Unwin R J, Reed T, Thom S, Calam J, Peart W S
Br J Clin Pharmacol. 1987 May;23(5):523-8. doi: 10.1111/j.1365-2125.1987.tb03087.x.
The mechanisms of the cardiovascular and renin responses to vasoactive intestinal polypeptide (VIP) are unclear. Rabbit studies suggest that VIP-induced tachycardia is largely beta-adrenoceptor mediated, but that the renin response may be partially prostaglandin-dependent. To examine the relative importance of prostaglandins and reflex sympathetic activation in the haemodynamic and renin responses to VIP infusion in man, we completed two randomised single-blind crossover studies in two groups of six healthy male volunteers (aged 24-35 years). We recorded the effects of indomethacin and propranolol pretreatment on VIP-related changes in heart rate (HR), blood pressure (BP), forearm vascular resistance (FVR), plasma renin activity (PRA), plasma noradrenaline (PNA) and plasma arginine vasopressin (AVP) concentrations. Intravenous VIP (calculated dose: 6 pmol kg-1 min-1) produced cutaneous flushing, increased HR and PRA, decreased FVR, but did not alter mean arterial BP or AVP levels. Indomethacin (375 mg over 3 days) lowered basal PRA and propranolol (circa 40 mg i.v. over 60 min) decreased resting HR and increased FVR. Although indomethacin and propranolol reduced the absolute rise in PRA and HR, respectively, during VIP infusion, the percentage changes were no different from control. Neither drug altered the flush response to VIP and propranolol did not affect the fall in FVR. We conclude that the measured cardiovascular responses to VIP infusion in man are probably direct and do not involve a significant contribution from reflex sympathetic stimulation, nor prostaglandin release.
血管活性肠肽(VIP)引起心血管和肾素反应的机制尚不清楚。对兔子的研究表明,VIP诱导的心动过速主要由β-肾上腺素能受体介导,但肾素反应可能部分依赖于前列腺素。为了研究前列腺素和反射性交感神经激活在人体对VIP输注的血流动力学和肾素反应中的相对重要性,我们在两组各6名健康男性志愿者(年龄24 - 35岁)中完成了两项随机单盲交叉研究。我们记录了吲哚美辛和普萘洛尔预处理对VIP相关的心率(HR)、血压(BP)、前臂血管阻力(FVR)、血浆肾素活性(PRA)、血浆去甲肾上腺素(PNA)和血浆精氨酸加压素(AVP)浓度变化的影响。静脉注射VIP(计算剂量:6 pmol kg-1 min-1)引起皮肤潮红,HR和PRA升高,FVR降低,但未改变平均动脉压或AVP水平。吲哚美辛(3天内375 mg)降低基础PRA,普萘洛尔(静脉注射约40 mg,60分钟内)降低静息HR并增加FVR。虽然吲哚美辛和普萘洛尔分别降低了VIP输注期间PRA和HR的绝对升高,但百分比变化与对照组无差异。两种药物均未改变对VIP的潮红反应,普萘洛尔也未影响FVR的下降。我们得出结论,人体对VIP输注的测量到的心血管反应可能是直接的,不涉及反射性交感神经刺激或前列腺素释放的显著贡献。