Schmidt P T, Lördal M, Gazelius B, Hellström P M
Department of Medicine, Unit of Gastroenterology, Karolinska Hospital, Stockholm, Sweden.
Gut. 2003 Jan;52(1):53-6. doi: 10.1136/gut.52.1.53.
The two tachykinins substance P and neurokinin A are abundantly present in the gastrointestinal tract. Substance P preferring neurokinin 1 receptors are mainly found in submucosal blood vessels while neurokinin A preferring neurokinin 2 receptors seem to be confined to smooth muscle cells. Tachykinin effects on intestinal mucosal blood flow in humans are not known.
To study the effects of substance P and neurokinin A on small bowel mucosal blood flow in humans.
A manometry tube supplied with single fibre microprobes recorded mucosal blood flow in the proximal small bowel using laser Doppler flowmetry, concomitant with luminal manometry, defining phases I, II, and III of the migrating motor complex. Simultaneously, flowmetry of temporal skin was performed. Under fasting conditions saline was infused intravenously over four hours followed by infusion of substance P, neurokinin A, or saline.
During phase I, substance 1-6 pmol/kg/min increased mucosal blood flow dose dependently by a maximum of 158%. Blood flow of the temporal skin increased in parallel. Neurokinin A 6-50 pmol/kg/min increased mucosal blood flow maximally by 86% at 25 pmol/kg/min while blood flow of temporal skin increased at all doses. Substance P at all doses and neurokinin A at the highest dose only, increased pulse rate. Systolic blood pressure was unchanged by either peptide while substance P at the highest dose decreased diastolic pressure.
Tachykinins increase blood flow of the small bowel and temporal skin. With substance P being more potent than neurokinin A, these effects are probably mediated through neurokinin 1 receptors.
速激肽P物质和神经激肽A在胃肠道中大量存在。P物质主要作用于神经激肽1受体,主要存在于黏膜下血管,而神经激肽A主要作用于神经激肽2受体,似乎局限于平滑肌细胞。速激肽对人体小肠黏膜血流的影响尚不清楚。
研究P物质和神经激肽A对人体小肠黏膜血流的影响。
一根配备单纤维微探针的测压管,使用激光多普勒血流仪记录近端小肠的黏膜血流,同时进行腔内测压,确定移行性运动复合波的I、II和III期。同时,对颞部皮肤进行血流测定。在禁食条件下,静脉输注生理盐水4小时,随后输注P物质、神经激肽A或生理盐水。
在I期,P物质以1 - 6 pmol/kg/min的剂量静脉输注时,黏膜血流呈剂量依赖性增加,最大增幅为158%。颞部皮肤血流也相应增加。神经激肽A以6 - 50 pmol/kg/min的剂量静脉输注时,在25 pmol/kg/min时黏膜血流最大增加86%,而颞部皮肤血流在所有剂量下均增加。所有剂量的P物质和仅最高剂量的神经激肽A可增加脉搏率。两种肽均未改变收缩压,而最高剂量的P物质可降低舒张压。
速激肽可增加小肠和颞部皮肤的血流。由于P物质比神经激肽A更有效,这些作用可能是通过神经激肽1受体介导的。