Giusti-Paiva Alexandre, Martinez Maria Regina, Felix Jorge Vinicius Cestari, da Rocha Maria Jose Alves, Carnio Evelin Capellari, Elias Lucila Leico Kagohara, Antunes-Rodrigues Jose
Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, SP, Brazil.
Shock. 2004 Mar;21(3):271-5. doi: 10.1097/10.shk.0000115756.74059.ce.
Lipopolysaccharides (LPS) can be used to induce experimental endotoxic shock, which is characterized by a significant decrease in mean arterial pressure (MAP) and a decreased vasoconstrictor response that have been attributed to excessive nitric oxide production. Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), in addition to lowering serum cholesterol levels, exert many pleiotropic effects, including anti-inflammatory action. In the present study, we investigated the effect of simvastatin, an HMG-CoA reductase inhibitor, on the production of nitric oxide and the cardiovascular response to LPS. Male Wistar rats were pretreated with different doses of simvastatin (10, 20, 40, and 80 mg/kg, i.p.) or saline 20 min before i.v. injection of LPS (1.5 mg/kg) or saline (control). MAP was continuously recorded and nitrate plasma concentration was determined during the 6-h experimental session at 1-h intervals. The pressor response to phenylephrine (1 microg/kg) was evaluated before and 6 h after LPS administration. In the LPS-treated group, there was a time-dependent increase in nitrate plasma concentration (P<0.001), and this response was decreased in simvastatin pretreated rats (P<0.001). We also observed that LPS decreased the pressor response to phenylephrine (P<0.001), an effect that was reverted by simvastatin pretreatment (P<0.05). However, simvastatin did not modify the decrease of MAP induced by LPS. We concluded that simvastatin decreases nitrate plasma concentration in response to LPS and recovers vascular responsiveness during an experimental endotoxic shock. These data suggest the potential use of HMG-CoA reductase inhibitors as a coadjuvant in the treatment of septic shock.
脂多糖(LPS)可用于诱导实验性内毒素休克,其特征为平均动脉压(MAP)显著降低以及血管收缩反应减弱,这归因于一氧化氮产生过多。3-羟基-3-甲基戊二酰辅酶A还原酶(HMG-CoA还原酶)抑制剂除了能降低血清胆固醇水平外,还具有多种多效性作用,包括抗炎作用。在本研究中,我们调查了HMG-CoA还原酶抑制剂辛伐他汀对一氧化氮产生以及对LPS的心血管反应的影响。雄性Wistar大鼠在静脉注射LPS(1.5mg/kg)或生理盐水(对照)前20分钟,分别用不同剂量的辛伐他汀(10、20、40和80mg/kg,腹腔注射)或生理盐水进行预处理。在6小时的实验过程中,每隔1小时连续记录MAP并测定血浆硝酸盐浓度。在给予LPS前和给予LPS后6小时评估对去氧肾上腺素(1μg/kg)的升压反应。在LPS处理组中,血浆硝酸盐浓度呈时间依赖性增加(P<0.001),而在辛伐他汀预处理的大鼠中这种反应减弱(P<0.001)。我们还观察到LPS降低了对去氧肾上腺素的升压反应(P<0.001),辛伐他汀预处理可逆转这一效应(P<0.05)。然而,辛伐他汀并未改变LPS诱导的MAP降低。我们得出结论,辛伐他汀可降低LPS诱导的血浆硝酸盐浓度,并在实验性内毒素休克期间恢复血管反应性。这些数据表明HMG-CoA还原酶抑制剂在治疗脓毒性休克中具有作为辅助药物的潜在用途。