Pediatric Anesthesia Unit, Geneva Children's Hospital, Geneva, Switzerland.
Am J Physiol Lung Cell Mol Physiol. 2010 Apr;298(4):L607-14. doi: 10.1152/ajplung.00222.2009. Epub 2010 Feb 5.
Although chronic normobaric hypoxia (CH) alters lung function, its potential to induce bronchial hyperreactivity (BHR) is still controversial. Thus the effects of CH on airway and tissue mechanics separately and changes in lung responsiveness to methacholine (MCh) were investigated. To clarify the mechanisms, mechanical changes were related to end-expiratory lung volume (EELV), in vivo results were compared with those in vitro, and lung histology was assessed. EELV was measured plethysmographically in two groups of rats exposed to 21 days of CH (11% O(2)) or to normoxia. Total respiratory impedance was measured under baseline conditions and following intravenous MCh challenges (2-18 microg x kg(-1) x min(-1)). The lungs were then excised and perfused, and the pulmonary input impedance was measured, while MCh provocations were repeated under a pulmonary capillary pressure of 5, 10, and 15 mmHg. Airway resistance, tissue damping, and elastance were extracted from the respiratory impedance and pulmonary input impedance spectra. The increases in EELV following CH were associated with decreases in airway resistance, whereas tissue damping and elastance remained unaffected. CH led to the development of severe BHR to MCh (206 +/- 30 vs. 95 +/- 24%, P < 0.001), which was not detectable when the same lungs were studied in vitro at any pulmonary capillary pressure levels maintained. Histology revealed pulmonary arterial vascular remodeling with overexpression of alpha-smooth muscle actin antibody in the bronchial wall. These findings suggest that, despite the counterbalancing effect of the increased EELV, BHR develops following CH, only in the presence of intact autonomous nervous system. Thus neural control plays a major role in the changes in the basal lung mechanics and responsiveness following CH.
尽管慢性常压低氧(CH)改变肺功能,但它诱导支气管高反应性(BHR)的潜力仍然存在争议。因此,研究了 CH 对气道和组织力学的单独影响以及对乙酰甲胆碱(MCh)的肺反应性变化。为了阐明机制,将机械变化与呼气末肺容积(EELV)相关联,将体内结果与体外结果进行比较,并评估肺组织学。两组大鼠分别暴露于 21 天 CH(11%O2)或常氧中,用体积描记法测量 EELV。在基线条件下和静脉内给予 MCh 挑战(2-18 microg x kg(-1) x min(-1))后测量总呼吸阻抗。然后切除肺并进行灌注,测量肺输入阻抗,同时在肺毛细血管压为 5、10 和 15 mmHg 时重复进行 MCh 激发。从呼吸阻抗和肺输入阻抗谱中提取气道阻力、组织阻尼和弹性。CH 后 EELV 的增加与气道阻力的降低有关,而组织阻尼和弹性保持不变。CH 导致对 MCh 的严重 BHR 发展(206 +/- 30 对 95 +/- 24%,P < 0.001),当在任何维持的肺毛细血管压力水平下在体外研究相同的肺时,无法检测到这种情况。组织学显示肺动脉血管重塑,支气管壁中 α-平滑肌肌动蛋白抗体过度表达。这些发现表明,尽管 EELV 的增加具有平衡作用,但 CH 后仍会发生 BHR,仅在自主神经系统完整的情况下发生。因此,神经控制在 CH 后基础肺力学和反应性的变化中起着主要作用。