Mardon Karine, Montagne Olivier, Elbaz Nathalie, Malek Zoulikha, Syrota André, Dubois-Randé Jean-Luc, Meignan Michel, Merlet Pascal
Service Hospitalier Frédéric Joliot, Département de Recherche Médicale, Direction des Sciences du Vivant-Commissariat à l'Energie Atomique, Orsay, France.
J Nucl Med. 2003 Sep;44(9):1459-66.
Imaging techniques have demonstrated in various cardiomyopathies that an altered uptake of radiolabeled norepinephrine (NE) analogs may coexist with beta-adrenergic receptor downregulation, but the relationships between these 2 alterations and their mechanisms remain unclear. The aim of this study was to evaluate the hypothesis of a chronic elevation of circulating NE levels as a mechanism of decreased uptake of radiolabeled NE analogs and reduced beta-adrenergic receptor sites in the heart.
Osmotic minipumps containing either NE or NaCl were implanted intravenously in rats for 5 d. The uptake-1 function was assessed in vitro by measuring in excised hearts (3)H-NE and (123)I-metaiodobenzylguanidine ((123)I-MIBG) uptakes and uptake-1 carrier density using (3)H-mazindol binding assay. The myocardial beta-adrenergic receptor pathway was assessed in vitro by (3)H-CGP 12177 binding and measurement of adenylyl cyclase activity at baseline and under stimulation.
A 34% decrease in (3)H-NE uptake and a 35% decrease in (123)I-MIBG uptake were found in the hearts of rats infused with the NE pump compared with that of rats infused with saline solution (P < 0.05 for both). Moreover, the uptake-1 carrier protein density was decreased by 29% (P < 0.05) and 33% (P < 0.05) in right and left ventricles, respectively, of rats infused with NE compared with those infused with saline solution. Myocardial beta-adrenergic receptor desensitization was associated with a 36% reduction in receptor density in the right ventricle (P < 0.05) and a 31% reduction in the left ventricle (P < 0.05) of rats infused with NE compared with those infused with saline solution.
The decrease in myocardial beta-adrenergic receptors and radiolabeled NE analog uptake found in different cardiomyopathies using neuroimaging techniques may be related to a functional mechanism of NE-induced downregulation of both beta-adrenergic receptor and uptake-1 carrier sites.
成像技术已在多种心肌病中表明,放射性标记去甲肾上腺素(NE)类似物摄取改变可能与β-肾上腺素能受体下调同时存在,但这两种改变之间的关系及其机制仍不清楚。本研究的目的是评估循环NE水平慢性升高作为放射性标记NE类似物摄取减少和心脏β-肾上腺素能受体位点减少机制的假说。
将含NE或NaCl的渗透微型泵静脉植入大鼠体内5天。通过测量离体心脏中(3)H-NE和(123)I-间碘苄胍((123)I-MIBG)摄取以及使用(3)H-吗茚酮结合试验测量摄取-1载体密度来体外评估摄取-1功能。通过(3)H-CGP 12177结合以及在基线和刺激下测量腺苷酸环化酶活性来体外评估心肌β-肾上腺素能受体途径。
与输注盐溶液的大鼠相比,输注NE泵的大鼠心脏中(3)H-NE摄取减少34%,(123)I-MIBG摄取减少35%(两者P均<0.05)。此外,与输注盐溶液的大鼠相比,输注NE的大鼠右心室和左心室摄取-1载体蛋白密度分别降低29%(P<0.05)和33%(P<0.05)。与输注盐溶液的大鼠相比,输注NE的大鼠心肌β-肾上腺素能受体脱敏与右心室受体密度降低36%(P<0.05)和左心室降低31%(P<0.05)相关。
使用神经成像技术在不同心肌病中发现的心肌β-肾上腺素能受体和放射性标记NE类似物摄取减少可能与NE诱导β-肾上腺素能受体和摄取-1载体位点下调的功能机制有关。