Neugebauer E, Rixen D, Garcia-Caballero M, Scheid B, Lorenz W
Department of Surgery, University of Cologne, Germany.
Shock. 1994 Apr;1(4):299-306. doi: 10.1097/00024382-199404000-00009.
Increased histamine release and formation (induced histamine) are two hypotheses considered in the pathogenesis of endotoxic shock development. To prove both hypotheses a sequence of four randomized controlled studies in rats was performed. Histamine release was measured indirectly as a decrease in tissue-histamine contents (lung, liver, spleen, stomach); histamine formation was estimated directly as an increase in histidine decarboxylase (HDC) activity in the same organs. Changes in contents and enzymatic activities were determined 4 and 8 h after shock induction; in addition, at the time of death, the activity of HDC was measured in heart, kidney, and small intestine. 4 h after shock induction, there was a significant decrease in the tissue-histamine content as measured only in the liver, with the same trend in lung and spleen. 8 h after endotoxin application, however, histamine concentration increased in the liver (significantly p < .05) and lung compared to the NaCl control group. The manifestation of changes in HDC activity in various organs was selective (i.e., not all organs showed alterations), not uniform (decreased as well as increased activities were measured), and time-dependent (no increase in HDC activity in animals dying at > 20 h). At 4 and 8 h, only the liver showed a strong increase in HDC activity which can explain the increase in histamine content. In lung, spleen, and stomach, a significant decrease occurred. The results on histamine release and formation let us conclude that histamine is involved in the pathogenesis of endotoxic shock development.
组胺释放增加和组胺生成(诱导性组胺)是内毒素性休克发生机制中被考虑的两种假说。为了验证这两种假说,在大鼠中进行了一系列四项随机对照研究。组胺释放通过组织组胺含量(肺、肝、脾、胃)的降低间接测量;组胺生成通过相同器官中组氨酸脱羧酶(HDC)活性的增加直接评估。在休克诱导后4小时和8小时测定含量和酶活性的变化;此外,在死亡时,测量心脏、肾脏和小肠中HDC的活性。休克诱导后4小时,仅在肝脏中测量到组织组胺含量显著降低,肺和脾也有相同趋势。然而,在内毒素应用8小时后,与生理盐水对照组相比,肝脏和肺中的组胺浓度增加(p <.05,差异显著)。不同器官中HDC活性变化的表现具有选择性(即并非所有器官都有改变),不具有一致性(测量到活性降低以及增加),且具有时间依赖性(在>20小时死亡的动物中HDC活性没有增加)。在4小时和8小时时,只有肝脏显示HDC活性强烈增加,这可以解释组胺含量的增加。在肺、脾和胃中,HDC活性显著降低。关于组胺释放和生成的结果让我们得出结论,组胺参与了内毒素性休克的发生机制。