Trimetazidine: Activating AMPK Signal to Ameliorate Coronary Microcirculation Dysfunction after Myocardial Infarction.

IF 3.1 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Frontiers in bioscience (Landmark edition) Pub Date : 2025-01-20 DOI:10.31083/FBL25565
Xiaolong Qu, Pan Yang, Li Jiao, Yuehui Yin
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Abstract

Background: Myocardial ischemia-reperfusion (I/R) injury and coronary microcirculation dysfunction (CMD) are observed in patients with myocardial infarction after vascular recanalization. The antianginal drug trimetazidine has been demonstrated to exert a protective effect in myocardial ischemia-reperfusion injury.

Objectives: This study aimed to investigate the role of trimetazidine in endothelial cell dysfunction caused by myocardial I/R injury and thus improve coronary microcirculation.

Methods: The myocardial I/R mouse model was established, and trimetazidine was administered for 7 days before myocardial I/R model establishment. Echocardiography, 2,3,5-triphenyltetrazolium chloride (TTC) staining, hematoxylin-eosin (H&E) staining, and thioflavin S staining were applied to assess myocardial injury and microvascular function. Additionally, the oxygen-glucose deprivation/reperfusion (OGD/R) model was developed in endothelial cells to simulate myocardial I/R injury in vitro. Griess reaction method, immunofluorescence, and western blotting (WB) were employed to detect the expressions of nitric oxide (NO), platelet endothelial cell adhesion molecule-1 (CD31) and vascular endothelial (VE)-cadherin, zonula occludens protein 1 (ZO-1), occludin, vascular endothelial growth factor (VEGF) and adenosine monophosphate (AMP)-activated protein kinase (AMPK) signaling-related proteins in endothelial cells and mouse cardiomyocytes. AMPK pathway inhibitor compound C was used for further mechanism validation.

Results: Our research demonstrated that trimetazidine can alleviate myocardial pathological injury and cardiac function injury during myocardial I/R. Trimetazidine was observed to improve microvascular reflux phenomenon and microvascular function and barrier injury in myocardial I/R and OGD/R models. Additionally, the expressions of AMPK signal-related proteins were found to be inhibited in myocardial I/R and OGD/R models, which were then activated in mice administered trimetazidine. However, the effects of trimetazidine on endothelial cell function and barrier damage were attenuated after co-treatment with compound C and trimetazidine.

Conclusion: Trimetazidine ameliorated myocardial I/R-induced CMD by activating AMPK signaling.

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曲美他嗪:激活AMPK信号改善心肌梗死后冠状动脉微循环功能障碍。
背景:心肌梗死患者血管再通术后可观察到心肌缺血再灌注(I/R)损伤和冠状动脉微循环功能障碍(CMD)。抗心绞痛药物曲美他嗪已被证明对心肌缺血再灌注损伤有保护作用。目的:探讨曲美他嗪对心肌I/R损伤所致内皮细胞功能障碍的作用,从而改善冠状动脉微循环。方法:建立小鼠心肌I/R模型,建立心肌I/R模型前给予曲美他嗪7 d。超声心动图、2,3,5-三苯四唑氯(TTC)染色、苏木精-伊红(H&E)染色、硫黄素S染色评价心肌损伤及微血管功能。此外,在内皮细胞中建立氧葡萄糖剥夺/再灌注(OGD/R)模型,模拟体外心肌I/R损伤。采用Griess反应法、免疫荧光法和western blotting (WB)检测内皮细胞和小鼠心肌细胞中一氧化氮(NO)、血小板内皮细胞粘附分子-1 (CD31)和血管内皮(VE)-cadherin、闭塞带蛋白1 (ZO-1)、occludin、血管内皮生长因子(VEGF)和单磷酸腺苷(AMP)活化蛋白激酶(AMPK)信号相关蛋白的表达。使用AMPK通路抑制剂化合物C进行进一步的机制验证。结果:我们的研究表明曲美他嗪可以减轻心肌I/R时的心肌病理损伤和心功能损伤。曲美他嗪可改善I/R和OGD/R模型微血管反流现象,改善微血管功能和屏障损伤。此外,AMPK信号相关蛋白的表达在心肌I/R和OGD/R模型中被抑制,然后在给予曲美他嗪的小鼠中被激活。然而,复方C和曲美他嗪联合使用后,曲美他嗪对内皮细胞功能和屏障损伤的影响减弱。结论:曲美他嗪通过激活AMPK信号改善I/ r诱导的心肌CMD。
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