Mitaka C, Hirata Y, Yokoyama K, Nagura T, Tsunoda Y, Amaha K
Intensive Care Unit, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113, Japan.
Crit Care. 1997;1(1):45-50. doi: 10.1186/cc6.
Nitric oxide (NO) production following bacterial infection may play a physiological role in the host defense mechanism due to its antimicrobial activity. However, excess production of NO in severe infection such as sepsis has been implicated in the pathogenesis of septic shock. To determine whether a nitronyl nitroxide NO scavenger compound could prevent the hemodynamic and blood gas alterations in sepsis, bacterial lipopolysaccharide (LPS: 250ng/kg/min) was administered for 2 h in anesthetized dogs with or without infusion of carboxy-2-phenyl-4, 4, 5, 5-tetramethylimidazoline-1-oxyl-3-oxide (carboxy-PTIO: 0.1 mg/kg/min) for 1 h. Control animals received isotonic saline instead of LPS with or without carboxy-PTIO. RESULTS: Infusion of LPS caused a marked decrease in mean arterial pressure (MAP), metabolic acidosis, and hypoxia. These effects were reversed by co-administration of carboxy-PTIO, without affecting other hemodynamic parameters. In control animals, neither hemodynamic nor blood gas parameters changed with or without carboxy-PTIO. CONCLUSION: These results indicate that carboxy-PTIO attenuates LPS-induced hypotension, metabolic acidosis, and hypoxia by scavenging excess NO from the circulation without affecting NO synthase (NOS) activity. An NO scavenger, carboxy-PTIO, may be preferable to non-selective NOS inhibitors for the treatment of human septic shock.
细菌感染后一氧化氮(NO)的产生可能因其抗菌活性在宿主防御机制中发挥生理作用。然而,在严重感染如脓毒症中,NO的过量产生与脓毒性休克的发病机制有关。为了确定一种硝酰基氮氧化物NO清除剂化合物是否能预防脓毒症时的血流动力学和血气改变,在麻醉犬中给予细菌脂多糖(LPS:250ng/kg/min)2小时,同时或不给予羧基-2-苯基-4,4,5,5-四甲基咪唑啉-1-氧基-3-氧化物(羧基-PTIO:0.1mg/kg/min)1小时。对照动物给予等渗盐水代替LPS,同时或不给予羧基-PTIO。结果:输注LPS导致平均动脉压(MAP)显著降低、代谢性酸中毒和低氧血症。羧基-PTIO联合给药可逆转这些效应,且不影响其他血流动力学参数。在对照动物中,无论有无羧基-PTIO,血流动力学和血气参数均无变化。结论:这些结果表明,羧基-PTIO通过清除循环中过量的NO减轻LPS诱导的低血压、代谢性酸中毒和低氧血症,而不影响一氧化氮合酶(NOS)活性。对于人类脓毒性休克的治疗,NO清除剂羧基-PTIO可能比非选择性NOS抑制剂更可取。