Boquist L, Bäckman A M, Strömberg C
Eur J Pharmacol. 1980 Jun 27;64(4):325-32. doi: 10.1016/0014-2999(80)90240-x.
Isolated mouse islets exposed to 3mM glucose released an increased amount of insulin in the presence of acetazolamide (AZM) (10 mM) and diphenylhydantoin (DPH) (0.35 or 3.5 mM), whereas insulin secretion due to 20 mM glucose was decreased in the presence of AZM (10 mM) and DPH (0.35, 0.70 or 3.5 mM). The serum insulin concentration was increased 1 h after AZM injection, but was not significantly altered 1 h after combined administration of AZM and DPH. A moderate transient hyperglycemia was found 1 and 2 h after DPH injection (100 mg/kg b.w.) in fed mice, and a slight, transient hyperglycemic response was observed 24 h after administration of AZM (1.5 g/kg b.w.) to fed mice. A steadily increasing, marked hyperglycemia was seen in both fed and starved mice when AZM was given shortly before or after DPH. All animals subjected to this kind of treatment died within 48 h after the injections. Ketones were found in urine and serum of the hyperglycemic animals, and the hyperglycemia was abolished and the survival of the animals was prolonged by insulin administration, suggesting that ketoacidosis contributed to the death. Light microscopy disclosed degeneration and necrosis of some B-cells, and occasionally insulitis after combined treatment with AZM and DPH. Pretreatment with AZM inhibited the hyperglycemic response to p-hydroxymercuribenzoate in fed mice, but did not affect the hyperglycemic response of fed mice to D-mannoheptulose. The findings indicate that AZM and DPH, when given to mice in combination and in sufficient amount, cause impaired B-cell function with an inhibited glucose-induced insulin release and a severe, fatal hyperglycemia. The B-cell changes are believed to be due to intracellular ionic alterations.
在3mM葡萄糖环境下分离的小鼠胰岛,在乙酰唑胺(AZM)(10mM)和苯妥英(DPH)(0.35或3.5mM)存在时释放出更多的胰岛素,而在20mM葡萄糖环境下,在AZM(10mM)和DPH(0.35、0.70或3.5mM)存在时胰岛素分泌减少。注射AZM后1小时血清胰岛素浓度升高,但AZM与DPH联合给药1小时后血清胰岛素浓度无显著变化。喂食的小鼠注射DPH(100mg/kg体重)后1小时和2小时出现中度短暂高血糖,喂食的小鼠注射AZM(1.5g/kg体重)后24小时观察到轻微的短暂高血糖反应。当在DPH之前或之后不久给予AZM时,喂食和饥饿的小鼠均出现持续升高的明显高血糖。接受这种治疗的所有动物在注射后48小时内死亡。在高血糖动物的尿液和血清中发现了酮体,胰岛素给药可消除高血糖并延长动物的存活时间,这表明酮症酸中毒导致了死亡。光学显微镜检查显示,联合使用AZM和DPH治疗后,一些B细胞发生变性和坏死,偶尔出现胰岛炎。AZM预处理可抑制喂食小鼠对对羟基汞苯甲酸的高血糖反应,但不影响喂食小鼠对D-甘露庚酮糖的高血糖反应。这些发现表明,AZM和DPH联合并足量给予小鼠时,会导致B细胞功能受损,葡萄糖诱导的胰岛素释放受到抑制,并出现严重的致命性高血糖。B细胞的变化被认为是由于细胞内离子改变所致。