Mazzoni L, Naef R, Chapman I D, Morley J
Sandoz Pharma Ltd., Basel, Switzerland.
Pulm Pharmacol. 1994 Dec;7(6):367-76. doi: 10.1006/pulp.1994.1043.
Allergic bronchospasm in sensitized guinea-pigs was totally suppressed by acute subcutaneous infusion of rac-salbutamol (0.69 microgram/kg per min) for < 1 h. More prolonged infusion of rac-salbutamol induced a progressive susceptibility to inhaled antigen so that, by 48 h, animals collapsed and died following inhalation of antigen. In anaesthetized animals, acute infusion of rac-salbutamol (1.67 micrograms/kg per min) suppressed airway obstruction, an effect that can be attributed to beta 2-adrenoceptor activation by the eutomer (R-salbutamol). Acute intravenous infusion of the distomer (S-salbutamol) (1.67 micrograms/kg per min) induced hyperresponsiveness to histamine without having any effect upon airway calibre. It is suggested therefore that subcutaneous infusion of rac-salbutamol initially abrogates the bronchoconstrictor response to antigen because the bronchodilator action of the eutomer predominates over hyperreactivity attributable to the distomer. Conversion from protection to susceptibility was not determined by reduced beta 2-adrenoceptor activation since animals could be protected from a lethal response to antigen by inhalation of rac-isoprenaline or by subcutaneous injection of rac-salbutamol. The seeming progressive loss of efficacy of R-salbutamol may result from disproportionate accumulation of S-salbutamol if, as in man, there is stereospecific metabolism of R-salbutamol. The capacity of S-salbutamol to evoke hyperresponsiveness is shared by S-isoprenaline and S-terbutaline and, as has been shown previously for rac-isoprenaline, the capacity of S-salbutamol to elicit hyperresponsiveness was not evidenced following section of the vagus nerves. No mechanism has yet been established which might account for this property of S-salbutamol or for other S-enantiomers of sympathomimetics.
对致敏豚鼠,急性皮下输注消旋沙丁胺醇(0.69微克/千克每分钟)持续<1小时可完全抑制过敏性支气管痉挛。输注消旋沙丁胺醇时间延长会导致对吸入抗原的易感性逐渐增加,以至于到48小时时,动物吸入抗原后会虚脱并死亡。在麻醉动物中,急性输注消旋沙丁胺醇(1.67微克/千克每分钟)可抑制气道阻塞,这种作用可归因于优映体(R-沙丁胺醇)对β2-肾上腺素能受体的激活。急性静脉输注劣映体(S-沙丁胺醇)(1.67微克/千克每分钟)会诱发对组胺的高反应性,而对气道口径没有任何影响。因此,有人提出皮下输注消旋沙丁胺醇最初可消除对抗原的支气管收缩反应,因为优映体的支气管舒张作用超过了劣映体所致的高反应性。从保护状态转变为易感性并非由β2-肾上腺素能受体激活减少所致,因为吸入消旋异丙肾上腺素或皮下注射消旋沙丁胺醇可保护动物免于对抗原的致死反应。如果像在人体中一样,R-沙丁胺醇存在立体特异性代谢,那么R-沙丁胺醇疗效看似逐渐丧失可能是由于S-沙丁胺醇不成比例地蓄积所致。S-异丙肾上腺素和S-特布他林也具有S-沙丁胺醇诱发高反应性的能力,并且正如之前对消旋异丙肾上腺素所显示的,切断迷走神经后未证实S-沙丁胺醇有诱发高反应性的能力。尚未确定任何机制可以解释S-沙丁胺醇的这种特性或拟交感神经药的其他S-对映体的特性。