Brott David A, Katein Anne, Thomas Heath, Lawton Michael, Montgomery Robert R, Richardson Rudy J, Louden Calvert S
Global Safety Assessment, AstraZeneca Pharmaceuticals, Wilmington, Delaware, USA
Global Safety Assessment, AstraZeneca Pharmaceuticals, Wilmington, Delaware, USA.
Toxicol Pathol. 2014 Jun;42(4):672-83. doi: 10.1177/0192623313518664. Epub 2014 Feb 4.
Pharmacologically, vasoactive agents targeting endothelial and/or smooth muscle cells (SMC) are known to cause acute drug-induced vascular injury (DIVI) and the resulting pathology is due to endothelial cell (EC) perturbation, activation, and/or injury. Alteration in EC structure and/or function may be a critical event in vascular injury and, therefore, evaluation of the circulatory kinetic profile and secretory pattern of EC-specific proteins such as VWF and VWFpp could serve as acute vascular injury biomarkers. In rat and dog models of DIVI, this profile was determined using pharmacologically diverse agents associated with functional stimulation/perturbation (DDAVP), pathological activation (lipopolysaccharide [LPS]/endotoxin), and structural damage (fenoldopam [FD], dopamine [DA], and potassium channel opener (PCO) ZD6169). In rats, FD caused moderate DIVI and time-related increase in plasma VWF levels ∼33% while in control rats VWF increased ∼5%. In dogs, VWF levels transiently increased ∼30% when there was morphologic evidence of DIVI by DA or ZD6169. However, in dogs, VWFpp increased >60-fold (LPS) and >6-fold (DDAVP), respectively. This was in comparison to smaller dynamic 1.38-fold (LPS) and 0.54-fold (DDAVP) increases seen in plasma VWF. Furthermore, DA was associated with a dose-dependent increase in plasma VWFpp. In summary, VWF and VWFpp can discriminate between physiological and pathological perturbation, activation, and injury to ECs.
从药理学角度来看,已知作用于内皮细胞和/或平滑肌细胞(SMC)的血管活性药物会导致急性药物性血管损伤(DIVI),其病理结果是由于内皮细胞(EC)受到干扰、激活和/或损伤。内皮细胞结构和/或功能的改变可能是血管损伤中的关键事件,因此,评估循环动力学特征以及内皮细胞特异性蛋白(如血管性血友病因子(VWF)和VWF前体蛋白(VWFpp))的分泌模式可作为急性血管损伤的生物标志物。在DIVI的大鼠和犬模型中,使用与功能刺激/干扰(去氨加压素(DDAVP))、病理激活(脂多糖(LPS)/内毒素)和结构损伤(非诺多泮(FD)、多巴胺(DA)和钾通道开放剂(PCO)ZD6169)相关的药理学不同的药物来确定这种特征。在大鼠中,FD导致中度DIVI,血浆VWF水平随时间增加约33%,而在对照大鼠中VWF增加约5%。在犬中,当DA或ZD6169导致DIVI的形态学证据时,VWF水平短暂增加约30%。然而,在犬中,VWFpp分别增加>60倍(LPS)和>6倍(DDAVP)。与之相比,血浆VWF中LPS和DDAVP的动态增加较小,分别为1.38倍和0.54倍。此外,DA与血浆VWFpp的剂量依赖性增加有关。总之,VWF和VWFpp可以区分内皮细胞的生理和病理干扰、激活及损伤。