Unité de recherche en périnatologie, Centre Hospitalier Universitaire de Québec, Hôpital Saint-François d'Assise, Département de Pédiatrie, Université Laval, Québec, Canada.
Respir Physiol Neurobiol. 2011 Aug 15;177(3):301-12. doi: 10.1016/j.resp.2011.05.006. Epub 2011 May 14.
In human neonates, caffeine therapy for apnoea of prematurity, especially when associated with hypoxemia, is maintained for several weeks after birth. In the present study, we used newborn rats and whole-body plethysmography to test whether chronic exposure to neonatal caffeine treatment (NCT), alone or combined with neonatal intermittent hypoxia (n-IH) alters: (1) baseline ventilation and response to hypoxia (12% O(2), 20 min); and (2) response to acute i.p. injection of caffeine citrate (20 mg/kg) or domperidone, a peripheral dopamine D2 receptor antagonist (1 mg/kg). Four groups of rats were studied as follows: raised under normal conditions with daily gavage with water (NWT) or NCT, or exposed to n-IH (n-IH+NWT and n-IH+NCT) from postnatal days 3 to 12. In n-IH+NCT rats, baseline ventilation was higher than in the other groups. Caffeine or domperidone enhanced baseline ventilation only in NWT and n-IH+NWT rats, but neither caffeine nor domperidone affected the hypoxic ventilatory response in these groups. In n-IH+NWT rats, the response during the early phase of hypoxia (<10 min) was higher than in other groups. During the late response phase to hypoxia (20 min), ventilation was lower in n-IH+NWT and n-IH+NCT rats compared to NWT or NCT, and were not affected by caffeine or domperidone injection. NCT or caffeine injection decreased baseline apnoea frequency in all groups. These data suggest that chronic exposure to NCT alters both carotid body dopaminergic and adenosinergic systems and central regulation of breathing under baseline conditions and in response to hypoxia.
在人类早产儿中,咖啡因治疗呼吸暂停早产儿,特别是与低氧血症相关时,在出生后数周内持续进行。在本研究中,我们使用新生大鼠和全身 plethysmography 来测试慢性暴露于新生咖啡因治疗(NCT)是否会改变:(1)基础通气和对缺氧的反应(12%O(2),20 分钟);(2)对急性腹腔内注射柠檬酸咖啡因(20mg/kg)或外周多巴胺 D2 受体拮抗剂多潘立酮(1mg/kg)的反应。研究了以下四组大鼠:在正常条件下饲养,每天用白开水灌胃(NWT)或 NCT,或从出生后第 3 天到第 12 天暴露于间歇性低氧(n-IH)。在 n-IH+NCT 大鼠中,基础通气量高于其他组。咖啡因或多潘立酮仅在 NWT 和 n-IH+NWT 大鼠中增强基础通气,但咖啡因和多潘立酮均不影响这些组的低氧通气反应。在 n-IH+NWT 大鼠中,缺氧早期(<10 分钟)的反应高于其他组。在缺氧的晚期反应阶段(20 分钟),n-IH+NWT 和 n-IH+NCT 大鼠的通气量低于 NWT 或 NCT,且不受咖啡因或多潘立酮注射的影响。NCT 或咖啡因注射降低了所有组的基础呼吸暂停频率。这些数据表明,慢性暴露于 NCT 会改变颈动脉体多巴胺能和腺苷能系统以及基础条件下和对缺氧的呼吸中枢调节。