Smith P L, Blumberg J B, Stoff J S, Field M
Gastroenterology. 1981 Feb;80(2):356-65.
Prior in vivo studies have shown that indomethacin, which inhibits prostaglandin (PG) synthesis, affects fluid transport in the small bowel, enhancing spontaneous fluid absorption and reducing the amount of fluid that accumulates in response to cholera toxin and other secretory stimuli. To further explore the mechanisms involved, we determined the effects of indomethacin on ion transport, cAMP concentration, and PGE2 production in rabbit ileal mucosa in vitro. Indomethacin (1 mM), when added alone, had no significant effect on short-circuit current (either basal or glucose-stimulated), Cl fluxes, or cAMP concentration. Indomethacin did, however, inhibit the ion transport changes caused by several secretagogues: Effects of theophylline, Ca-ionophore A23187, and arachidonate were reversibly inhibited by at least 65%, whereas effects of dibutyryl cAMP, 16,16-dimethyl PGE2, cholera toxin, and heat-stable Escherichia coli enterotoxin were inhibited by about 30%. Indomethacin also inhibited the theophylline-evoked increase in cAMP concentration. Indomethacin decreased PGE2 production under basal conditions and in the presence of theophylline and A23187, which may partly explain the antisecretory action of the drug. Since arachidonate increased PGE2 release from the mucosa more than 10-fold and indomethacin did not inhibit this effect, indomethacin at high concentration (0.5-1 mM) appears to also inhibit the action of intestinal secretagogues by a prostaglandin-independent mechanism. This study also demonstrates that the antisecretory effect of indomethacin is not simply due to stimulation of an unrelated absorptive process.
先前的体内研究表明,抑制前列腺素(PG)合成的吲哚美辛会影响小肠中的液体转运,增强自发液体吸收,并减少因霍乱毒素和其他分泌性刺激而积聚的液体量。为了进一步探究其中涉及的机制,我们在体外测定了吲哚美辛对兔回肠黏膜离子转运、环磷酸腺苷(cAMP)浓度和前列腺素E2(PGE2)产生的影响。单独添加吲哚美辛(1 mM)时,对短路电流(基础或葡萄糖刺激的)、氯离子通量或cAMP浓度均无显著影响。然而,吲哚美辛确实抑制了几种促分泌剂引起的离子转运变化:茶碱、钙离子载体A23187和花生四烯酸的作用被可逆地抑制了至少65%,而二丁酰cAMP、16,16-二甲基PGE2、霍乱毒素和热稳定的大肠杆菌肠毒素的作用被抑制了约30%。吲哚美辛还抑制了茶碱引起的cAMP浓度升高。在基础条件下以及存在茶碱和A23187的情况下,吲哚美辛降低了PGE2的产生,这可能部分解释了该药物的抗分泌作用。由于花生四烯酸使黏膜释放的PGE2增加了10倍以上,而吲哚美辛并未抑制这种作用,高浓度(0.5 - 1 mM)的吲哚美辛似乎还通过一种不依赖前列腺素的机制抑制肠道促分泌剂的作用。这项研究还表明,吲哚美辛的抗分泌作用并非仅仅是由于刺激了一个不相关的吸收过程。