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[皮质类固醇对拟交感神经药作用的影响]

[Effect of corticosteroids on the action of sympathomimetics].

作者信息

Pauwels R

出版信息

Bull Eur Physiopathol Respir. 1985 Sep-Oct;21(5):53s-55s.

PMID:2865993
Abstract

Corticosteroids restore the bronchial responsiveness to beta-adrenergic stimulants in man. This has been shown both in severe asthmatic patients and in normal subjects, rendered insensitive by artificial means. On the contrary, in patients with bronchial asthma who have airways reactive to beta-adrenergic stimulants, the combination of corticosteroids and sympathicomimetics results in an additive effect of their bronchodilating capacity. Animal models, both in vivo and in vitro, show the same type of interaction between corticosteroids and beta-adrenergic stimulants. The mechanism by which corticosteroids restore the bronchial sensitivity to beta-adrenergic stimulation is not completely understood. Several mechanisms may be involved such as increased agonist binding, decreased receptor turn-over, increased uncoupling between receptor and adenylcyclase, decreased extraneuronal uptake, decreased COMT-activity. The relevance of the influence of corticosteroids on the metabolism of membrane phospholipids remains highly speculative.

摘要

皮质类固醇可恢复人体支气管对β-肾上腺素能兴奋剂的反应性。这在重度哮喘患者以及通过人工方法使其变得不敏感的正常受试者中均已得到证实。相反,在气道对β-肾上腺素能兴奋剂有反应的支气管哮喘患者中,皮质类固醇与拟交感神经药联合使用会产生相加的支气管扩张能力效应。体内和体外的动物模型均显示皮质类固醇与β-肾上腺素能兴奋剂之间存在相同类型的相互作用。皮质类固醇恢复支气管对β-肾上腺素能刺激敏感性的机制尚未完全明了。可能涉及多种机制,如激动剂结合增加、受体周转率降低、受体与腺苷酸环化酶之间的解偶联增加、神经外摄取减少、儿茶酚-O-甲基转移酶(COMT)活性降低。皮质类固醇对膜磷脂代谢影响的相关性仍极具推测性。

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