Janosi Tibor, Peták Ferenc, Fontao Fabienne, Morel Denis R, Beghetti Maurice, Habre Walid
Paediatric Anaesthesia Unit, Geneva Children's Hospital, Rue Willy Donze 6, CH-1205 Geneva, Switzerland.
Exp Physiol. 2008 Nov;93(11):1210-9. doi: 10.1113/expphysiol.2008.042481. Epub 2008 Jun 20.
The available treatment strategies against pulmonary hypertension include the administration of endothelin-1 (ET-1) receptor subtype blockers (ET(A) and ET(B) antagonists); vasoactive intestinal polypeptide (VIP) has recently been suggested as a potential new therapeutic agent. We set out to investigate the ability of these agents to protect against the vasoconstriction and impairment of lung function commonly observed in patients with pulmonary hypertension. An ET(A) blocker (BQ123), ET(B) blocker (BQ788), a combination of these selective blockers (ET(A) + ET(B) blockers) or VIP (V6130) was administered into the pulmonary circulation in four groups of perfused normal rat lungs. Pulmonary vascular resistance (PVR) and forced oscillatory lung input impedance (Z(L)) were measured in all groups under baseline conditions and at 1 min intervals following ET-1 administrations. The airway resistance, inertance, tissue damping and elastance were extracted from the Z(L) spectra. While VIP, ET(A) blocker and combined ET(A) and ET(B) blockers significantly prevented the pulmonary vasoconstriction induced by ET-1, ET(B) blockade enhanced the ET-1-induced increases in PVR. In contrast, the ET(A) and ET(B) blockers markedly elevated the ET-1-induced increases in airway resistance, while VIP blunted this constrictor response. Our results suggest that VIP potently acts against the airway and pulmonary vascular constriction mediated by endothelin-1, while the ET(A) and ET(B) blockers exert a differential effect between airway resistance and PVR.
针对肺动脉高压的现有治疗策略包括给予内皮素 -1(ET -1)受体亚型阻滞剂(ET(A)和ET(B)拮抗剂);最近,血管活性肠肽(VIP)被认为是一种潜在的新型治疗药物。我们着手研究这些药物预防肺动脉高压患者常见的血管收缩和肺功能损害的能力。将ET(A)阻滞剂(BQ123)、ET(B)阻滞剂(BQ788)、这些选择性阻滞剂的组合(ET(A) + ET(B)阻滞剂)或VIP(V6130)注入四组灌注正常大鼠肺的肺循环中。在基线条件下以及给予ET -1后每隔1分钟测量所有组的肺血管阻力(PVR)和强迫振荡肺输入阻抗(Z(L))。从Z(L)频谱中提取气道阻力、惯性、组织阻尼和弹性。虽然VIP、ET(A)阻滞剂以及ET(A)和ET(B)阻滞剂的组合显著预防了ET -1诱导的肺血管收缩,但ET(B)阻滞剂增强了ET -1诱导的PVR增加。相反,ET(A)和ET(B)阻滞剂显著提高了ET -1诱导的气道阻力增加,而VIP减弱了这种收缩反应。我们的结果表明,VIP能有效对抗内皮素 -1介导的气道和肺血管收缩,而ET(A)和ET(B)阻滞剂在气道阻力和PVR之间发挥不同的作用。