Allen P D, López J R, Sánchez V, Ryan J F, Sreter F A
Department of Anesthesia, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Anesthesiology. 1992 Jan;76(1):132-8. doi: 10.1097/00000542-199201000-00019.
The mechanisms causing the malignant hyperthermia (MH) syndrome are related to a malfunction of intracellular Ca2+ homeostasis and can be prevented or reversed by dantrolene. EU 4093 (Azumolene, 1-[[[5-(4-bromophenyl)-2-oxyzolyl] methylene]amino]-2-4- imidazolidinedione) is a 30-fold more water-soluble analogue of dantrolene that is believed to have the same effects as dantrolene on the intracellular free Ca2+ concentration [( Ca2+]i) in skeletal muscle and that should have similar efficacy in treating and preventing the clinical manifestations of MH in response to a halothane/succinylcholine challenge. To test this hypothesis, experiments were carried out in four controls (Yorkshire) and eight MH-susceptible crossbreed swine (Poland China X Pietrain). The resting [Ca2+]i in normal muscle fibers measured by Ca(2+)-selective microelectrodes was 111 +/- 12 nM (mean +/- standard deviation, n = 30), whereas in the MH muscles the resting [Ca2+]i was 395 +/- 36 nM, (n = 28) (P = 0.0001). EU 4093 decreased [Ca2+]i in MH-susceptible skeletal muscle in a dose-related fashion from 207 to 38 nM after 0.5 to 2.0 mg/kg, respectively, and had a similar effect in control skeletal muscle (58 to 30 nM) after the same doses. In MH-susceptible swine, a dose of 2.0 mg/kg was successful in preventing any clinical signs of the MH syndrome during a subsequent halothane/succinylcholine challenge. A dose of 0.5 mg/kg was able to attenuate but not reverse the clinical signs of the MH syndrome after a halothane challenge, whereas a dose of 1.0 mg/kg was completely successful in reversing this effect in all subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
导致恶性高热(MH)综合征的机制与细胞内钙离子稳态失调有关,丹曲林可预防或逆转这种情况。EU 4093(阿祖莫林,1-[[[5-(4-溴苯基)-2-氧代唑基]亚甲基]氨基]-2,4-咪唑烷二酮)是一种水溶性比丹曲林高30倍的类似物,据信其对骨骼肌细胞内游离钙离子浓度[Ca2+]i的作用与丹曲林相同,并且在应对氟烷/琥珀酰胆碱激发时,在治疗和预防MH的临床表现方面应具有相似疗效。为验证这一假设,在4只对照(约克夏)猪和8只MH易感杂交猪(波兰中国猪×皮特兰猪)身上进行了实验。用钙离子选择性微电极测量,正常肌纤维的静息[Ca2+]i为111±12 nM(平均值±标准差,n = 30),而在MH肌中,静息[Ca2+]i为395±36 nM(n = 28)(P = 0.0001)。EU 4093以剂量相关方式使MH易感骨骼肌中的[Ca2+]i分别从207 nM降至38 nM(在0.5至2.0 mg/kg剂量后),相同剂量下对对照骨骼肌也有类似作用(从58 nM降至30 nM)。在MH易感猪中,2.0 mg/kg的剂量成功预防了随后氟烷/琥珀酰胆碱激发期间MH综合征的任何临床体征。0.5 mg/kg的剂量能够减轻但不能逆转氟烷激发后MH综合征的临床体征,而1.0 mg/kg的剂量在所有受试对象中完全成功逆转了这种效应。(摘要截短于250字)