Angus P W, Mihaly G W, Morgan D J, Smallwood R A
University of Melbourne Department of Medicine, Austin Hospital, Heidelberg, Victoria, Australia.
Biochem Pharmacol. 1989 May 1;38(9):1443-9. doi: 10.1016/0006-2952(89)90183-4.
Although impairment of drug metabolism by severe hypoxia is well documented in perfused liver preparations, the degree of hypoxia required to produce inhibition of drug elimination pathways in the intact liver has not been defined. In this study, in the isolated perfused rat liver, we examined the relationship between the rate of hepatic oxygen supply and the elimination rate of the drug salbutamol, which in the rat liver is eliminated largely by glucuronidation. Livers (N = 15) from male Sprague-Dawley rats were perfused in a non-recycling design with 10% human red cells in a Krebs-Henseleit electrolyte solution. Salbutamol elimination was examined during normal oxygenation (perfusate equilibrated with 100% O2; mean O2 delivery 3.21 mumol/min/g liver), at a given lower rate of oxygen delivery (achieved by producing different mixtures of N2 with O2 in the perfusate oxygenator) and after reoxygenation. In these experiments, hepatic clearance of salbutamol (perfusate concentration 50 ng/ml) was essentially independent of oxygen delivery above a rate of 2.0 mumol/min/g liver; below this level, clearance fell linearly as O2 supply was reduced. In all livers, reoxygenation restored drug elimination to control levels. In further experiments using a recycling design (N = 22), the effect of hypoxia on salbutamol elimination was found to be very similar. In recycling normoxic experiments (N = 3), the glucuronide metabolite was detected in perfusate and bile, but no sulphate metabolite was detected. While previous studies indicate that elimination of some oxidatively metabolised substrates is very sensitive to reductions in hepatic oxygenation, the present study shows that, in the isolated liver, large reductions in hepatic oxygen supply were required to produce significant impairment of the glucuronidation-dependent elimination of salbutamol.
虽然在灌注肝制剂中,严重缺氧对药物代谢的损害已有充分记录,但在完整肝脏中产生药物消除途径抑制所需的缺氧程度尚未明确。在本研究中,我们在离体灌注大鼠肝脏中,研究了肝脏氧气供应速率与药物沙丁胺醇消除速率之间的关系,在大鼠肝脏中,沙丁胺醇主要通过葡萄糖醛酸化消除。取15只雄性Sprague-Dawley大鼠的肝脏,在非循环设计中,用含10%人红细胞的Krebs-Henseleit电解质溶液进行灌注。在正常氧合(灌注液与100% O₂平衡;平均O₂输送量3.21 μmol/min/g肝脏)、给定的较低氧输送速率(通过在灌注液充氧器中产生不同的N₂与O₂混合物实现)以及复氧后,检测沙丁胺醇的消除情况。在这些实验中,当肝脏氧输送速率高于2.0 μmol/min/g肝脏时,沙丁胺醇(灌注液浓度50 ng/ml)的肝脏清除率基本与氧输送无关;低于此水平,随着O₂供应减少,清除率呈线性下降。在所有肝脏中,复氧后药物消除恢复到对照水平。在使用循环设计的进一步实验(n = 22)中,发现缺氧对沙丁胺醇消除的影响非常相似。在循环常氧实验(n = 3)中,在灌注液和胆汁中检测到葡萄糖醛酸代谢物,但未检测到硫酸盐代谢物。虽然先前的研究表明,一些经氧化代谢的底物的消除对肝脏氧合的降低非常敏感,但本研究表明,在离体肝脏中,需要大幅降低肝脏氧供应才能对沙丁胺醇依赖葡萄糖醛酸化的消除产生显著损害。