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碘对比剂在小鼠中差异地影响入球小动脉和出球小动脉的张力和反应性:肾小球滤过率降低的可能解释。

Iodinated contrast media differentially affect afferent and efferent arteriolar tone and reactivity in mice: a possible explanation for reduced glomerular filtration rate.

机构信息

Institute of Vegetative Physiology, Charité-Universitätsmedizin Berlin, Hessische Strasse 3-4, 10115 Berlin, Germany.

出版信息

Radiology. 2012 Dec;265(3):762-71. doi: 10.1148/radiol.12120044. Epub 2012 Sep 27.

Abstract

PURPOSE

To determine the effect of the iodinated contrast medium iodixanol on arteriolar tone in afferent and efferent arterioles of the glomerulus and the functional interactions with the major modulators of arteriolar tone, angiotensin II and nitric oxide, in mice.

MATERIALS AND METHODS

Animal handling conformed to the ethics guidelines of the Office for Health and Social Matters of Berlin. Arterioles were isolated from 136 C57BL/6 mice, perfused with either vehicle solution or iodixanol (23 mg of iodine per milliliter) for 20 minutes, followed by angiotensin II administration. Fluorescence of 3-amino-4-(N-methylamino)-2',7'-difluorofluorescein (DAF-FM) and dihydroethidium (DHE) were used for quantification of nitric oxide bioavailability and superoxide concentration, respectively. Statistical analysis of time- and dose-dependent data was performed by using the nonparametric test for repeated measurements.

RESULTS

With iodixanol, afferent arteriole diameters were significantly reduced from 9.2 µm to 8.3 µm; in control group, the diameters were increased from 8.7 µm to 9.3 µm (P = .008). Nitric oxide synthase inhibition augmented iodixanol-induced constriction, with diameters reduced from 9.9 µm to 5.8 µm (P < .0001). DAF-FM fluorescence increased less during iodixanol treatment and nitric oxide synthase inhibition (3.6% and 3.7% vs 10.7% in control group, P = .009 and P = .049, respectively), indicating impaired nitric oxide bioavailability. With iodixanol, DHE fluorescence ratio was increased by 12% (P < .0001). Angiotensin II responses were enhanced by iodixanol and by nitric oxide synthase inhibition after perfusion with iodixanol (3.3 µm and 4.3 µm vs 7.5 µm [control group] with 1 × 10(-6)/mol/L angiotensin II, P = .03 for both). In contrast, in efferent arterioles, neither their basal diameters nor the responses to angiotensin II were significantly affected by iodixanol.

CONCLUSION

A more pronounced effect of iodixanol on afferent than on efferent arterioles may contribute to the reduction of glomerular filtration rate in contrast medium-induced acute kidney injury. Decreased nitric oxide bioavailability and increased concentration of superoxide explain the increased tone and reactivity in afferent arterioles perfused with iodixanol.

摘要

目的

确定碘造影剂碘克沙醇对肾小球入球小动脉和出球小动脉的动脉张力的影响,以及其与血管紧张素 II 和一氧化氮这两种主要的动脉张力调节剂之间的功能相互作用,在小鼠体内的情况。

材料和方法

动物处理符合柏林卫生和社会事务办公室的伦理准则。从小鼠 136 只 C57BL/6 中分离出小动脉,用载体溶液或碘克沙醇(每毫升 23 毫克碘)灌注 20 分钟,然后给予血管紧张素 II。使用 3-氨基-4-(N-甲基氨基)-2',7'-二氟荧光素(DAF-FM)和二氢乙啶(DHE)的荧光分别用于定量一氧化氮的生物利用度和超氧化物浓度。通过使用非参数重复测量检验对时间和剂量依赖性数据进行统计分析。

结果

用碘克沙醇处理时,入球小动脉直径从 9.2µm 减小到 8.3µm;在对照组中,直径从 8.7µm 增加到 9.3µm(P=0.008)。一氧化氮合酶抑制增强了碘克沙醇引起的收缩,直径从 9.9µm 减小到 5.8µm(P<0.0001)。在碘克沙醇处理和一氧化氮合酶抑制期间,DAF-FM 荧光的增加较少(分别为 3.6%和 3.7%与对照组的 10.7%相比,P=0.009 和 P=0.049),表明一氧化氮的生物利用度受损。用碘克沙醇处理时,DHE 荧光比率增加 12%(P<0.0001)。用碘克沙醇灌注后,血管紧张素 II 的反应增强,并且在灌注碘克沙醇后抑制一氧化氮合酶也会增强(用 1×10(-6)/mol/L 血管紧张素 II 时,分别为 3.3µm 和 4.3µm 与对照组的 7.5µm 相比,P=0.03)。相比之下,在出球小动脉中,碘克沙醇对其基础直径和对血管紧张素 II 的反应均无显著影响。

结论

碘克沙醇对入球小动脉的影响比出球小动脉更明显,这可能导致对比剂诱导的急性肾损伤中肾小球滤过率降低。灌流碘克沙醇后一氧化氮生物利用度降低和超氧化物浓度增加解释了入球小动脉张力和反应性的增加。

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