術前グルタミン投与は熱ショックタンパク質70の発現を誘発し,酸化窒素合成酵素の活性を調節することにより,心肺バイパス誘発の炎症反応を弱める
Yoshitaka Hayashi1, Yoshiki Sawa, Naoto Fukuyama
1Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. hayashi@surg1.med.osaka-u.ac.jp
Circulation
|November 13, 2002
まとめ
術前グルタミン投与は熱ショックタンパク質70 (HSP70) を誘導し,心肺バイパス (CPB) 誘発の炎症から保護します. この自己保護メカニズムは,臓器の損傷と炎症マーカーを減少させ,潜在的な治療戦略を提供します.
科学分野:
- 生物医学科学 生物医学科学とは
- 炎症の研究 炎症の研究
- 外科生理学の外科生理学
背景:
- 熱ショックタンパク質70 (HSP70) は,炎症の管理と臓器損傷の軽減に不可欠です.
- HSP70の前誘導は,炎症的侮辱に対する自己防衛システムを活性化させます.
- グルタミン (Glutamine) はHSP70の誘発因子として特定されており,手術前炎症を和らげる可能性を示唆しています.
研究 の 目的:
- 心肺バイパス (CPB) 誘発の炎症反応を弱める術前グルタミン投与の有効性を調査する.
- CPBに関連する臓器損傷から保護するグルタミンによるHSP70誘導の役割を調査する.
- 酸化窒素合成酵素 (NOS) の活性を含むグルタミン酸の保護効果の背後にあるメカニズムを解明する.
主な方法:
- 成人オスのスプラグ・ダウリーマウスは,グルタミン治療群 (G) と対照群 (C) に分けられた.
- グループGは,手術前およびCPB開始前にグルタミン (100mg/kg) を投与された.
- 両グループとも34°Cで60分間のCPBを受け,検査のために検査後3時間後にサンプルを採取した.
主要な成果:
- グルタミン投与は,CPB後のインタールヒキン-6およびインタールヒキン-8の血濃度を有意に低下させた.
- 中性粒子の粘着を含む心筋および呼吸器損傷マーカーは,グルタミン群で有意に弱まりました.
- グルタミン群の心臓,肺,肝臓では,HSP70の発現が上昇し,内皮構成性酸化窒素合成酵素 (eNOS) の活性が保存され,誘導性酸化窒素合成酵素 (iNOS) の活性が弱まった.
結論:
- 術前グルタミン投与は,HSP70の発現を効果的に誘発し,CPB誘発の炎症から保護します.
- 保護メカニズムは,酸化窒素合成酵素 (NOS) の活性を調節することを含む.
- これは,CPB誘発の炎症反応を管理するための有望な自己保護戦略を示唆しています.
関連する概念動画
Anticholinesterase Agents: Poisoning and Treatment
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...
Skeletal Muscle Relaxants: Adverse Effects
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
Antianginal Drugs: Nitrates and β-Blockers
In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Acute Coronary Syndrome IV: Interprofessional Care
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Angina V: Nursing Management
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...


