关键词: 4-HNE, 4-hydroxy-2-nonenal ADP, Adenosine diphosphate ASA, American Society of Anesthesiologists ATP, Adenosine triphosphate BSA, Bovine serum albumin CAT, Catalase CHOP, C/EBP homologous protein Drp1, Dynamin-related protein-1 ER, Endoplasmic reticulum ETC, Electron transport chain FGF21, Fibroblast growth factor 21 Fis1, Fission protein-1 GPx, Glutathione peroxidase I/R, Ischemia and reperfusion IL-6, Interleukin-6 IPACK, Interspace between the popliteal artery and capsule of the posterior knee IPC, Ischemic preconditioning Ischemia reperfusion injury Ischemic preconditioning Knee arthroplasty MDA, Malondialdehyde Mfn, Mitofusin Mitochondrial dynamics MnSOD, Manganese superoxide dismutase NF-κB, Nuclear factor kappa B OXPHOS, Oxidative phosphorylation PGC-1ɑ, Peroxisome proliferator-activated receptor-gamma coactivator-1ɑ RIPC, Remote ischemic preconditioning ROS, Reactive oxygen species SBP, Systolic blood pressure SOD, Superoxide dismutase TKA, Total knee arthroplasty TNF, Tumor necrosis factor TQ, Tourniquet Tourniquet UPR, Unfolded protein response mPTP, Mitochondrial permeability transition pore 4-HNE, 4-hydroxy-2-nonenal ADP, Adenosine diphosphate ASA, American Society of Anesthesiologists ATP, Adenosine triphosphate BSA, Bovine serum albumin CAT, Catalase CHOP, C/EBP homologous protein Drp1, Dynamin-related protein-1 ER, Endoplasmic reticulum ETC, Electron transport chain FGF21, Fibroblast growth factor 21 Fis1, Fission protein-1 GPx, Glutathione peroxidase I/R, Ischemia and reperfusion IL-6, Interleukin-6 IPACK, Interspace between the popliteal artery and capsule of the posterior knee IPC, Ischemic preconditioning Ischemia reperfusion injury Ischemic preconditioning Knee arthroplasty MDA, Malondialdehyde Mfn, Mitofusin Mitochondrial dynamics MnSOD, Manganese superoxide dismutase NF-κB, Nuclear factor kappa B OXPHOS, Oxidative phosphorylation PGC-1ɑ, Peroxisome proliferator-activated receptor-gamma coactivator-1ɑ RIPC, Remote ischemic preconditioning ROS, Reactive oxygen species SBP, Systolic blood pressure SOD, Superoxide dismutase TKA, Total knee arthroplasty TNF, Tumor necrosis factor TQ, Tourniquet Tourniquet UPR, Unfolded protein response mPTP, Mitochondrial permeability transition pore

来  源:   DOI:10.1016/j.jot.2022.09.012   PDF(Pubmed)

Abstract:
UNASSIGNED: Tourniquet-induced ischemia and reperfusion (I/R) has been related to postoperative muscle atrophy through mechanisms involving protein synthesis/breakdown, cellular metabolism, mitochondrial dysfunction, and apoptosis. Ischemic preconditioning (IPC) could protect skeletal muscle against I/R injury. This study aims to determine the underlying mechanisms of IPC and its effect on muscle strength after total knee arthroplasty (TKA).
UNASSIGNED: Twenty-four TKA patients were randomized to receive either sham IPC or IPC (3 cycles of 5-min ischemia followed by 5-min reperfusion). Vastus medialis muscle biopsies were collected at 30 ​min after tourniquet (TQ) inflation and the onset of reperfusion. Western blot analysis was performed in muscle protein for 4-HNE, SOD2, TNF-ɑ, IL-6, p-Drp1ser616, Drp1, Mfn1, Mfn2, Opa1, PGC-1ɑ, ETC complex I-V, cytochrome c, cleaved caspase-3, and caspase-3. Clinical outcomes including isokinetic muscle strength and quality of life were evaluated pre- and postoperatively.
UNASSIGNED: IPC significantly increased Mfn2 (2.0 ​± ​0.2 vs 1.2 ​± ​0.1, p ​= ​0.001) and Opa1 (2.9 ​± ​0.3 vs 1.9 ​± ​0.2, p ​= ​0.005) proteins expression at the onset of reperfusion, compared to the ischemic phase. There were no differences in 4-HNE, SOD2, TNF-ɑ, IL-6, p-Drp1ser616/Drp1, Mfn1, PGC-1ɑ, ETC complex I-V, cytochrome c, and cleaved caspase-3/caspase-3 expression between the ischemic and reperfusion periods, or between the groups. Clinically, postoperative peak torque for knee extension significantly reduced in the sham IPC group (-16.6 [-29.5, -3.6] N.m, p ​= ​0.020), while that in the IPC group was preserved (-4.7 [-25.3, 16.0] N.m, p ​= ​0.617).
UNASSIGNED: In TKA with TQ application, IPC preserved postoperative quadriceps strength and prevented TQ-induced I/R injury partly by enhancing mitochondrial fusion proteins in the skeletal muscle.
UNASSIGNED: Mitochondrial fusion is a potential underlying mechanism of IPC in preventing skeletal muscle I/R injury. IPC applied before TQ-induced I/R preserved postoperative quadriceps muscle strength after TKA.
摘要:
未经证实:止血带诱导的缺血和再灌注(I/R)通过涉及蛋白质合成/分解的机制与术后肌肉萎缩有关,细胞代谢,线粒体功能障碍,和凋亡。缺血预处理(IPC)可以保护骨骼肌免受I/R损伤。这项研究旨在确定IPC的潜在机制及其对全膝关节置换术(TKA)后肌肉力量的影响。
未经证实:24名TKA患者随机接受假IPC或IPC(3个周期的5分钟缺血,然后5分钟再灌注)。在止血带(TQ)充气和再灌注开始后30分钟收集横肌活检。蛋白质印迹分析在肌肉蛋白中进行4-HNE,SOD2,TNF-α,IL-6,p-Drp1ser616,Drp1,Mfn1,Mfn2,Opa1,PGC-1,ETC复杂I-V,细胞色素c,切割的胱天蛋白酶-3和胱天蛋白酶-3。术前和术后评估临床结果,包括等速肌力和生活质量。
UNASSIGNED:IPC显着增加Mfn2(2.0±0.2vs1.2±0.1,p=0.001)和Opa1(2.9±0.3vs1.9±0.2,p=0.005)在再灌注开始时的蛋白质表达,与缺血期相比。4-HNE没有差异,SOD2,TNF-α,IL-6,p-Drp1ser616/Drp1,Mfn1,PGC-1α,ETC复杂I-V,细胞色素c,缺血和再灌注期之间caspase-3/caspase-3的表达,或群体之间。临床上,假IPC组术后膝关节伸展最大扭矩显著降低(-16.6[-29.5,-3.6]N.m,p​=​0.020),而IPC组中的保留(-4.7[-25.3,16.0]N.m,p​=​0.617)。
未经评估:在带有TQ应用程序的TKA中,IPC保留了术后股四头肌的力量,并部分通过增强骨骼肌中的线粒体融合蛋白来防止TQ引起的I/R损伤。
UASSIGNED:线粒体融合是IPC预防骨骼肌I/R损伤的潜在潜在潜在机制。在TQ诱导的I/R之前应用IPC保留了TKA术后股四头肌肌力。
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