Bengtsson F, Bugge M, Hansson L, Fyge K, Jeppsson B, Nobin A
Department of Surgery, University of Lund, Sweden.
J Surg Res. 1987 Nov;43(5):420-9. doi: 10.1016/0022-4804(87)90100-4.
Similar neurological disturbances and metabolic alterations have been observed in liver insufficiency and in bacterial sepsis. In both liver failure and sepsis an altered neurotransmitter profile in the central nervous system (CNS) has been implicated in the pathogenesis of encephalopathic symptoms. It has been suggested that equivalent disturbances in brain neurotransmitters, especially serotonin, play a role in the encephalopathy accompanying sepsis and liver failure. The objective of this study was to compare the CNS serotonin metabolism in rats with an end-to-side portacaval shunt (PCS) with that found in rats with 12 or 24 hr of intraabdominal sepsis. The metabolism of CNS serotonin was estimated after inhibition of two enzymes acting in the 5-hydroxyindole synthetic pathway (decarboxylase and monoamine oxidase). The 5-hydroxyindoleacetic acid (5-HIAA) concentrations were determined in different regions of the CNS, thereby permitting evaluation of the synthetic activity of the serotonin neurotransmitter system. As previously reported, a marked increase in CNS serotonin synthetic rate was noted following PCS. In contrast, and in contradistinction to several recent reports, no major changes in the CNS serotonin synthesis rate were present following 12 or 24 hr of sepsis. CNS levels of the serotonin metabolite 5-HIAA were elevated in both sepsis and PCS rats. These data indicate that sepsis and liver failure have different effects upon serotonin metabolism in the CNS and suggest that differing pathogenetic mechanisms may underlie the encephalopathy clinically associated with these conditions.
在肝功能不全和细菌性败血症中已观察到类似的神经功能紊乱和代谢改变。在肝衰竭和败血症中，中枢神经系统（CNS）中神经递质谱的改变都与脑病症状的发病机制有关。有人提出，脑内神经递质，尤其是血清素的同等紊乱，在败血症和肝衰竭伴发的脑病中起作用。本研究的目的是比较端侧门腔分流术（PCS）大鼠与腹腔内感染12或24小时大鼠的中枢神经系统血清素代谢情况。在抑制5-羟吲哚合成途径中的两种酶（脱羧酶和单胺氧化酶）后，估计中枢神经系统血清素的代谢情况。测定中枢神经系统不同区域的5-羟吲哚乙酸（5-HIAA）浓度，从而评估血清素神经递质系统的合成活性。如先前报道，PCS后中枢神经系统血清素合成率显著增加。相比之下，与最近的几份报告不同，败血症12或24小时后中枢神经系统血清素合成率没有重大变化。败血症大鼠和PCS大鼠中枢神经系统中血清素代谢产物5-HIAA的水平均升高。这些数据表明，败血症和肝衰竭对中枢神经系统血清素代谢有不同影响，并提示不同的发病机制可能是这些疾病临床相关脑病的基础。
