Neuwelt E A, Kikuchi K, Hill S A, Lipsky P, Frenkel E
J Neurosurg. 1982 Feb;56(2):254-9. doi: 10.3171/jns.1982.56.2.0254.
The present studies evaluated the effect of phenobarbital, pentobarbital, and thiopental at concentrations comparable to those attained during therapeutic barbiturate-induced coma, on in vitro mitogen-induced lymphocyte activation. Lymphocytes from normal volunteers were incubated for 72 hours in culture medium containing mitogen (phytohemagglutinin) and a range of concentrations of the barbiturates (5 to 833 microgram/ml). Three parameters of lymphocyte activation (mitogen-induced blast transformation, 3H-thymidine incorporation, and cell proliferation) were all suppressed by the barbiturates. The suppression was dose-dependent. The greatest suppression was caused by the short-acting barbiturate, thiopental. Lymphocyte responses were much less affected by the long-acting barbiturate, phenobarbital. The intermediate-acting barbiturate, pentobarbital, was also intermediate in its ability to inhibit lymphocyte activation. The two-to threefold difference between the effects of thiopental and pentobarbital on lymphocyte function may have direct clinical relevance, since it is primarily these two agents that are employed to induce therapeutic "barbiturate coma." Since lymphocyte suppression appears to be much more marked in the presence of thiopental, these observations support a role for the other barbiturates in programs of induced coma.
本研究评估了苯巴比妥、戊巴比妥和硫喷妥钠在与治疗性巴比妥类药物诱导昏迷期间达到的浓度相当的浓度下，对体外有丝分裂原诱导的淋巴细胞活化的影响。将来自正常志愿者的淋巴细胞在含有有丝分裂原（植物血凝素）和一系列浓度巴比妥类药物（5至833微克/毫升）的培养基中孵育72小时。巴比妥类药物抑制了淋巴细胞活化的三个参数（有丝分裂原诱导的母细胞转化、3H-胸腺嘧啶核苷掺入和细胞增殖）。这种抑制是剂量依赖性的。作用最强的是短效巴比妥类药物硫喷妥钠。长效巴比妥类药物苯巴比妥对淋巴细胞反应的影响要小得多。中效巴比妥类药物戊巴比妥抑制淋巴细胞活化的能力也处于中间水平。硫喷妥钠和戊巴比妥对淋巴细胞功能的影响相差两到三倍，这可能具有直接的临床意义，因为主要就是这两种药物用于诱导治疗性“巴比妥类昏迷”。由于在硫喷妥钠存在的情况下淋巴细胞抑制似乎更为明显，这些观察结果支持了其他巴比妥类药物在诱导昏迷方案中的作用。
