Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, Virginia; and
Department of Biochemistry and Molecular Biology, Virginia Commonwealth University, Richmond, Virginia; and.
Am J Physiol Heart Circ Physiol. 2016 Jul 1;311(1):H157-67. doi: 10.1152/ajpheart.00926.2015. Epub 2016 May 13.
The decompensatory phase of hemorrhage (shock) is caused by a poorly defined phenomenon termed vascular hyporeactivity (VHR). VHR may reflect an acute in vivo imbalance in levels of contractile and relaxant stimuli favoring net vascular smooth muscle (VSM) relaxation. Alternatively, VHR may be caused by intrinsic VSM desensitization of contraction resulting from prior exposure to high levels of stimuli that temporarily adjusts cell signaling systems. Net relaxation, but not desensitization, would be expected to resolve rapidly in an artery segment removed from the in vivo shock environment and examined in vitro in a fresh solution. Our aim was to 1) induce shock in rabbits and apply an in vitro mechanical analysis on muscular arteries isolated pre- and postshock to determine whether VHR involves intrinsic VSM desensitization, and 2) identify whether net VSM relaxation induced by nitric oxide and cyclic nucleotide-dependent protein kinase activation in vitro can be sustained for some time after relaxant stimulus washout. The potencies of phenylephrine- and histamine-induced contractions in in vitro epigastric artery removed from rabbits posthemorrhage were decreased by ∼0.3 log units compared with the control contralateral epigastric artery removed prehemorrhage. Moreover, a decrease in KCl-induced tonic, relative to phasic, tension of in vitro mesenteric artery correlated with the degree of shock severity as assessed by rates of lactate and K(+) accumulation. VSM desensitization was also caused by tyramine in vivo and PE in vitro, but not by relaxant agents in vitro. Together, these results support the hypothesis that VHR during hemorrhagic decompensation involves contractile stimulus-induced long-lasting, intrinsic VSM desensitization.
出血(休克)的失代偿阶段是由一种定义不明确的现象引起的,称为血管低反应性(VHR)。VHR 可能反映了体内平衡中收缩和舒张刺激水平的急性失衡,有利于血管平滑肌(VSM)的净舒张。或者,VHR 可能是由于先前暴露于高水平刺激导致的内在 VSM 收缩脱敏引起的,这种刺激暂时调整了细胞信号转导系统。预计在远离体内休克环境并在新鲜溶液中进行体外检查的动脉段中,净舒张而非脱敏将迅速解决。我们的目的是:1)在兔子中诱导休克,并在休克前后应用体外机械分析来分离肌肉动脉,以确定 VHR 是否涉及内在 VSM 脱敏,2)确定体外一氧化氮和环核苷酸依赖性蛋白激酶激活诱导的净 VSM 舒张是否可以在松弛刺激洗脱后持续一段时间。与对照对侧剖腹动脉相比,从出血后兔子中取出的体外胃动脉中,去甲肾上腺素和组胺诱导的收缩力在体外降低了约 0.3 个对数单位。此外,与体外肠系膜动脉的相比较,KCl 诱导的紧张度相对于相比较,与休克严重程度呈负相关,休克严重程度由乳酸和 K(+)积累率评估。体内的 tyramine 和 PE 以及体外的 relaxant agents 也会引起 VSM 脱敏,但体内的 tyramine 和体外的 PE 不会引起 VSM 脱敏。这些结果共同支持了这样一种假说,即在出血性失代偿期间,VHR 涉及收缩刺激诱导的长期内在 VSM 脱敏。