Tanaka H
Hokkaido Igaku Zasshi. 1985 Mar;60(2):273-81.
The mechanisms of histamine release due to d-tubocurarine from rat mast cells have long been known to anesthesiologists, such as degranulatory process, Ca++ dependent process and energy coupled process. However, not much is known about histamine release due to some drugs such as trimethaphan and muscle relaxants other than d-tubocurarine, like alcuronium, pancuronium or succinylcholine, although many clinical reports related to hypersensitivity reactions due to muscle relaxants can be found. In this experiment, the histamine releasing activities of trimethaphan and muscle relaxants were examined using the laboratory model created by Ellis (1970) who reported the selective release of histamine due to d-tubocurarine. Also observed the effects of autonomic neuro-effective drugs such as theophylline, isoproterenol or carbamylcholine on histamine release due to d-tubocurarine. From this experiment, it is suggested that trimethaphan releases histamine through nonselective process but muscle relaxants release histamine selectively. It is also found that pancuronium had little effects on rat mast cells and its histamine releasing activity was selective, if any. Histamine release from rat mast cells due to d-tubocurarine was clearly depressed by pretreatment of theophylline or isoproterenol. In the case of carbamylcholine, low doses inhibited histamine release, but higher doses allowed histamine to be liberated from mast cells. From these findings, it is concluded that some drugs like theophylline or isoproterenol may diminish the side effects of d-tubocurarine and perhaps some other muscle relaxants. Also, as theophylline and isoproterenol are concerned, increase of cyclic AMP may play a role in the inhibition of histamine release. The data using carbamylcholine suggested that the cholinergic receptors on the rat mast cells may be involved through the process of histamine release.
麻醉学家早就知道,d - 筒箭毒碱导致大鼠肥大细胞释放组胺的机制,如脱颗粒过程、钙离子依赖过程和能量偶联过程。然而,对于诸如三甲噻芬以及除d - 筒箭毒碱之外的其他肌肉松弛剂(如阿库氯铵、泮库溴铵或琥珀酰胆碱)导致的组胺释放,人们了解得并不多,尽管可以找到许多与肌肉松弛剂引起的过敏反应相关的临床报告。在本实验中,利用埃利斯(1970年)创建的实验室模型,检测了三甲噻芬和肌肉松弛剂的组胺释放活性,埃利斯曾报告d - 筒箭毒碱可选择性释放组胺。还观察了自主神经效应药物(如茶碱、异丙肾上腺素或氨甲酰胆碱)对d - 筒箭毒碱引起的组胺释放的影响。从该实验结果表明,三甲噻芬通过非选择性过程释放组胺,但肌肉松弛剂选择性释放组胺。还发现泮库溴铵对大鼠肥大细胞影响很小,其组胺释放活性即便有也是选择性的。茶碱或异丙肾上腺素预处理可明显抑制d - 筒箭毒碱引起的大鼠肥大细胞组胺释放。就氨甲酰胆碱而言,低剂量时抑制组胺释放,但高剂量时则使组胺从肥大细胞中释放出来。从这些发现可以得出结论,某些药物(如茶碱或异丙肾上腺素)可能会减少d - 筒箭毒碱以及或许其他一些肌肉松弛剂的副作用。此外,就茶碱和异丙肾上腺素而言,环磷酸腺苷的增加可能在抑制组胺释放中起作用。使用氨甲酰胆碱的数据表明,大鼠肥大细胞上的胆碱能受体可能参与了组胺释放过程。