叶酸缺失引起的高同型半胱氨酸血症:对冠状动脉和颈动脉功能的影响

J. Symons, A. Mullick, J. Ensunsa, Amy Ma, J. Rutledge, D. Symons
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引用次数: 81

摘要

高循环浓度的同型半胱氨酸(即高同型半胱氨酸血症[Hhcy])损害外周导管动脉和灌注内脏和骨骼肌区域的小动脉的血管功能。HHcy对冠状动脉阻力血管功能及其他血管功能指标(动脉通透性、硬化性)的影响尚不清楚。我们检验了HHcy损害冠状动脉阻力血管反应性的假设;增加颈动脉通透性;引发动脉硬化。摄入叶酸充足(CON, n=44)或叶酸缺乏(HHcy, n=48)食物4 ~ 5周的雄性大鼠,血浆总同型半胱氨酸浓度分别为7±2 mol/L或58±4 mol/L。与对照组相比,从HHcy动物分离的冠状动脉阻力血管(内径≈120 μ m)中,乙酰胆碱诱发的最大舒张(≈40% vs≈60%)和从基线开始的张力发展(≈20% vs≈40%)分别较低(P <0.05),而硝普钠诱发的舒张和对5 -羟色胺和氯化钾的收缩反应在两组之间相似。hcy组颈动脉对4400 MW和65 000 MW荧光标记(TRITC)葡聚糖参比大分子(定量荧光显微镜)的通透性分别比对照组高约44%和约24% (P <0.05)。用血管弹性仪评估的最大应变,HHcy组颈动脉段比CON组更小(≈32% vs 42%, P <0.05)。最后,与对照组相比,HHcy组动脉组织中氧化(铜锌+锰超氧化物歧化酶活性)和糖氧化(戊苷)应激的估计值升高(P <0.05)。这些发现表明,叶酸缺失引起的中度严重HHcy损害冠状动脉阻力血管内皮依赖性松弛,增加颈动脉通透性,并引发动脉硬化。HHcy可能通过与氧化应激和糖氧化应激增加相关的机制产生这些作用。
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Hyperhomocysteinemia Evoked by Folate Depletion: Effects on Coronary and Carotid Arterial Function
High circulating concentrations of homocysteine (ie, hyperhomocysteinemia [Hhcy]) impair the vascular function of peripheral conduit arteries and arterioles perfusing splanchnic and skeletal muscle regions. The effects of HHcy on coronary resistance vessel function and other indexes of vascular function, ie, arterial permeability and stiffening, are unclear. We tested the hypotheses that HHcy impairs coronary resistance vessel reactivity; increases carotid arterial permeability; and initiates arterial stiffening. Male rats that consumed folate-replete (CON, n=44) or folate-deplete (HHcy, n=48) chow for 4 to 5 weeks had total plasma homocysteine concentrations of 7±2 or 58±4 &mgr;mol/L, respectively. Maximal acetylcholine-evoked relaxation (≈40% vs ≈60%) and tension development from baseline in response to nitric oxide synthase inhibition (≈20% vs ≈40%) were lower (both P <0.05) in coronary resistance vessels (≈120 &mgr;m, internal diameter) isolated from HHcy versus CON animals, respectively, whereas sodium nitroprusside-evoked relaxation and contractile responses to serotonin and potassium chloride were similar between groups. Permeability to 4400 MW and 65 000 MW fluorescently labeled (TRITC) dextran reference macromolecules (quantitative fluorescence microscopy) was ≈44% and ≈24% greater (P <0.05), respectively, in carotid arteries from HHcy versus CON rats. Maximal strain, evaluated by using a vessel elastigraph, was less (≈32% vs 42%, P <0.05) in carotid arterial segments from HHcy versus CON animals, respectively. Finally, estimates of oxidative (copper-zinc+manganese superoxide dismutase activity) and glycoxidative (pentosidine) stress were elevated (P <0.05) in arterial tissue from HHcy versus CON rats. These findings suggest that moderately severe HHcy evoked by folate-depletion impairs endothelium-dependent relaxation of coronary resistance vessels, increases carotid arterial permeability, and initiates arterial stiffening. HHcy may produce these effects by a mechanism associated with increased oxidative and glycoxidative stress.
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