Wiener C M, Dunn A, Sylvester J T
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland 21205.
J Clin Invest. 1991 Aug;88(2):500-4. doi: 10.1172/JCI115331.
In normo- and hypoglycemic ferret lungs, the pulmonary vascular response to severe hypoxia (PiO2 less than or equal to 10 mmHg) is characterized by an initial intense vasoconstriction followed by marked vasodilation, whereas in hyperglycemic lungs, vasodilation is minimal, causing vasoconstriction to be sustained. In contrast, the response to moderate hypoxia is characterized by a slowly developing sustained vasoconstriction which is unaffected by glucose concentration. To determine the role of ATP-dependent K+ (KATP) channels in these responses, we examined the effects of cromakalim, which opens KATP channels, and glibenclamide, which closes them. During steady-state vasoconstriction induced in isolated ferret lungs by moderate hypoxia, cromakalim caused dose-dependent vasodilation (EC50 = 7 x 10(-7) M) which was reversed by glibenclamide (IC50 = 8 x 10(-7) M), indicating that KATP channels were present and capable of modulating vascular tone. During severe hypoxia in hypoglycemic lungs [( glucose] less than 1 mM), glibenclamide markedly inhibited the secondary vasodilation. Raising perfusate glucose concentration to 14 +/- 0.4 mM had the same effect. As a result, initial vasoconstrictor responses were well sustained. However, neither glibenclamide nor hyperglycemia affected vasoconstrictor responses to moderate hypoxia or KCl, indicating that effects during severe hypoxia were not due to nonspecific potentiation of vasoconstriction. These findings suggest that in the ferret lung (a) severe hypoxia decreased ATP concentration and thereby opened KATP channels, resulting in increased K+ efflux, hyperpolarization, vasodilation, and reversal of the initial vasoconstrictor response; and (b) hyperglycemia prevented this sequence of events.
在血糖正常和低血糖的雪貂肺中,肺血管对严重低氧(动脉血氧分压小于或等于10 mmHg)的反应特点是起初强烈的血管收缩,随后是明显的血管舒张,而在高血糖的肺中,血管舒张很轻微,导致血管收缩持续存在。相比之下,对中度低氧的反应特点是缓慢发展的持续性血管收缩,且不受葡萄糖浓度的影响。为了确定ATP依赖性钾(KATP)通道在这些反应中的作用,我们研究了可打开KATP通道的克罗卡林和可关闭该通道的格列本脲的作用。在中度低氧诱导的离体雪貂肺稳态血管收缩过程中,克罗卡林引起剂量依赖性血管舒张(半数有效浓度=7×10⁻⁷ M),而格列本脲可逆转此作用(半数抑制浓度=8×10⁻⁷ M),这表明存在KATP通道且其能够调节血管张力。在低血糖肺(血糖浓度小于1 mM)的严重低氧过程中,格列本脲显著抑制了继发性血管舒张。将灌注液葡萄糖浓度提高到14±0.4 mM也有同样的效果。结果,起初的血管收缩反应得以很好地持续。然而,格列本脲和高血糖均未影响对中度低氧或氯化钾的血管收缩反应,这表明严重低氧期间的作用并非由于血管收缩的非特异性增强。这些发现提示,在雪貂肺中:(a)严重低氧降低了ATP浓度,从而打开KATP通道,导致钾离子外流增加、超极化、血管舒张以及起初血管收缩反应的逆转;(b)高血糖阻止了这一系列事件的发生。