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稀有气体氩气的临床前和临床应用全面综述:安全性与保护作用的证据

A complete review of preclinical and clinical uses of the noble gas argon: Evidence of safety and protection.

作者信息

Nespoli Francesca, Redaelli Simone, Ruggeri Laura, Fumagalli Francesca, Olivari Davide, Ristagno Giuseppe

机构信息

Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

出版信息

Ann Card Anaesth. 2019 Apr-Jun;22(2):122-135. doi: 10.4103/aca.ACA_111_18.

Abstract

The noble gas argon (Ar) is a "biologically" active element and has been extensively studied preclinically for its organ protection properties. This work reviews all preclinical studies employing Ar and describes the clinical uses reported in literature, analyzing 55 pertinent articles found by means of a search on PubMed and Embase. Ventilation with Ar has been tested in different models of acute disease at concentrations ranging from 20% to 80% and for durations between a few minutes up to days. Overall, lesser cell death, smaller infarct size, and better functional recovery after ischemia have been repeatedly observed. Modulation of the molecular pathways involved in cell survival, with resulting anti-apoptotic and pro-survival effects, appeared as the determinant mechanism by which Ar fulfills its protective role. These beneficial effects have been reported regardless of onset and duration of Ar exposure, especially after cardiac arrest. In addition, ventilation with Ar was safe both in animals and humans. Thus, preclinical and clinical data support future clinical studies on the role of inhalatory Ar as an organ protector.

摘要

惰性气体氩(Ar)是一种具有“生物学”活性的元素,其器官保护特性已在临床前得到广泛研究。本文综述了所有使用氩气的临床前研究,并描述了文献中报道的临床应用,分析了通过在PubMed和Embase上搜索找到的55篇相关文章。在不同的急性疾病模型中,已对浓度范围为20%至80%、持续时间从几分钟到几天的氩气通气进行了测试。总体而言,缺血后反复观察到细胞死亡减少、梗死面积缩小和功能恢复更好。参与细胞存活的分子途径的调节,产生抗凋亡和促存活作用,似乎是氩气发挥其保护作用的决定性机制。无论氩气暴露的开始时间和持续时间如何,尤其是在心脏骤停后,均已报道了这些有益效果。此外,氩气通气在动物和人类中都是安全的。因此,临床前和临床数据支持未来关于吸入氩气作为器官保护剂作用的临床研究。

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