Rodman D M
Division of Pulmonary Sciences, University of Colorado Health Sciences Center, Denver 80262.
Am J Physiol. 1992 Jul;263(1 Pt 1):L88-94. doi: 10.1152/ajplung.1992.263.1.L88.
The initiating event in hypoxic pulmonary hypertension is felt to be sustained hypoxic vasoconstriction, ultimately leading to vascular remodeling and fixed pulmonary hypertension. During the initial vasospastic phase endogenous vasodilatory pathways may serve to ameliorate the development of pulmonary hypertension. However, various studies in the systemic and pulmonary circulations have shown that chronic hemodynamic stress alters both endothelial and smooth muscle cell function. The effect of chronic hypoxia in rats was therefore tested on three major vasodilatory pathways: 1) endothelium-dependent relaxation (using endothelium-derived relaxing factor agonists and antagonists); 2) smooth muscle cell cyclic nucleotide-mediated relaxation [using guanosine and adenosine 3',5'-cyclic monophosphate (cGMP and cAMP) agonists]; and 3) ion channel-dependent relaxation (using K+ channel agonists and Ca2+ channel antagonists). It was found that short-term exposure (72 h) to hypoxia caused augmentation of K+ and Ca2+ channel-dependent relaxation with no effect on endothelium-dependent or cyclic nucleotide-mediated relaxation. More prolonged exposure (4-5 wk) was additionally associated with inhibition of endothelium-dependent relaxation and smooth muscle cell cGMP-mediated relaxation. There was no effect on either basal modulation of tone by the endothelium, cAMP-mediated relaxation, or systemic vessel relaxation. It is concluded that an early response to hemodynamic stress in the pulmonary circulation is alteration in smooth muscle cell ion channel function and/or Ca2+ homeostasis.
低氧性肺动脉高压的起始事件被认为是持续性的低氧性血管收缩,最终导致血管重塑和固定性肺动脉高压。在初始血管痉挛阶段,内源性血管舒张途径可能有助于改善肺动脉高压的发展。然而,在体循环和肺循环中的各种研究表明,慢性血流动力学应激会改变内皮细胞和平滑肌细胞的功能。因此,在大鼠中测试了慢性低氧对三种主要血管舒张途径的影响:1)内皮依赖性舒张(使用内皮衍生的舒张因子激动剂和拮抗剂);2)平滑肌细胞环核苷酸介导的舒张[使用鸟苷和腺苷3',5'-环磷酸(cGMP和cAMP)激动剂];3)离子通道依赖性舒张(使用钾通道激动剂和钙通道拮抗剂)。结果发现,短期暴露(72小时)于低氧会导致钾通道和钙通道依赖性舒张增强,而对内皮依赖性或环核苷酸介导的舒张无影响。更长时间的暴露(4-5周)还会抑制内皮依赖性舒张和平滑肌细胞cGMP介导的舒张。对内皮对张力的基础调节、cAMP介导的舒张或体循环血管舒张均无影响。结论是,肺循环中对血流动力学应激的早期反应是平滑肌细胞离子通道功能和/或钙稳态的改变。