko Y,et al.Uridine-5'-triphosphate(UTP)reduces infarct size and improves rat heart function after myocardial infarct[J].Biochem Pharmacol,2006,72(8):949-955.
[22]Hochhauser E,Cohen R,Waldman M,et al.P2Y2receptor agonist with enhanced stability protects the heart from ischemic damage in vitro and in vivo[J].Purinergic Signal,2013,9(4):633-642.
[23]汪克明,周逸平,周美启,等.电针心经、小肠经对急性心肌缺血大鼠心功能的影响[J].安徽中医学院学报,2003,22(4):24-25.
[24]胡玲,何璐,蔡荣林,等.电针不同单穴与原络配穴对急性心肌缺血家兔心功能及心肌酶的影响[J].针刺研究,2010,35(5):363-367.
[25]周美启,周逸平,汪克明,等.电针心经、小肠经对心肌缺血损伤大鼠心电图和心肌酶学的影响[J].中医药临床杂志,2005,17(6):572-573.
[26]汪克明,刘婧,吴子建,等.针刺不同经穴干预心肌缺血模型大鼠下丘脑内单胺类递质的相对特异性[J].针刺研究,2011,36(3):205-208,235.
[27]孙国杰,黄娥梅,吴绪平,等.针刺“内关”穴对急性心肌缺血家兔延髓中cAMP和cGMP的影响[J].湖北中医杂志,1995,17(6):46-47.
[28]张田宁.针刺心经对急性心肌缺血模型大鼠海马神经元放电及c-fos表达的影响[D].合肥:安徽中医药大学,2014.
[29]李明磊,王华,陈泽斌.电针内关穴对急性心肌缺血大鼠心电图及超微结构的影响[J].中西医结合心脑血管病杂志,2007,5(8):708-710.
[30]谢芳,梁勋厂,吴红金,等.电针“内关"对急性心肌缺血大鼠心肌c-fos基因表达的影响[J].中国针灸,2005,25(5):355-358.
[31]李强,吴绪平.电针内关穴对急性心肌缺血家兔一氧化氮及血小板活性物质的影响[J].湖北中医学院学报,2006,8(2):3-5.
[32]管义红.电针内关对急性心肌缺血家兔内皮源性血管活性物质影响的研究[D].武汉:湖北中医学院,2005.
[33]田岳凤,李雷勇,王军,等.针刺手厥阴心包经穴对大鼠缺血再灌注损伤心肌组织ATP、ADP和AMP的影响[J].中国中医药科技,2007,14(1):1-2,5.
[34]Zhan E,McIntosh VJ,Lasley RD.Adenosine A2Aand A2Breceptors are both required for adenosine A1receptor-mediated cardioprotection[J].Am J Physiol Heart Circ Physiol,2011,301(3):H1183-H1189.