Rho Ji Yoon, Shin Hwa Yong, Kim Hyun Chang, Lee Ji Won, Kim Seong Deok
Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Korea.
Korean J Anesthesiol. 2009 Oct;57(4):472-482. doi: 10.4097/kjae.2009.57.4.472.
Hypoxic pulmonary vasoconstriction (HPV) is unique to pulmonary circulation but the mechanism remains elusive. Red blood cells (RBCs) are known to augment HPV and to release more ATP as oxygen content falls. Leukotrienes constrict smooth muscle and could be important for the regulation of the pulmonary circulation. Hence we hypothesized that ATP and leukotrienes are mediators of HPV produced during acute alveolar hypoxia.
In forty Sprague-Dawley rats, lungs were isolated and perfused. We administered ATP (10 micrometer) to the ATP group (n = 8), the ATP antagonist, suramin (100 micrometer) to the suramin group (n = 8), leukotriene C4 (LTC4, 5 microgram) to the LTC4 group (n = 8), the LTC4 antagonist, LY171883 (20 micrometer) to the LY171883 group (n = 8), and LTC4 (5 microgram) + ATP (10 micrometer) to the LTC4 + ATP group (n = 8) during normoxic ventilation. HPV responses were induced by three hypoxic challenges for 5 minutes separated by 5 minutes of ventilation with a normoxic gas mixture. Baseline pulmonary artery pressure change after exposure to each drug and hypoxic pressor response between a period 21% normoxic gas ventilation and that of 3% hypoxic gas ventilation were measured.
ATP and LTC4 + ATP increased baseline pulmonary artery pressures but LTC4 did not alter it. ATP did not affect hypoxic pressor response. Suramin, LY171883 and LTC4 + ATP inhibited the pressor response to hypoxia. LTC4 increased hypoxic pressor response.
In isolated rat lungs, HPV may be mediated by ATP and LTC4 appears more likely to be a modulator than a mediator of HPV.
低氧性肺血管收缩(HPV)是肺循环所特有的,但机制仍不清楚。已知红细胞(RBCs)可增强HPV,并随着氧含量下降释放更多ATP。白三烯可使平滑肌收缩,可能对肺循环调节很重要。因此,我们假设ATP和白三烯是急性肺泡低氧期间产生的HPV的介质。
在40只Sprague-Dawley大鼠中,分离并灌注肺脏。在常氧通气期间,我们给ATP组(n = 8)给予ATP(10微摩尔),给苏拉明组(n = 8)给予ATP拮抗剂苏拉明(100微摩尔),给LTC4组(n = 8)给予白三烯C4(LTC4,5微克),给LY171883组(n = 8)给予LTC4拮抗剂LY171883(20微摩尔),给LTC4 + ATP组(n = 8)给予LTC4(5微克)+ ATP(10微摩尔)。通过三次低氧刺激诱导HPV反应,每次刺激5分钟,中间间隔5分钟的常氧气体通气。测量暴露于每种药物后基线肺动脉压力变化以及在21%常氧气体通气期和3%低氧气体通气期之间的低氧升压反应。
ATP和LTC4 + ATP增加了基线肺动脉压力,但LTC4未改变。ATP不影响低氧升压反应。苏拉明、LY171883和LTC4 + ATP抑制了对低氧的升压反应。LTC4增加了低氧升压反应。
在离体大鼠肺中,HPV可能由ATP介导,LTC4似乎更可能是HPV的调节剂而非介质。