Hermsmeyer K, Kuthe C
J Cardiovasc Pharmacol. 1984;6 Suppl 7:S933-6.
Several mechanisms of action for Ca2+ antagonists are possible at the vascular muscle cell membrane and at subsequent steps. In rat caudal artery, nitrendipine hyperpolarizes the resting vascular muscle cell, an action different from that of verapamil. Hyperpolarization might be expected to explain the relaxant action of nitrendipine because hyperpolarization per se causes a decrease in Ca2+ influx. SHR vascular muscle cells show a greater dependence on extracellular K+ concentration for the action of nitrendipine than WKY, as indicated by both tension and membrane potential measurements, suggesting an action on an ion pump. It is possible to directly test the hypothesis that inhibition of Ca2+ influx can directly account for the entire effect of nitrendipine by determination of intracellular Ca2+ with the metallochromic absorbence dye, arsenazo III. Nitrendipine not only decreased the magnitude of the Ca2+ signal but also enhanced the return to resting, or below resting, intracellular Ca2+ levels. Experiments on isolated single cells from the azygous vein of neonatal rats showed evidence of both blockade of Ca2+ influx and enhancement of Ca2+ efflux. These measurements suggest that nitrendipine might cause relaxation by stimulating Ca2+ efflux as well as by decreasing passive Ca2+ influx. Therefore, the action of nitrendipine might be more complicated than simply blocking Ca2+ channels, possibly involving stimulation of active ion transport.
钙拮抗剂在血管平滑肌细胞膜及后续步骤可能存在多种作用机制。在大鼠尾动脉中,尼群地平可使静息血管平滑肌细胞超极化,这一作用与维拉帕米不同。超极化可能解释了尼群地平的舒张作用,因为超极化本身会导致钙离子内流减少。如张力和膜电位测量所示,与WKY相比,SHR血管平滑肌细胞对细胞外钾离子浓度在尼群地平作用方面的依赖性更强,提示其作用于离子泵。通过使用金属络合吸收染料偶氮胂III测定细胞内钙离子,可以直接检验钙离子内流抑制能否直接解释尼群地平的全部效应这一假设。尼群地平不仅降低了钙离子信号的幅度,还增强了细胞内钙离子水平恢复到静息或低于静息水平的能力。对新生大鼠奇静脉分离的单个细胞进行的实验显示出钙离子内流被阻断以及钙离子外流增强的证据。这些测量结果表明,尼群地平可能通过刺激钙离子外流以及减少被动钙离子内流来引起舒张。因此,尼群地平的作用可能比单纯阻断钙离子通道更为复杂,可能涉及对主动离子转运的刺激。