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内毒素作用后甲泼尼龙对循环类花生酸和血管舒缩张力的影响

Methylprednisolone on circulating eicosanoids and vasomotor tone after endotoxin.

作者信息

Hales C A, Brandstetter R D, Neely C F, Peterson M B, Kong D, Watkins W D

出版信息

J Appl Physiol (1985). 1986 Jul;61(1):185-91. doi: 10.1152/jappl.1986.61.1.185.

Abstract

Acute pulmonary and systemic vasomotor changes induced by endotoxin in dogs have been related, at least in part, to the production of eicosanoids such as the vasoconstrictor thromboxane and the vasodilator prostacyclin. Steroids in high doses, in vitro, inhibit activation of phospholipase A2 and prevent fatty acid release from cell membranes to enter the arachidonic acid cascade. We, therefore, administered methylprednisolone (40 mg/kg) to dogs to see if eicosanoid production and the ensuing vasomotor changes could be prevented after administration of 150 micrograms/kg of endotoxin. The stable metabolites of thromboxane B2 (TxB2) and 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) were measured by radioimmunoassay. Methylprednisolone by itself did not alter circulating eicosanoids but when given 2.5 h before endotoxin not only failed to inhibit endotoxin-induced eicosanoid production but actually resulted in higher circulating levels of 6-keto-PGF1 alpha (P less than 0.05) compared with animals receiving endotoxin alone. Indomethacin prevented the steroid-enhanced concentrations of 6-keto-PGF1 alpha after endotoxin and prevented the greater fall (P less than 0.05) in systemic blood pressure and systemic vascular resistance with steroid plus endotoxin than occurred with endotoxin alone. Administration of methylprednisolone immediately before endotoxin resulted in enhanced levels (P less than 0.05) of both TxB2 and 6-keto-PGF1 alpha but with a fall in systemic blood pressure and vascular resistance similar to the animals pretreated by 2.5 h. In contrast to the early steroid group in which all of the hypotensive effect was due to eicosanoids, in the latter group steroids had an additional nonspecific effect. Thus, in vivo, high-dose steroids did not prevent endotoxin-induced increases in eicosanoids but actually increased circulating levels of TxB2 and 6-keto-PGF1 alpha with a physiological effect favoring vasodilation.

摘要

内毒素在犬体内诱导的急性肺血管和全身血管舒缩变化,至少部分与类二十烷酸的产生有关,如血管收缩剂血栓素和血管舒张剂前列环素。高剂量的类固醇在体外可抑制磷脂酶A2的激活,并阻止脂肪酸从细胞膜释放进入花生四烯酸级联反应。因此,我们给犬注射甲泼尼龙(40mg/kg),以观察在给予150μg/kg内毒素后,类二十烷酸的产生及随之而来的血管舒缩变化是否能够被阻止。通过放射免疫分析法测定血栓素B2(TxB2)和6-酮前列腺素F1α(6-酮-PGF1α)的稳定代谢产物。甲泼尼龙本身并不会改变循环中的类二十烷酸水平,但在内毒素给药前2.5小时给予时,不仅未能抑制内毒素诱导的类二十烷酸产生,实际上与仅接受内毒素的动物相比,导致6-酮-PGF1α的循环水平更高(P<0.05)。吲哚美辛可防止内毒素后类固醇增强的6-酮-PGF1α浓度,并防止与单独使用内毒素相比,类固醇加内毒素导致的全身血压和全身血管阻力更大幅度的下降(P<0.05)。在内毒素给药前立即给予甲泼尼龙导致TxB2和6-酮-PGF1α水平均升高(P<0.05),但全身血压和血管阻力下降,类似于提前2.5小时预处理的动物。与早期类固醇组中所有降压作用均归因于类二十烷酸不同,在后一组中类固醇具有额外的非特异性作用。因此,在体内,高剂量类固醇并不能阻止内毒素诱导的类二十烷酸增加,实际上却增加了TxB2和6-酮-PGF1α的循环水平,并产生有利于血管舒张的生理效应。

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