Lu Zengbing, Ngan Man P, Lin Ge, Yew David T W, Fan Xiaodan, Andrews Paul L R, Rudd John A
School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Oncotarget. 2017 Oct 16;8(58):98691-98707. doi: 10.18632/oncotarget.21859. eCollection 2017 Nov 17.
Preclinical studies show that the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39), can reduce acute emesis induced by cisplatin. In the present study, we investigate the effect of exendin (9-39) (100 nmol/24 h, i.c.v), on cisplatin (5 mg/kg, i.p.)-induced acute and delayed emesis and changes indicative of 'nausea' in ferrets. Cisplatin induced 37.2 ± 2.3 and 59.0 ± 7.7 retches + vomits during the 0-24 (acute) and 24-72 h (delayed) periods, respectively. Cisplatin also increased (<0.05) the dominant frequency of gastric myoelectric activity from 9.4 ± 0.1 to 10.4 ± 0.41 cpm and decreased the dominant power (DP) during acute emesis; there was a reduction in the % power of normogastria and an increase in the % power of tachygastria; food and water intake was reduced. DP decreased further during delayed emesis, where normogastria predominated. Advanced multifractal detrended fluctuation analysis revealed that the slow wave signal shape became more simplistic during delayed emesis. Cisplatin did not affect blood pressure (BP), but transiently increased heart rate, and decreased heart rate variability (HRV) during acute emesis; HRV spectral analysis indicated a shift to 'sympathetic dominance'. A hyperthermic response was seen during acute emesis, but hypothermia occurred during delayed emesis and there was also a decrease in HR. Exendin (9-39) did not improve feeding and drinking but reduced cisplatin-induced acute emesis by ~59 % (<0.05) and antagonised the hypothermic response (<0.05); systolic, diastolic and mean arterial BP increased during the delayed phase. In conclusion, blocking GLP-1 receptors in the brain reduces cisplatin-induced acute but not delayed emesis. Restoring power and structure to slow waves may represent a novel approach to treat the side effects of chemotherapy.
临床前研究表明,胰高血糖素样肽-1(GLP-1)受体拮抗剂艾塞那肽(9-39)可减轻顺铂诱导的急性呕吐。在本研究中,我们调查了艾塞那肽(9-39)(100 nmol/24 h,脑室内注射)对顺铂(5 mg/kg,腹腔注射)诱导的雪貂急性和延迟性呕吐以及“恶心”相关变化的影响。顺铂在0-24小时(急性)和24-72小时(延迟)期间分别诱发37.2±2.3次干呕+呕吐和59.0±7.7次。顺铂还使急性呕吐期间胃肌电活动的主导频率从9.4±0.1次/分钟增加到10.4±0.41次/分钟(P<0.05),并降低了主导功率(DP);正常胃动的功率百分比降低,而快速胃动的功率百分比增加;食物和水摄入量减少。在延迟性呕吐期间DP进一步降低,此时以正常胃动为主。高级多重分形去趋势波动分析显示,延迟性呕吐期间慢波信号形状变得更加简单。顺铂不影响血压(BP),但在急性呕吐期间使心率短暂增加,并降低心率变异性(HRV);HRV频谱分析表明转变为“交感神经优势”。急性呕吐期间出现体温过高反应,但延迟性呕吐期间出现体温过低,且心率也降低。艾塞那肽(9-39)并未改善进食和饮水,但使顺铂诱导的急性呕吐减少约59%(P<0.05),并拮抗体温过低反应(P<0.05);延迟期收缩压、舒张压和平均动脉压升高。总之,阻断大脑中的GLP-1受体可减轻顺铂诱导的急性呕吐,但不能减轻延迟性呕吐。恢复慢波的功率和结构可能代表一种治疗化疗副作用的新方法。
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