Erdem Aysen, Meltem Sevgili A, Akbiyik Filiz, Atilla Pergin, Cakar Nur, Balkanci Z Dicle, Iskit Alper B, Guc M Oguz
Department of Physiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Surg Res. 2007 Aug;141(2):211-9. doi: 10.1016/j.jss.2006.08.028. Epub 2007 Jun 20.
Decreased mesenteric blood flow and multiple organ injury due to free radicals are the consequences of septic shock. Since the blockade of endothelin receptors was reported to exert beneficial effects, we investigated the effects of tezosentan, a novel dual endothelin receptor antagonist, in two different experimental models of septic shock induced either by the injection of Escherichia coli endotoxin (ETX, 20 mg/kg, i.p.) or by cecal ligation and puncture (CLP).
Swiss albino mice received tezosentan (10 mg/kg, i.p.) or its solvent saline (0.9% NaCl, w/v) twice at 2 and 22 h after ETX or CLP. At 24 h, the animals were anesthetized and the mesenteric blood flow was monitored for 15 min by using perivascular ultrasonic Doppler flowmeter. Then the animals were exsanguinated, and spleen, liver, and kidneys were isolated accordingly for histopathological examination. Thiobarbituric acid reacting substances and glutathione and myeloperoxides activities were also determined in the liver.
In both ETX and CLP models, there was a decrease in mesenteric blood flow which was blocked by tezosentan. Similarly, tezosentan significantly attenuated the histopathological injury inflicted by both models. Although the glutathione levels were decreased and thiobarbituric acid reacting substances and myeloperoxidase activity were increased by ETX and CLP, tezosentan has failed to block these alterations in a consistent manner. However, a significant interaction between CLP and tezosentan with regard to myeloperoxidase activity and glutathione should be taken as partial evidence to explain the underlying mechanism of protection offered by tezosentan against liver injury.
Therefore, we concluded that tezosentan, by working via mechanisms mostly other than the blockade of free radical induced damage, is a useful treatment option for combating the deleterious effects of septic shock such as mesenteric ischemia as well as liver, spleen, and kidney injury.
脓毒性休克会导致肠系膜血流量减少以及自由基引发的多器官损伤。由于据报道内皮素受体阻断具有有益作用,我们研究了新型双重内皮素受体拮抗剂替唑生坦在两种不同的脓毒性休克实验模型中的作用,这两种模型分别通过注射大肠杆菌内毒素(ETX,20mg/kg,腹腔注射)或盲肠结扎穿刺(CLP)诱导。
瑞士白化小鼠在ETX或CLP后2小时和22小时接受两次替唑生坦(10mg/kg,腹腔注射)或其溶剂生理盐水(0.9%NaCl,w/v)。24小时时,将动物麻醉,使用血管周围超声多普勒流量计监测肠系膜血流量15分钟。然后对动物放血,相应分离出脾脏、肝脏和肾脏进行组织病理学检查。还测定了肝脏中的硫代巴比妥酸反应物质、谷胱甘肽和髓过氧化物活性。
在ETX和CLP模型中,肠系膜血流量均减少,而替唑生坦可阻断这种减少。同样,替唑生坦显著减轻了两种模型造成 的组织病理学损伤。尽管ETX和CLP使谷胱甘肽水平降低,硫代巴比妥酸反应物质和髓过氧化物活性升高,但替唑生坦未能始终一致地阻断这些改变。然而,CLP与替唑生坦在髓过氧化物活性和谷胱甘肽方面的显著相互作用应作为部分证据来解释替唑生坦对肝损伤的潜在保护机制。
因此,我们得出结论,替唑生坦主要通过非阻断自由基诱导损伤的机制发挥作用,是对抗脓毒性休克有害影响(如肠系膜缺血以及肝、脾和肾损伤)的一种有效治疗选择。