Huang Hui-Chun, Wang Sun-Sang, Lee Fa-Yauh, Chang Ching-Chih, Chang Full-Young, Lin Han-Chieh, Hou Ming-Chih, Lee Shou-Dong
Department of Medicine, Division of Gastroenterology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan.
J Gastroenterol Hepatol. 2008 Jul;23(7 Pt 2):e265-9. doi: 10.1111/j.1440-1746.2007.05122.x. Epub 2007 Aug 30.
Nitric oxide (NO) plays a significant role in the vascular hyposensitivity to vasoconstrictors in cirrhosis. Chronic NO inhibition improves the portal-systemic collateral responsiveness to arginine(8)-vasopressin (AVP) and ameliorates shunting degree in rats with prehepatic portal hypertension. This study investigated whether long-term NO inhibition by N(G)-nitro-L-arginine methyl ester (L-NAME) enhances the collateral vascular responsiveness to AVP and alleviates the severity of shunting in cirrhotic rats.
Bile duct-ligated (BDL) rats received L-NAME in tap water (25 mg/kg/day) or tap water only (control) for 1 week from the 36th day after BDL. On the 43rd day, the mean arterial pressure and portal pressure were measured. With an in situ perfusion model of portal-systemic collateral vasculature, different concentrations of AVP (10(-10)-10(-7) mol/L) with a constant flow rate (12 mL/min) were applied to assess the perfusion pressure changes of collaterals. In addition, flow pressure curves were obtained with different flow rates (6-18 mL/min): the slopes serve as indices of collateral vascular resistance and the higher resistance indicates less collateral.
The mean arterial pressure was significantly increased after L-NAME treatment (P < 0.05), whereas the heart rate and portal pressure were not significantly modified. As compared with the controls, the L-NAME group exerted significantly higher perfusion pressure changes to AVP at the concentrations of 3 x 10(-8), 10(-7) and 3 x 10(-7) mol/L. In addition, chronic L-NAME administration induced collateral vascular resistance elevation, suggesting the attenuation of portal-systemic shunting.
Chronic NO inhibition improves the collateral vascular responsiveness to AVP and ameliorates portal-systemic shunting in BDL cirrhotic rats.
一氧化氮(NO)在肝硬化时血管对血管收缩剂的低反应性中起重要作用。慢性抑制NO可改善肝前性门静脉高压大鼠门静脉 - 体循环侧支循环对精氨酸加压素(AVP)的反应性,并减轻分流程度。本研究探讨N(G)-硝基-L-精氨酸甲酯(L-NAME)长期抑制NO是否能增强肝硬化大鼠侧支血管对AVP的反应性并减轻分流严重程度。
胆管结扎(BDL)大鼠从BDL后第36天起,在自来水中接受L-NAME(25mg/kg/天)或仅接受自来水(对照),持续1周。在第43天,测量平均动脉压和门静脉压力。采用门静脉 - 体循环侧支血管原位灌注模型,以恒定流速(12mL/min)施加不同浓度的AVP(10(-10)-10(-7)mol/L),评估侧支循环的灌注压力变化。此外,通过不同流速(6 - 18mL/min)获得流量 - 压力曲线:斜率作为侧支血管阻力的指标,阻力越高表明侧支越少。
L-NAME治疗后平均动脉压显著升高(P < 0.05),而心率和门静脉压力无显著改变。与对照组相比,L-NAME组在3×10(-8)、10(-7)和3×10(-7)mol/L浓度的AVP作用下,灌注压力变化显著更高。此外,长期给予L-NAME导致侧支血管阻力升高,提示门静脉 - 体循环分流减轻。
慢性抑制NO可改善BDL肝硬化大鼠侧支血管对AVP的反应性并减轻门静脉 - 体循环分流。