Kivilaakso E, Kiviluoto T
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Gastroenterology. 1988 Nov;95(5):1198-205. doi: 10.1016/0016-5085(88)90350-2.
Intracellular pH (pHi) was measured with proton-sensitive liquid sensor microelectrodes in isolated Necturus antral mucosa, paying special attention to arranging experimental conditions to simulate conditions frequently associated with in vivo "stress ulceration." Intracellular pH in mucosas perfused under standard conditions (Ringer's solution containing HCO3-/CO2) was 7.22 + 0.02 (n = 27). Removal of Na+ and HCO3- or addition of amiloride or 4-acetamido-4-isothiocyanostillbene-2,2-disulfonic acid (blockers of Na+/H+ and Cl-/HCO3-exchangers) had no influence on steady-state pHi, suggesting that these ion exchangers do not significantly contribute to the maintenance of pHi in the presence of normal external pH. Acidification of mucosal (luminal) perfusate to pH 3 (mimicking the presence of gastric acid) had no influence on pHi, but mucosal pH 2 (10 mM HCl) acidified pHi to 6.93 +/- 0.07. Acidification of serosal (nutrient) perfusate to pH 6 (mimicking intramucosal acidosis caused by back-diffusion of luminal H+) acidified pHi to 6.72 +/- 0.10. Removal of Na+ from and addition of amiloride to the serosal perfusate during exposure to serosal pH 6.0 induced further acidification of pHi, suggesting that in this acidotic situation (with very low ambient HCO3- concentration) a Na+/H+ exchanger does contribute to the maintenance of steady-state pHi. Increased PCO2 (10% vol/vol in the gas) in a slightly acidic milieu (mimicking mucosal ischemia) likewise acidified pHi to 6.73 +/- 0.05. A combination of mucosal acid (pH 3), high PCO2 (10% CO2), and low serosal pH (pH 6) (mimicking conditions that prevail, for example, during hemorrhagic shock) acidified pHi and ultimately resulted in cell death. These derangements of intracellular acid-base balance may have pathogenetic importance also in in vivo stress ulceration.
使用质子敏感液体传感器微电极测量离体美西螈胃窦黏膜的细胞内pH(pHi),特别注意安排实验条件以模拟与体内“应激性溃疡”经常相关的情况。在标准条件下(含HCO3-/CO2的林格氏液)灌注的黏膜中,细胞内pH为7.22±0.02(n = 27)。去除Na+和HCO3-或添加氨氯吡脒或4-乙酰氨基-4-异硫氰基芪-2,2-二磺酸(Na+/H+和Cl-/HCO3-交换体的阻滞剂)对稳态pHi无影响,这表明在正常外部pH存在的情况下,这些离子交换体对pHi的维持没有显著贡献。将黏膜(管腔)灌注液酸化至pH 3(模拟胃酸的存在)对pHi无影响,但黏膜pH 2(10 mM HCl)将pHi酸化至6.93±0.07。将浆膜(营养)灌注液酸化至pH 6(模拟由管腔H+反向扩散引起的黏膜内酸中毒)将pHi酸化至6.72±0.10。在暴露于浆膜pH 6.0期间,从浆膜灌注液中去除Na+并添加氨氯吡脒会导致pHi进一步酸化,这表明在这种酸中毒情况下(环境HCO3-浓度非常低),Na+/H+交换体确实有助于维持稳态pHi。在微酸性环境中(模拟黏膜缺血)增加PCO2(气体中体积分数为10%)同样将pHi酸化至6.73±0.05。黏膜酸(pH 3)、高PCO2(10% CO2)和低浆膜pH(pH 6)的组合(模拟例如失血性休克期间普遍存在的情况)使pHi酸化并最终导致细胞死亡。这些细胞内酸碱平衡的紊乱在体内应激性溃疡中可能也具有发病机制上的重要性。