De Maeyer J H, Schuurkes J A J, Lefebvre R A
Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.
Br J Pharmacol. 2009 Jan;156(2):362-76. doi: 10.1111/j.1476-5381.2008.00007.x. Epub 2009 Jan 13.
The time dependency of the effect of 5-HT(4) receptor agonists depends on many specific regulatory mechanisms, which vary between tissues. This has important implications with regard to the effects of endogenous 5-HT, as well as to the clinical use of 5-HT(4) receptor agonists, and might contribute to tissue selectivity of agonists.
The progression and desensitization of 5-HT(4) receptor-mediated responses were evaluated in an organ bath set-up using two, clinically relevant, porcine in vitro models: gastric cholinergic neurotransmission and atrial contractility.
Exposure of gastric tissue to 5-HT or to the selective 5-HT(4) receptor agonists prucalopride and M0003 results in a sustained non-transient effect during exposure; after washout, the response to a subsequent challenge with 5-HT shows no clear desensitization. Incubation of left atrial tissue with 5-HT resulted in a transient response, leading after washout to a marked desensitization of the subsequent response to 5-HT. The selective 5-HT(4) receptor agonists prucalopride and M0003 induce only very weak atrial responses whereas they are very effective in desensitizing the atrial response to 5-HT. The observations also suggest that the properties of prucalopride and M0003 to bind to and/or activate the 5-HT(4) receptor differ from those of 5-HT. This difference might have contributed to the observed desensitization.
The high potency of prucalopride and M0003 in desensitizing the response to 5-HT together with their low efficacy in the atrium emphasizes the cardiac safety of this class of 5-HT(4) receptor agonists.
5-羟色胺(5-HT)4受体激动剂作用的时间依赖性取决于许多特定的调节机制,这些机制在不同组织间存在差异。这对于内源性5-HT的作用以及5-HT4受体激动剂的临床应用具有重要意义,并且可能有助于激动剂的组织选择性。
在器官浴装置中,使用两种与临床相关的猪体外模型(胃胆碱能神经传递和心房收缩性)评估5-HT4受体介导反应的进展和脱敏情况。
将胃组织暴露于5-HT或选择性5-HT4受体激动剂普芦卡必利和M0003时,在暴露期间会产生持续的非瞬时效应;冲洗后,对随后5-HT激发的反应未显示出明显脱敏。用5-HT孵育左心房组织会导致瞬时反应,冲洗后对随后5-HT的反应会出现明显脱敏。选择性5-HT4受体激动剂普芦卡必利和M0003仅诱导非常微弱的心房反应,而它们在使心房对5-HT的反应脱敏方面非常有效。这些观察结果还表明,普芦卡必利和M0003与5-HT4受体结合和/或激活的特性不同。这种差异可能导致了观察到的脱敏现象。
普芦卡必利和M0003在使对5-HT的反应脱敏方面的高效性以及它们在心房中的低效性强调了这类5-HT4受体激动剂的心脏安全性。