AIMTo investigate the effect on myocardial apoptosis and Bcl-2/Bax induced by remote preconditioning (RP) and to discuss the hypothesis from opioid receptors in pigs.

METHODSSkeletal muscle ischemia was performed in pigs by occlusion of the femoral artery (FAO) for 15 min followed by a 10 min of reperfusion. Infarction of the heart was induced by 40 min of left anterior descending coronary artery (LAD) occlusion followed by 120 min reperfusion. In the RP model induced by FAO, the role of opioid receptors was investigated by using antagonist of the opioid receptors (naloxone). The signal transduction pathway of RP was investigated by using hexamethonium. Apoptosis of left ventricular samples from nonischemic and ischemic areas was detected in situ with end-labeling (TUNEL) method and measured by flow cytometry. Bcl-2 and Bax was also measured by flow cytometry.

RESULTS(1) The apoptosis rate in ischemic myocardium in RP group measured by flow cytometry was lower (4.43% +/- 0.74%) compared with that in CONT group (15.4% +/- 1.15%), but Bcl-2/Bax was higher (1.36 +/- 0.09, CONT group: 0.56 +/- 0.08). (2) The protective effect could be prevented by naloxone used before RP protocol (apoptosis rate: 13.0% +/- 0.56% and Bcl-2/Bax: 0.69 +/- 0.18, P < 0.05). (3) Naloxone had no effect on apoptosis rate in CONT group. (4) Hexamethonium used before RP protocol had no effect on apoptosis rate and bcl-2/bax. Apoptotic cardiomyocytes detected in TUNEL correspond to the above.

CONCLUSIONRP induced by skeletal muscle ischemia could prevent myocardium from apoptosis, in which Bcl-2 and Bax might take part in regulation and control. Furthermore opioid receptors could take part in triggering the course and a neuronal signal transmission from the remote area to heart could be excluded.