Griesbacher T
Department of Experimental and Clinical Pharmacology, University of Graz, Austria.
Pharmacology. 2000 Apr;60(3):113-20. doi: 10.1159/000028355.
The development of selective antagonists for bradykinin B(2) receptors has greatly advanced research on the role of the kallikrein-kinin system in acute pancreatitis. Kinins released during the course of the inflammatory injury are the major cause of the vascular symptoms, i.e. pancreatic oedema formation and its consequences, such as haemoconcentration, hypovolaemia and hypotension. Kinins are also involved in the accumulation of potentially cytotoxic factors in the pancreatic tissue. However, treatment with B(2) antagonists must begin prior to the formation of pancreatic oedema in order to inhibit or attenuate the vascular effects. Visceral pain as a possible target symptom for treatment with B(2) antagonists at later time points is suggested by the B(2) receptor-mediated activation of nociceptive afferents.
缓激肽B2受体选择性拮抗剂的研发极大地推动了激肽释放酶-激肽系统在急性胰腺炎中作用的研究。炎症损伤过程中释放的激肽是血管症状的主要原因，即胰腺水肿形成及其后果，如血液浓缩、血容量不足和低血压。激肽还参与胰腺组织中潜在细胞毒性因子的积聚。然而，必须在胰腺水肿形成之前开始用B2拮抗剂治疗，以抑制或减轻血管效应。B2受体介导的伤害性传入神经激活提示，内脏疼痛可能是后期用B2拮抗剂治疗的目标症状。
