Brock James A, Yeoh Melanie, McLachlan Elspeth M
Prince of Wales Medical Research Institute, University of New South Wales, Randwick, NSW 2031, Australia.
Am J Physiol Heart Circ Physiol. 2006 Jan;290(1):H398-405. doi: 10.1152/ajpheart.00712.2005. Epub 2005 Sep 2.
In patients with high thoracic spinal lesions that remove most of the central drive to splanchnic preganglionic neurons, visceral or nociceptive stimuli below the lesion can provoke large increases in blood pressure (autonomic dysreflexia). We have examined the effects of T4 spinal transection on isometric contractions of mesenteric arteries isolated from spinalized rats. Nerve-evoked contractions involved synergistic roles for norepinephrine and ATP. At 7 wk after spinal transection, responses to perivascular stimulation at 1-5 Hz were enhanced fivefold, whereas the alpha1-adrenoceptor antagonist prazosin (10 nM) produced a twofold larger reduction in contraction (to 20 pulses at 10 Hz) than in unoperated controls. In contrast, the reduction in nerve-evoked contractions by the P2-purinoceptor antagonist suramin (0.1 mM) and the responses to the P2-purinoceptor agonist alpha,beta-methylene ATP or to high K+ concentration did not greatly differ between groups, indicating that arteries from spinalized rats were not generally hyperreactive. Sensitivity to the alpha1-adrenoceptor agonist phenylephrine was enhanced in arteries from spinalized rats, and the difference from controls was abolished by the norepinephrine uptake blocker desmethylimipramine. Sensitivity to the alpha1-adrenoceptor agonist methoxamine, which is not a substrate for the neuronal norepinephrine transporter, was similar among the groups. Thus the increased neurally evoked response after spinal transection appeared to be due to a reduction in neuronal uptake of released norepinephrine, a mechanism that did not explain the enhanced response of tail arteries after spinal transection that we previously reported. The findings provide further support for potentiated neurovascular responses contributing to the genesis of autonomic dysreflexia.
在高位胸段脊髓损伤患者中,大部分内脏节前神经元的中枢驱动被消除,损伤平面以下的内脏或伤害性刺激可引起血压大幅升高(自主神经反射异常)。我们研究了T4脊髓横断对脊髓损伤大鼠肠系膜动脉等长收缩的影响。神经诱发的收缩涉及去甲肾上腺素和ATP的协同作用。脊髓横断7周后,对1-5Hz血管周围刺激的反应增强了5倍,而α1肾上腺素能受体拮抗剂哌唑嗪(10nM)在10Hz时对20个脉冲收缩的抑制作用比未手术对照组大两倍。相比之下,P2嘌呤受体拮抗剂苏拉明(0.1mM)对神经诱发收缩的抑制作用以及对P2嘌呤受体激动剂α,β-亚甲基ATP或高钾浓度的反应在两组之间没有显著差异,表明脊髓损伤大鼠的动脉一般没有过度反应。脊髓损伤大鼠动脉对α1肾上腺素能受体激动剂去氧肾上腺素的敏感性增强,而去甲肾上腺素摄取阻滞剂去甲丙咪嗪消除了与对照组的差异。对不是去甲肾上腺素神经元转运体底物的α1肾上腺素能受体激动剂甲氧明的敏感性在各组之间相似。因此,脊髓横断后神经诱发反应的增加似乎是由于释放的去甲肾上腺素的神经元摄取减少,这一机制无法解释我们之前报道的脊髓横断后尾动脉反应增强的现象。这些发现为增强的神经血管反应导致自主神经反射异常的发生提供了进一步的支持。