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选择性内皮素B受体刺激对心肌的影响及其调控机制与心力衰竭的关系

Modulation of the myocardial effects of selective ETB receptor stimulation and its implications for heart failure.

作者信息

Brás-Silva Carmen, Leite-Moreira Adelino F

机构信息

Serviço de Fisiologia da Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

出版信息

Rev Port Cardiol. 2005 Sep;24(9):1125-33.

Abstract

INTRODUCTION

Endothelin-1 (ET-1) acts on two types of receptors, ET(A) and ET(B). Recent functional studies suggest the existence of two ET(B) receptor subtypes in the heart: ET(B1), located on endocardial endothelial cells and responsible for negative inotropism, and ET(B2), located on myocardial cells and responsible for positive inotropism. The aim of the present study was to investigate the mechanisms underlying the myocardial effects of selective ET(B) receptor stimulation.

METHODS

The study was performed on right papillary muscles from New Zealand white rabbits (n = 39; Krebs-Ringer; 1.8 mM CaCl2; 35 degrees C). The effects of sarafotoxin S6c (SRTXc, ET(B) agonist; 0.2 microM) were evaluated in muscles with: (i) intact endocardial endothelium (EE) (n = 6); (ii) damaged EE (Triton X100; 0.5%; n = 6); (iii) intact EE, in the presence of N(G)-nitro-L-arginine (L-NNA, nitric oxide synthase inhibitor; n = 6); (iv) intact EE, in the presence of indomethacin (INDO, cyclooxygenase inhibitor; n = 6); (v) intact EE, in the presence of BQ-123 (ET(A) antagonist; n = 7); and (vi) damaged EE, in the presence of BQ-123 (n = 8). Only significant results (mean +/- SEM, p < 0.05) are given, expressed as % change from baseline.

RESULTS

In muscles with intact EE, SRTXc alone induced negative inotropic and lusitropic effects, decreasing active tension (AT) by 11.0 +/- 5.6%, maximum velocity of tension rise (dT/dt(max)) by 11.2 +/- 5.9% and maximum velocity of tension decline (dT/dt(min)) by 11.5 +/- 6.2%. However, after removal of EE, or in the presence of L-NNA or INDO, SRTXc increased AT by 35.2 +/- 11.7%, 22.8 +/- 2.9% and 15.2 +/- 3.4%, dT/dt(max) by 29.5 +/- 7.9%, 20.1 +/- 2.1% and 13.3 +/- 5.0%, and dT/dt(min) by 28.2 +/- 8.1%, 21.2 +/- 3.8% and 12.3 +/- 2.2%, respectively. In muscles with intact EE and in the presence of BQ-123, the negative inotropic and lusitropic effects of SRTXc were enhanced: AT decreased by 27.0 +/- 7.4%, dT/dt(max) by 13.3 +/- 4.9% and dT/dt(min) by 31.1 +/- 7.9%. On the other hand, the positive inotropic and lusitropic effects of SRTXc in the absence of intact EE were reversed in the presence of ET(A) blockade: AT decreased by 9.0 +/- 1.8%, dT/dt(max) by 4.1 +/- 3.5% and dT/dt(min) by 8.1 +/- 3.6%.

CONCLUSIONS

The present study shows that the inotropic and lusitropic effects mediated by ET(B) receptors are modulated by endocardial endothelium and by ET(A) receptor activity. These results may have pathophysiological and therapeutic implications in heart failure, a condition in which ET-1 levels are increased and endothelial dysfunction may be present.

摘要

引言

内皮素 -1(ET-1)作用于两种类型的受体,即ET(A)和ET(B)。最近的功能研究表明,心脏中存在两种ET(B)受体亚型:ET(B1),位于心内膜内皮细胞上,负责负性变力作用;ET(B2),位于心肌细胞上,负责正性变力作用。本研究的目的是探讨选择性刺激ET(B)受体产生心肌效应的潜在机制。

方法

本研究在新西兰白兔的右乳头肌上进行(n = 39;Krebs-Ringer液;1.8 mM氯化钙;35℃)。在以下几种情况下评估了sarafotoxin S6c(SRTXc,ET(B)激动剂;0.2 microM)的作用:(i)心内膜内皮(EE)完整的肌肉(n = 6);(ii)EE受损的肌肉(Triton X100;0.5%;n = 6);(iii)EE完整且存在N(G)-硝基-L-精氨酸(L-NNA,一氧化氮合酶抑制剂;n = 6)的肌肉;(iv)EE完整且存在吲哚美辛(INDO,环氧化酶抑制剂;n = 6)的肌肉;(v)EE完整且存在BQ-123(ET(A)拮抗剂;n = 7)的肌肉;以及(vi)EE受损且存在BQ-123的肌肉(n = 8)。仅给出显著结果(均值±标准误,p < 0.05),以相对于基线的变化百分比表示。

结果

在EE完整的肌肉中,单独使用SRTXc可诱导负性变力和变时作用,使主动张力(AT)降低11.0±5.6%,张力上升最大速度(dT/dt(max))降低11.2±5.9%,张力下降最大速度(dT/dt(min))降低11.5±6.2%。然而,去除EE后,或在存在L-NNA或INDO的情况下,SRTXc使AT分别增加35.2±11.7%、22.8±2.9%和15.2±3.4%,dT/dt(max)分别增加29.5±7.9%、20.1±2.1%和13.3±5.0%,dT/dt(min)分别增加28.2±8.1%、21.2±3.8%和12.3±2.2%。在EE完整且存在BQ-123的肌肉中,SRTXc的负性变力和变时作用增强:AT降低27.0±7.4%,dT/dt(max)降低13.3±4.9%,dT/dt(min)降低31.1±7.9%。另一方面,在不存在完整EE的情况下,SRTXc的正性变力和变时作用在存在ET(A)阻断时发生逆转:AT降低9.0±1.8%,dT/dt(max)降低4.1±3.5%,dT/dt(min)降低8.1±3.6%。

结论

本研究表明,ET(B)受体介导的变力和变时作用受心内膜内皮和ET(A)受体活性的调节。这些结果可能对心力衰竭具有病理生理学和治疗学意义,在心力衰竭这种情况下,ET-1水平升高且可能存在内皮功能障碍。

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