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β1-肾上腺素能受体活化可通过L型钙通道依赖性和非L型钙通道依赖性通路诱导小鼠心肌细胞死亡
β1-adrenergic receptor activation induces mouse cardiac myocyte death through both L-type calcium channel-dependent and -independent pathways
Wang W,Zhang H ,Gao H ,Kubo H ,Berretta RM, Chen X ,Houser SR  2010/9/10 17:51:00 
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American Journal of Physiology - Heart and Circulatory Physiology, 2010, Volume 299, Issue 2 
 

Cardiac diseases persistently increase the contractility demands of cardiac myocytes, which require activation of the sympathetic nervous system and subsequent increases in myocyte Ca2+ transients. Persistent exposure to sympathetic and/or Ca2+ stress is associated with myocyte death. This study examined the respective roles of persistent β-adrenergic receptor (β-AR) agonist exposure and high Ca2+ concentration in myocyte death. Ventricular myocytes (VMs) were isolated from transgenic (TG) mice with cardiac-specific and inducible expression of the β2a- subunit of the L-type Ca2+ channel (LTCC). VMs were cultured, and the rate of myocyte death was measured in the presence of isoproterenol (ISO), other modulators of Ca2+ handling and the β-adrenergic system, and inhibitors of caspases and reactive oxygen species generation. The rate of myocyte death was greater in TG vs. wild-type myocytes and accelerated by ISO in both groups, although ISO did not increase LTCC current (ICa-L) in TG-VMs. Nifedipine, an LTCC antagonist, only partially prevented myocyte death. These results suggest both LTCC-dependent and -independent mechanisms in ISO induced myocyte death. ISO increased the contractility of wild type and TG-VMs by enhancing sarcoplasmic reticulum function and inhibiting sarco(endo)plasmic reticulum Ca2+-ATPase, Na+/Ca2+ exchanger, and CaMKII partially protected myocyte from death induced by both Ca2+ and ISO. Caspase and reactive oxygen species inhibitors did not, but β2-AR activation did, reduce myocyte death induced by enhanced ICa-L and ISO stimulation. Our results suggest that catecholamines induce myocyte necrosis primarily through β1-AR-mediated increases in ICa-L, but other mechanisms are also involved in rodents. Copyright © 2010 the American Physiological Society.

Correspondence Address: Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China 
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 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者,女,69岁。2009年1月无明显诱因下出现乏力,当时程度较轻,未予以重视。2009年3月患者乏力症状加重,尿色逐渐加深,大便习惯改变,颜色变淡。4月18日入我院感染科治疗,诉轻度头晕、心慌,体重减轻10kg。无肝区疼痛,无发热,无腹痛、腹泻、腹胀、里急后重,无恶性、呕吐等。入院半月前于外院就诊,查肝功能:ALT 601IU/L,AST 785IU/L,TBIL 97.7umol/L,白蛋白 41g/L,甲状腺功能:游离T3 30.6pmol/L,游离T4 51.9pmol/L,心电图示快速房颤。
 

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