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选择性β1 受体阻滞剂能否在创伤/失血性休克后提供骨髓保护?

Does selective beta-1 blockade provide bone marrow protection after trauma/hemorrhagic shock?

机构信息

Division of Trauma, Department of Surgery, UMDNJ-New Jersey Medical School, Newark, NJ, USA.

出版信息

Surgery. 2012 Sep;152(3):322-30. doi: 10.1016/j.surg.2012.06.016.

Abstract

BACKGROUND

Previously, nonselective beta-blockade (BB) with propranolol demonstrated protection of the bone marrow (BM) after trauma and hemorrhagic shock (HS). Because selective beta-1 blockers are used commonly for their cardiac protection, the aim of this study was to more clearly define the role of specific beta adrenergic receptors in BM protection after trauma and HS.

METHODS

Male Sprague-Dawley rats underwent unilateral lung contusion (LC) followed by HS for 45 minutes. After resuscitation, animals were injected with a selective beta-blocker, atenolol (B1B), butoxamine (B2B), or SR59230A (B3B). Animals were killed at 3 hours or 7 days. Heart rate and blood pressure were measured throughout the study period. BM cellularity, growth of hematopoietic progenitor cells (HPCs) in BM, and hemoglobin levels (Hb) were assessed.

RESULTS

Treatment with a B2B or B3B after LCHS restored both BM cellularity and BM HPC colony growth at 3 hours and 7 days. In contrast, treatment with a B1B had no effect on BM cellularity or HPC growth but did decrease heart effectively rate throughout the study. Treatment with a B3B after LCHS increased Hb as compared with LCHS alone.

CONCLUSION

After trauma and HS, protection of BM for 7 days was seen with use of either a selective beta-2 or beta-3 blocker. Use of a selective beta-1 blocker was ineffective in protecting the BM despite a physiologic decrease in heart rate. Therefore, the protection of BM is via the beta-2 and beta-3 receptors and it is not via a direct cardiovascular effect.

摘要

背景

先前,普萘洛尔等非选择性β受体阻滞剂在创伤和失血性休克(HS)后显示出对骨髓(BM)的保护作用。由于选择性β1受体阻滞剂因其心脏保护作用而被广泛应用,因此本研究旨在更清楚地定义特定β肾上腺素能受体在创伤和 HS 后 BM 保护中的作用。

方法

雄性 Sprague-Dawley 大鼠行单侧肺挫伤(LC),继以 45 分钟 HS。复苏后,动物注射选择性β受体阻滞剂阿替洛尔(B1B)、丁氧胺(B2B)或 SR59230A(B3B)。动物在 3 小时或 7 天时被处死。整个研究期间测量心率和血压。评估骨髓细胞计数、骨髓造血祖细胞(HPC)的生长和血红蛋白水平(Hb)。

结果

LC-HS 后用 B2B 或 B3B 治疗可在 3 小时和 7 天恢复骨髓细胞计数和骨髓 HPC 集落生长。相比之下,B1B 治疗对骨髓细胞计数或 HPC 生长没有影响,但在整个研究过程中确实有效降低了心率。LC-HS 后用 B3B 治疗可增加 Hb,与 LC-HS 相比。

结论

在创伤和 HS 后,使用选择性β-2 或β-3 受体阻滞剂可保护骨髓 7 天。尽管心率生理性降低,但使用选择性β-1 受体阻滞剂对 BM 无保护作用。因此,BM 的保护是通过β-2 和β-3 受体实现的,而不是通过直接的心血管作用。

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