Udelsman R, Blake M J, Holbrook N J
Department of Surgery, Johns Hopkins Hospital, Baltimore, Md. 21205.
Surgery. 1991 Dec;110(6):1125-31.
The endocrine response to surgical stress results in activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. The cellular response to a wide variety of stresses results in the synthesis of a family of stress response proteins termed heat shock proteins. Potential interactions between endocrine and cellular stress responses have not been investigated in vivo. A surgical model was developed to define the genetic response to surgical stress. Wistar rats underwent ether anesthesia, laparotomy, hemorrhage, and variable recovery periods. Tissues were subsequently harvested and the RNA was isolated and probed for HSP70 messenger RNA levels. These studies showed a strong induction of HSP70 but only in the adrenal gland, aorta, and vena cava. This specific induction was rapid, occurring 30 minutes after surgery, and dramatic (greater than twentyfold induction). The induction occurred in parallel with HPA axis activation and was adrenal cortical specific as determined by in situ hybridization. These observations suggest a functional interaction between the molecular stress response and HPA axis activation.
对手术应激的内分泌反应会导致下丘脑 - 垂体 - 肾上腺（HPA）轴和交感神经系统的激活。细胞对多种应激的反应会导致一类被称为热休克蛋白的应激反应蛋白的合成。内分泌和细胞应激反应之间的潜在相互作用尚未在体内进行研究。开发了一种手术模型来确定对手术应激的基因反应。Wistar大鼠接受乙醚麻醉、剖腹术、出血以及不同的恢复期。随后采集组织，分离RNA并检测HSP70信使RNA水平。这些研究表明HSP70有强烈的诱导，但仅在肾上腺、主动脉和腔静脉中。这种特异性诱导迅速，在手术后30分钟出现，且非常显著（诱导超过二十倍）。诱导与HPA轴激活同时发生，并且通过原位杂交确定是肾上腺皮质特异性的。这些观察结果表明分子应激反应与HPA轴激活之间存在功能相互作用。
