Cole R S, Fry C H, Shuttleworth K E
Department of Urology, St Thomas' Hospital, London.
Br J Urol. 1990 Sep;66(3):257-64. doi: 10.1111/j.1464-410x.1990.tb14923.x.
Wide fluctuations of both urinary pH and the partial pressure of CO2 (PCO2) occur in normal physiological circumstances and in a variety of pathological conditions. However, the effect of extracellular pH on the contractility of human ureteric muscle has not been clearly defined. This study has established, using a microsuperfusion technique, that an increased superfusate PCO2 increases the magnitude of the phasic contraction to electrical field stimulation. A similar extracellular acidosis induced by alteration of the [HCO3-], at constant [Na+] and free [Ca2+], was without significant effect. Furthermore, when both superfusate PCO2 and [HCO3-] were simultaneously increased at constant pH the contractile response was similar to that when PCO2 alone was raised. These observations suggest that the changes of tension were mediated by intracellular pH changes, providing it is assumed that the ureteric smooth muscle cell membrane is permeable to CO2 but impermeable to H+ and HCO3-. The occurrence of an increase of force in the presence of an acidosis is a highly significant and unusual finding, since it has been assumed that the classical association between acidosis and negative inotropy, seen in cardiac muscle, was also applicable to smooth muscle.
在正常生理情况下以及多种病理状态下,尿液pH值和二氧化碳分压(PCO₂)都会出现较大波动。然而,细胞外pH值对人输尿管肌肉收缩性的影响尚未明确界定。本研究采用微量灌注技术证实,灌注液PCO₂升高会增加电场刺激引起的阶段性收缩幅度。在[Na⁺]和游离[Ca²⁺]恒定的情况下,通过改变[HCO₃⁻]诱导的类似细胞外酸中毒并无显著影响。此外,当灌注液PCO₂和[HCO₃⁻]在pH值恒定时同时升高时,收缩反应与仅升高PCO₂时相似。这些观察结果表明,张力变化是由细胞内pH值变化介导的,前提是假设输尿管平滑肌细胞膜对CO₂可通透,但对H⁺和HCO₃⁻不通透。酸中毒时力量增加这一现象是一个非常显著且不寻常的发现,因为一直以来人们认为在心肌中看到的酸中毒与负性肌力之间的经典关联也适用于平滑肌。