Bolognesi M, Sacerdoti D, Di Pascoli M, Angeli P, Quarta S, Sticca A, Pontisso P, Merkel C, Gatta A
Clinica Medica 5, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, Via Giustiniani 2, 35128 Padova, Italy.
Gut. 2005 Nov;54(11):1630-6. doi: 10.1136/gut.2004.063735. Epub 2005 Jun 10.
Haeme oxygenase could play a role in the pathogenesis of arterial vasodilation in cirrhosis. The aim of this study was to verify the role of haeme oxygenase in the hyporesponsiveness to phenylephrine of small mesenteric arteries in rats with CCl(4) induced cirrhosis, with and without ascites.
Pressurised small resistance mesenteric arteries were challenged with increasing doses of phenylephrine. Dose-response curves were evaluated under basal conditions, after inhibition of haeme oxygenase with chromium-mesoporphyrin, after inhibition of nitric oxide synthase (NOS) with N(G)-nitro-L-arginine-methyl-ester (L-NAME), and then after inhibition of both NOS and haeme oxygenase. Haeme oxygenase protein expression was also analysed.
Twenty six control rats and 35 rats with cirrhosis (17 with and 18 without ascites) were studied. Response to phenylephrine was lower in non-ascitic and ascitic cirrhosis than in controls. Chromium-mesoporphyrin increased the response to phenylephrine only in ascitic cirrhosis (p<0.001). L-NAME increased the response to phenylephrine in controls (p<0.001) and in ascitic and non-ascitic cirrhosis (p = 0.002, p<0.001, respectively) but the final response in non-ascitic cirrhosis was similar to that of control rats while it remained impaired in ascitic cirrhosis. Addition of chromium-mesoporphyrin to L-NAME improved the response to phenylephrine in ascitic cirrhosis (p<0.01), with final values not different from those of the other two groups. Protein expression of the inducible isoform of haeme oxygenase was increased in the mesenteric vessels of cirrhotic rats.
Haeme oxygenase mediates hyporeactivity to phenylephrine in the mesenteric vessels of experimental cirrhosis with ascites. NOS plays a major role only in the first stage of the disease.
血红素加氧酶可能在肝硬化动脉血管舒张的发病机制中发挥作用。本研究旨在验证血红素加氧酶在四氯化碳诱导的有腹水和无腹水肝硬化大鼠肠系膜小动脉对去氧肾上腺素反应性降低中的作用。
用递增剂量的去氧肾上腺素刺激加压的肠系膜小阻力动脉。在基础条件下、用中卟啉铬抑制血红素加氧酶后、用N(G)-硝基-L-精氨酸甲酯(L-NAME)抑制一氧化氮合酶(NOS)后以及同时抑制NOS和血红素加氧酶后评估剂量-反应曲线。还分析了血红素加氧酶蛋白表达。
研究了26只对照大鼠和35只肝硬化大鼠(17只有腹水,18只无腹水)。无腹水和有腹水肝硬化大鼠对去氧肾上腺素的反应低于对照组。中卟啉铬仅在有腹水的肝硬化大鼠中增加了对去氧肾上腺素的反应(p<0.001)。L-NAME在对照组(p<0.001)以及有腹水和无腹水的肝硬化大鼠中(分别为p = 0.002,p<0.001)增加了对去氧肾上腺素的反应,但无腹水肝硬化大鼠的最终反应与对照大鼠相似,而有腹水肝硬化大鼠的反应仍受损。在L-NAME基础上加用中卟啉铬可改善有腹水肝硬化大鼠对去氧肾上腺素的反应(p<0.01),最终值与其他两组无差异。肝硬化大鼠肠系膜血管中诱导型血红素加氧酶异构体的蛋白表达增加。
血红素加氧酶介导实验性有腹水肝硬化大鼠肠系膜血管对去氧肾上腺素的反应性降低。NOS仅在疾病的第一阶段起主要作用