Theodorakis Nicholas, Maluccio Mary, Skill Nicholas
Nicholas Theodorakis, Mary Maluccio, Nicholas Skill, Department of Surgery, Division of Transplant Surgery, Indiana School of Medicine, Indiana University, Indianapolis, IN 46202, United States.
World J Gastroenterol. 2015 Apr 28;21(16):4817-28. doi: 10.3748/wjg.v21.i16.4817.
To investigate endothelin-1 hypo-responsive associated with portal hypertension in order to improve patient treatment outcomes.
Wild type, eNOS(-/-) and iNOS(-/-) mice received partial portal vein ligation surgery to induce portal hypertension or sham surgery. Development of portal hypertension was determined by measuring the splenic pulp pressure, abdominal aortic flow and portal systemic shunting. To measure splenic pulp pressure, a microtip pressure transducer was inserted into the spleen pulp. Abdominal aortic flow was measured by placing an ultrasonic Doppler flow probe around the abdominal aorta between the diaphragm and celiac artery. Portal systemic shunting was calculated by injection of fluorescent microspheres in to the splenic vein and determining the percentage accumulation of spheres in liver and pulmonary beds. Endothelin-1 hypo-response was evaluated by measuring the change in abdominal aortic flow in response to endothelin-1 intravenous administration. In addition, thoracic aorta endothelin-1 contraction was measured in 5 mm isolated thoracic aorta rings ex-vivo using an ADI small vessel myograph.
In wild type and iNOS(-/-) mice splenic pulp pressure increased from 7.5 ± 1.1 mmHg and 7.2 ± 1 mmHg to 25.4 ± 3.1 mmHg and 22 ± 4 mmHg respectively. In eNOS(-/-) mice splenic pulp pressure was increased after 1 d (P = NS), after which it decreased and by 7 d was not significantly elevated when compared to 7 d sham operated controls (6.9 ± 0.6 mmHg and 7.3 ± 0.8 mmHg respectively, P = 0.3). Abdominal aortic flow was increased by 80% and 73% in 7 d portal vein ligated wild type and iNOS when compared to shams, whereas there was no significant difference in 7 d portal vein ligated eNOS(-/-) mice when compared to shams. Endothelin-1 induced a rapid reduction in abdominal aortic blood flow in wild type, eNOS(-/-) and iNOS(-/-) sham mice (50% ± 8%, 73% ± 9% and 47% ± 9% respectively). Following portal vein ligation endothelin-1 reduction in blood flow was significantly diminished in each mouse group. Abdominal aortic flow was reduced by 19% ± 9%, 32% ± 10% and 9% ± 9% in wild type, eNOS(-/-) and iNOS(-/-) mice respectively.
Aberrant endothelin-1 response in murine portal hypertension is NOS isoform independent. Moreover, portal hypertension in the portal vein ligation model is independent of ET-1 function.
研究与门静脉高压相关的内皮素-1低反应性,以改善患者治疗效果。
野生型、eNOS基因敲除和iNOS基因敲除小鼠接受部分门静脉结扎手术以诱导门静脉高压或假手术。通过测量脾髓压、腹主动脉血流量和门体分流来确定门静脉高压的发展情况。测量脾髓压时,将微尖端压力传感器插入脾髓。通过在膈肌和腹腔动脉之间的腹主动脉周围放置超声多普勒血流探头来测量腹主动脉血流量。通过向脾静脉注射荧光微球并确定微球在肝脏和肺床中的累积百分比来计算门体分流。通过测量静脉注射内皮素-1后腹主动脉血流量的变化来评估内皮素-1低反应性。此外,使用ADI小型血管肌动描记器在体外测量5毫米离体胸主动脉环中胸主动脉的内皮素-1收缩情况。
在野生型和iNOS基因敲除小鼠中,脾髓压分别从7.5±1.1毫米汞柱和7.2±1毫米汞柱增加到25.4±3.1毫米汞柱和22±4毫米汞柱。在eNOS基因敲除小鼠中,术后1天脾髓压升高(P=无显著性差异),之后下降,到第7天时与假手术对照组相比无显著升高(分别为6.9±0.6毫米汞柱和7.3±0.8毫米汞柱,P=0.3)。与假手术组相比,门静脉结扎7天的野生型和iNOS基因敲除小鼠腹主动脉血流量分别增加80%和73%,而门静脉结扎7天的eNOS基因敲除小鼠与假手术组相比无显著差异。内皮素-1可使野生型、eNOS基因敲除和iNOS基因敲除假手术小鼠的腹主动脉血流量迅速减少(分别为50%±8%、73%±9%和47%±9%)。门静脉结扎后,各小鼠组中内皮素-1引起的血流量减少均显著减弱。野生型、eNOS基因敲除和iNOS基因敲除小鼠的腹主动脉血流量分别减少19%±9%、32%±10%和9%±9%。
小鼠门静脉高压中异常的内皮素-1反应不依赖于一氧化氮合酶同工型。此外,门静脉结扎模型中的门静脉高压与内皮素-1功能无关。