Nilsson Kristofer F, Goździk Waldemar, Frostell Claes, Zieliński Stanisław, Zielińska Marzena, Ratajczak Kornel, Skrzypczak Piotr, Rodziewicz Sylwia, Albert Johanna, Gustafsson Lars E
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Drug Des Devel Ther. 2018 Mar 29;12:685-694. doi: 10.2147/DDDT.S149727. eCollection 2018.
Clinically available intravenous (IV) nitric oxide (NO) donor drugs such as nitroglycerin (GTN) cause systemic hypotension and/or tolerance development. In a porcine model, novel NO donor compounds - the organic mononitrites of 1,2-propanediol (PDNO) - were compared to GTN with regard to pulmonary selectivity and tolerance development. The vasodilatory effects of inorganic nitrite were investigated.
In anesthetized piglets, central hemodynamics were monitored. At normal pulmonary vascular resistance (PVR), IV infusions of PDNO (15-60 nmol kg min), GTN (13-132 nmol kg min), and inorganic nitrite (dosed as PDNO) were administered. At increased PVR (by U46619 IV), IV infusions of PDNO (60-240 nmol kg min) and GTN (75-300 nmol kg min) before and after a 5 h infusion of GTN (45 nmol kg min) were given.
At normal PVR, PDNO (n=12) and GTN (n=7) caused significant dose-dependent decreases in mean systemic and pulmonary arterial pressures, whereas inorganic nitrite (n=13) had no significant effect. At increased PVR, PDNO (n=6) and GTN (n=6) significantly decreased mean systemic and pulmonary pressures and resistances, but only PDNO reduced the ratio between pulmonary and systemic vascular resistances significantly. After the 5 h GTN infusion, the hemodynamic response to GTN infusions (n=6) was significantly suppressed, whereas PDNO (n=6) produced similar hemodynamic effects to those observed before the GTN infusion.
PDNO is a vasodilator with selectivity for pulmonary circulation exhibiting no cross-tolerance to GTN, but GTN causes non selective vasodilatation with substantial tolerance development in the pulmonary and systemic circulations. Inorganic nitrite has no vasodilatory properties at relevant doses.
临床上可用的静脉注射(IV)一氧化氮(NO)供体药物,如硝酸甘油(GTN),会导致全身性低血压和/或耐受性发展。在猪模型中,将新型NO供体化合物——1,2 - 丙二醇的有机亚硝酸盐(PDNO)——与GTN在肺选择性和耐受性发展方面进行了比较。研究了无机亚硝酸盐的血管舒张作用。
在麻醉的仔猪中监测中心血流动力学。在正常肺血管阻力(PVR)下,静脉输注PDNO(15 - 60 nmol·kg·min)、GTN(13 - 132 nmol·kg·min)和无机亚硝酸盐(按PDNO剂量给药)。在PVR升高时(通过静脉注射U46619),在静脉输注5小时GTN(45 nmol·kg·min)前后,分别静脉输注PDNO(60 - 240 nmol·kg·min)和GTN(75 - 300 nmol·kg·min)。
在正常PVR下,PDNO(n = 12)和GTN(n = 7)导致平均全身动脉压和肺动脉压出现显著的剂量依赖性下降,而无机亚硝酸盐(n = 13)没有显著影响。在PVR升高时,PDNO(n = 6)和GTN(n = 6)显著降低平均全身动脉压和肺动脉压以及阻力,但只有PDNO显著降低了肺血管阻力与全身血管阻力的比值。在5小时GTN输注后,GTN输注(n = 6)的血流动力学反应受到显著抑制,而PDNO(n = 6)产生的血流动力学效应与GTN输注前观察到的相似。
PDNO是一种对肺循环具有选择性的血管舒张剂,对GTN无交叉耐受性,但GTN会导致非选择性血管舒张,并在肺循环和体循环中出现显著的耐受性发展。无机亚硝酸盐在相关剂量下无血管舒张特性。