Janssens S, Derom E, Reid M B, Tjandramaga T B, Decramer M
Respiratory Division, University Hospitals, University of Leuven, Belgium.
Am Rev Respir Dis. 1991 Dec;144(6):1250-5. doi: 10.1164/ajrccm/144.6.1250.
To distinguish the effects of theophylline on respiratory muscle contractility from alterations in respiratory muscle interaction or blood flow, we examined in vitro contractile properties and fatigue of canine diaphragm in two series of experiments. In the first series, a 40-mg/kg aminophylline infusion was given to dogs, and diaphragm strips were removed for in vitro study when stable tissue fixation of the drug was reached. Compared with control bundles examined before aminophylline infusion, no alterations in twitch tension, tetanic tension, or force-frequency characteristics were observed. Moreover, theophylline-treated strips fatigued faster than control strips, whether subjected to repetitive submaximal or maximal contractions (p less than 0.01). In the second series, diaphragm bundles were equilibrated with high theophylline doses (400 mg/L) in vitro, and inotropic effects compared with the results in the first series. Supratherapeutic theophylline concentrations increased force development at low stimulation frequencies (p less than 0.05 at 10 Hz) and significantly elevated twitch-tetanus ratio (p less than 0.01) but did not protect against development of in vitro muscle fatigue. Poor penetration of theophylline in diaphragm bundles in vitro was excluded, since drug concentrations in the muscle bundle and the muscle bath were virtually equal. We conclude that diaphragmatic tissue concentrations correlate well with therapeutic serum and supratherapeutic bath levels and that only high theophylline concentrations increase canine diaphragmatic contractility in vitro. None of the theophylline concentrations studied could protect diaphragm bundles against the development of low- or high-frequency fatigue in vitro.
为了区分茶碱对呼吸肌收缩力的影响与呼吸肌相互作用或血流变化的影响,我们在两个系列的实验中研究了犬膈肌的体外收缩特性和疲劳情况。在第一个系列中,给犬输注40mg/kg的氨茶碱,当药物达到稳定的组织固定状态时,取出膈肌条进行体外研究。与氨茶碱输注前检查的对照束相比,未观察到单收缩张力、强直收缩张力或力-频率特性的改变。此外,无论进行重复的次最大或最大收缩,茶碱处理的肌条比对照肌条疲劳得更快(p<0.01)。在第二个系列中,将膈肌束在体外与高剂量的茶碱(400mg/L)平衡,并将其变力作用与第一个系列的结果进行比较。超治疗剂量的茶碱浓度在低刺激频率下增加了力的产生(在10Hz时p<0.05),并显著提高了单收缩-强直收缩比率(p<0.01),但并未防止体外肌肉疲劳的发生。由于肌束和肌肉浴中的药物浓度几乎相等,排除了茶碱在体外膈肌束中渗透不良的情况。我们得出结论,膈肌组织浓度与治疗性血清浓度和超治疗性浴液水平密切相关,并且只有高浓度的茶碱才能在体外增加犬膈肌的收缩力。所研究的任何茶碱浓度均不能保护膈肌束在体外免受低频或高频疲劳的发生。