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Naunyn Schmiedebergs Arch Pharmacol. 2018 Mar;391(3):299-308. doi: 10.1007/s00210-017-1458-0. Epub 2017 Dec 26.
Tachykinin NK2 receptor (NK2R) agonists have potential to alleviate clinical conditions associated with bladder and gastrointestinal under activity. The effects of agonists with differing selectivity for NK2R over NK1Rs on colorectal, bladder, and cardiovascular function were examined in anesthetized dogs. Intravenous (IV) administration of NKA, LMN-NKA ([Lys,MeLeu,Nle]-NKA), and [β-Ala]-NKA caused a dose-related increase in colorectal pressure (up to 98 mmHg) that was blocked by pretreatment with the NK2R antagonist GR 159897 (1 mg/kg), and hypotension (decrease in mean arterial pressure of ~40 mmHg) that was blocked by the NK1R antagonist CP-99,994 (1 mg/kg). Despite the greater in vitro selectivity of LMN-NKA and [β-Ala]-NKA for NK2R over NK1Rs compared with NKA, all 3 agonists increased colorectal pressure and caused hypotension within a similar dose range when administered as a bolus (0.1-300 μg/kg IV), or even as a slow IV infusion over 5 min (NKA; 0.02-0.6 μg/kg/min). In contrast, subcutaneous (SC) administration of LMN-NKA (3-10 μg/kg) increased colorectal pressure (up to 50 mmHg) and elicited micturition (≧ 85% voiding efficiency) without causing hypotension. NK2R agonists can produce rapid-onset, short-duration, colorectal contractions, and efficient voiding of urine without hypotension after SC administration, indicating that routes of administration that avoid the high plasma concentrations associated with IV dosing improve the separation between desired and unwanted pharmacodynamic effects. The potent hypotensive effect of NKA in dogs was unexpected based on published studies in humans in which IV infusion of NKA did not affect blood pressure at doses that increased gastrointestinal motility.
速激肽 NK2 受体(NK2R)激动剂具有缓解与膀胱和胃肠道活动不足相关的临床病症的潜力。在麻醉犬中,研究了对 NK2R 具有不同选择性的激动剂与 NK1R 相比对结直肠、膀胱和心血管功能的影响。静脉内(IV)给予 NKA、LMN-NKA([Lys,MeLeu,Nle]-NKA)和[β-Ala]-NKA 引起结直肠压力(高达 98mmHg)呈剂量依赖性增加,该增加被 NK2R 拮抗剂 GR 159897(1mg/kg)预处理阻断,同时引起低血压(平均动脉压下降约 40mmHg),该低血压被 NK1R 拮抗剂 CP-99994(1mg/kg)阻断。尽管 LMN-NKA 和[β-Ala]-NKA 对 NK2R 的体外选择性比 NKA 对 NK1R 的选择性更高,但当作为推注(0.1-300μg/kg IV)给予时,或甚至在 5 分钟内缓慢 IV 输注(NKA;0.02-0.6μg/kg/min)时,所有 3 种激动剂都在相似的剂量范围内增加结直肠压力并引起低血压。相比之下,皮下(SC)给予 LMN-NKA(3-10μg/kg)增加结直肠压力(高达 50mmHg)并引起排尿(≧85%的排空效率)而不引起低血压。NK2R 激动剂可在 SC 给药后产生快速发作、短持续时间的结直肠收缩和有效排尿,而不会引起低血压,这表明避免与 IV 给药相关的高血浆浓度的给药途径可改善所需和不需要的药效学作用之间的分离。根据在人类中进行的已发表研究,NKA 在狗中产生的强烈降压作用是出乎意料的,在这些研究中,静脉内输注 NKA 在增加胃肠道动力的剂量下不影响血压。