Kawanabe Yoshifumi, Masaki Tomoh, Hashimoto Nobuo
Department of Neurosurgery and Pharmacology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
J Neurosurg. 2003 Mar;98(3):561-4. doi: 10.3171/jns.2003.98.3.0561.
The Ca++ influx into vascular smooth-muscle cells (VSMCs) plays a fundamental role in the development and chronic effects of vasospasm after subarachnoid hemorrhage (SAH). The Ca++-permeable nonselective cation channels (NSCCs) are activated by several endothelium-derived constricting factors such as endothelin 1 (ET-1) and thromboxane A2. Moreover, the receptor-operated Ca++ channel blocker LOE 908 inhibits ET-1-induced extracellular Ca++ influx via NSCCs in the VSMCs of the basilar artery (BA) and the NSCC-dependent part of ET-1-induced vasoconstriction of BA rings. The purpose of the present study was to evaluate the in vivo role of LOE 908 on SAH-induced vasospasm.
Forty-two Japanese white rabbits were assigned to seven groups. Treatment groups consisted of the following: 1) control rabbits without SAH that received a cisternal injection of saline; 2) rabbits with SAH that were subjected to the intravenous administration of saline; 3 through 6) rabbits with SAH that underwent the intravenous administration of 0.01. 0.1, 1, or 10 mg/kg LOE 908, respectively; and 7) rabbits without SAH that underwent the intravenous administration of 10 mg/kg LOE 908. Autologous blood was injected into the cisterna magna. The caliber of the BA was measured on angiographic studies before and after the cisternal injection of autologous blood. The intravenous injection of LOE 908 inhibited the magnitude of an SAH-induced vasosapsm. In addition, the concentration of LOE 908 required to relax vasospasm (1 mg/kg) correlated with that required to block Ca++ influx into VSMCs.
The Ca++ channel blocker LOE 908 may inhibit the magnitude of an SAH-induced vasospasm by blocking the influx of Ca++ through NSCCs in rabbit BAs. Blocking the NSCCs may represent a new treatment for cerebral vasospasm after SAH.
钙离子流入血管平滑肌细胞(VSMC)在蛛网膜下腔出血(SAH)后血管痉挛的发生及慢性影响中起重要作用。钙离子通透非选择性阳离子通道(NSCC)可被多种内皮源性收缩因子激活,如内皮素1(ET-1)和血栓素A2。此外,受体操纵性钙离子通道阻滞剂LOE 908可抑制ET-1诱导的细胞外钙离子经基底动脉(BA)VSMC中的NSCC流入,以及ET-1诱导的BA环血管收缩中依赖NSCC的部分。本研究旨在评估LOE 908在SAH诱导血管痉挛中的体内作用。
42只日本白兔分为7组。治疗组包括:1)未发生SAH的对照兔,经脑池内注射生理盐水;2)发生SAH的兔,静脉注射生理盐水;3至6)发生SAH的兔,分别静脉注射0.01、0.1、1或10mg/kg的LOE 908;7)未发生SAH的兔,静脉注射10mg/kg的LOE 908。将自体血注入枕大池。在脑池内注射自体血前后,通过血管造影研究测量BA的管径。静脉注射LOE 908可抑制SAH诱导的血管痉挛程度。此外,舒张血管痉挛所需的LOE 908浓度(1mg/kg)与阻断钙离子流入VSMC所需浓度相关。
钙离子通道阻滞剂LOE 908可能通过阻断兔BA中NSCC的钙离子流入来抑制SAH诱导的血管痉挛程度。阻断NSCC可能代表SAH后脑血管痉挛的一种新治疗方法。