中文摘要
心房颤动(AF)是临床上最常见的心律失常,因其高患病率和死亡率,严重威胁着人类的健康。肾素(原)受体[(p)RR]被证明与多种心血管病和肾病相关。我们的前期实验结果发现:1)房颤患者血浆中(p)RR含量明显高于正常人;2)通过转基因技术在心脏特异过表达(p)RR则成功构建了转基因小鼠房颤模型。提示(p)RR在AF的发生过程中很可能发挥了关键作用,但其作用机制尚不明确。为此,我们提出假说:(p)RR可能是通过影响瞬时外向钾电流 Ito的电流密度,导致了房颤的发生。为验证这一假说,我们计划基于 (p)RR转基因小鼠房颤模型,从分子、细胞以及动物整体水平等多层次探讨(p)RR在AF发生过程中的作用,明确(p)RR通过降低瞬时外向钾电流Ito的电流密度影响心电活动的调控机制。本研究将从(p)RR这个新的视点为揭示房颤的发生机制提供理论依据,为房颤的预防治疗提供新的靶点与思路。
英文摘要
Atrial fibrillation is the most common cardiac arrhythmia, causing substantial cardiovascular morbidity and mortality. (pro)renin receptor[(p)RR] was related to many kinds of cardiovascular and renal diseases. We found from previous studies: 1) The plasma levels of (p)RR increased 3.6-fold in AF patients compared with healthy controls; 2) we generated a transgenic mouse with overexpression of human (p)RR gene specifically in the heart. Electrocardiograms from (p)RR transgenic mice showed typical atrial flutter since 2 months, then spontaneously converted to atrial fibrillation by 10 months. It is suggested that (p)RR play an important role in development of atrial fibrillation, however, the mechanism is not clear. So we proposed hypothesis: (p)RR leading to atrial fibrillation may be through influencing transient outward potassium current (Ito). To confirm this hypothesis, we plan to from the level of molecular、cellular and laboratory animal study the atrial fibrillation mice model and primary atrial myocytes, to clarify the mechanism of (p)RR inducing atrial fibrillation. From the new field of vision, this study will provide the theoretical basis of atrial fibrillation, to offer new target and thought for preventing and treatment of atrial fibrillation.
结题摘要
心房颤动(房颤)是临床上最常见的心律失常之一,其发病机制复杂多样,目前尚无确定的阐明其病理生理机制,本研究采用自发性房颤模型小鼠模型,研究小鼠心房肌细胞相关离子通道电流的改变,为进一步阐明房颤的发病机制提供理论基础。房颤的电生理特性改变的基础在于心房肌细胞的离子通道改变,离子通道蛋白是房颤的关键分子底物。膜片钳记录结果显示,模型小鼠和野生型小鼠的单个心房肌细胞动作电位AP近似于三角形,其复极较快,二者静息电位未见明显差异,APD未见明显差异, 其中APD20、APD50、APD90比较均未见统计学差异。在离子通道电流方面:Ito电流,模型小鼠的峰值较野生型小鼠的峰值稍低,从-30mV~+70mV二者电流密度均有统计学差异,但在通道动力学方面,即稳态激活曲线在二者并无差异;IK1电流,野生型小鼠和模型小鼠心房肌细胞的未见明显差异;If 电流,模型小鼠的电流峰值较野生型小鼠的电流幅度明显增大,尾电流(-40mV引出)也明显增大,从-70mV~-170mV二者电流密度均有统计学差异。模型小鼠和野生型小鼠的心房肌细胞的电生理特性即动作电位的特点未发现明显差异;离子通道电流方面,模型小鼠心房肌细胞的 Ito电流较野生型小鼠的略减弱,但通道动力学方面并无差异;IK1电流在二者的心房肌细胞中无差异;模型小鼠心房肌细胞的If 电流密度明显大于野生型小鼠,且心房肌细胞的If 电流更容易激活,提示起搏电流可能参与了房颤的某种发生机制。 模型小鼠心房肌组织的HCN2和HCN4 mRNA相对表达显著高于野生型小鼠;模型小鼠心房肌组织的HCN4 蛋白水平相对表达显著高于野生型小鼠;模型小鼠心房肌组织的 Kv 4.2 和 Kv 4.3 蛋白水平相对表达显著低于野生型小鼠。以上结果提示起搏电流和Ito电流可能参与了房颤的发生过程。
