Sellin J H, Field M
J Clin Invest. 1981 Mar;67(3):770-8. doi: 10.1172/JCI110094.
Physiologic and pharmacologic effects of glucocorticoids on ileal ion transport were examined in vitro. Tissues were obtained from the three following groups of rabbits: (a) normal; (b) glucocorticoid deficient, which were treated with aminoglutethimide (AG), 100 mg twice daily for 3 d, with a resulting marked reduction in urinary cortisol excretion but no decrease in urinary aldosterone; and (c) methylprednisolone-treated (MP), 40 mg daily for 2 d. Transileal NaCl fluxes were measured with radioisotopes under short-circuit conditions, and the net HCO(3) flux was assumed equal to that portion of the short-circuit current (I(sc)) not accounted for by Na and Cl. In NaCl Ringer's solution containing 25 mM HCO(3) (pH 7.4), normals absorbed both Na and Cl and secreted HCO(3); the I(sc) was greater in both AG and MP groups than in normals; in the AG group, no Na was absorbed, and Cl as well as HCO(3) was secreted; in the MP group, more Na was absorbed and more HCO(3) secreted than in normals. Addition of glucose to the luminal side caused similar increments in I(sc) in all three groups, suggesting similar rates of Na-coupled glucose absorption. Secretory response was assessed with a maximal secretory simulus (8-Br-cAMP) and also a submaximal, cGMP-related secretory stimulus (Escherichia coli heat-stable enterotoxin). After addition of 8-Br-cAMP, the rates of net Cl secretion were similar in all three groups, suggesting no effect of glucocorticoids on maximal secretory capacity. Because the AG group was already secreting Cl, however, the cAMP-induced change in net Cl flux was least in this group. After addition of heat-stable enterotoxin, there were similar changes in net Cl flux in all three groups. To examine specifically Cl-independent, electrogenic Na transport, we used a 10 mM HCO(3), Cl-free SO(4)-Ringer (ph 7.2) in which net Na absorption was previously shown to be equal to the I(sc). Under these conditions, I(sc) was greatest in the MP group and least in the AG group. In vitro addition of hydrocortisone, 50 mug/ml, to AG tissues had no effect on Cl fluxes or I(sc) over a 3.5-h period. No differences among groups were observed with respect to morphology, electrical resistance, or cGMP concentration. We conclude that (a) the effect of glucocorticoid deficiency is similar to that of a submaximal secretory stimulus in that Na absorption is inhibited and some Cl secretion develops; (b) electrogenic Na absorption is depressed in glucocorticoid deficiency and enhanced in glucocorticoid excess; (c) glucocorticoid excess increases HCO(3) secretion; and (d) glucocorticoid status does not affect maximal secretory capacity.
在体外研究了糖皮质激素对回肠离子转运的生理和药理作用。组织取自以下三组兔子:(a)正常组;(b)糖皮质激素缺乏组,用氨鲁米特(AG)治疗,每日两次,每次100mg,共3天,导致尿皮质醇排泄显著减少,但尿醛固酮无降低;(c)甲基强的松龙治疗组(MP),每日40mg,共2天。在短路条件下用放射性同位素测量经回肠的NaCl通量,净HCO₃通量假定等于短路电流(Isc)中未被Na和Cl占有的部分。在含有25mM HCO₃(pH 7.4)的NaCl林格氏液中,正常组吸收Na和Cl并分泌HCO₃;AG组和MP组的Isc均高于正常组;在AG组,不吸收Na,分泌Cl和HCO₃;在MP组,比正常组吸收更多的Na,分泌更多的HCO₃。向肠腔侧添加葡萄糖在所有三组中引起Isc类似的增加,表明Na偶联葡萄糖吸收速率相似。用最大分泌刺激物(8-溴-cAMP)以及次最大的、与cGMP相关的分泌刺激物(大肠杆菌热稳定肠毒素)评估分泌反应。添加8-溴-cAMP后,所有三组的净Cl分泌速率相似,表明糖皮质激素对最大分泌能力无影响。然而,由于AG组已经在分泌Cl,因此该组中cAMP诱导的净Cl通量变化最小。添加热稳定肠毒素后,所有三组的净Cl通量有类似变化。为了具体研究不依赖Cl的电中性Na转运,我们使用了10mM HCO₃、无Cl的SO₄-林格氏液(pH 7.2),先前已证明其中净Na吸收等于Isc。在这些条件下,MP组的Isc最大,AG组最小。在体外向AG组织中添加50μg/ml氢化可的松,在3.5小时内对Cl通量或Isc无影响。在形态学、电阻或cGMP浓度方面未观察到组间差异。我们得出结论:(a)糖皮质激素缺乏的作用类似于次最大分泌刺激物的作用,即Na吸收受到抑制,出现一些Cl分泌;(b)糖皮质激素缺乏时电中性Na吸收降低,糖皮质激素过量时增强;(c)糖皮质激素过量增加HCO₃分泌;(d)糖皮质激素状态不影响最大分泌能力。