Abernethy D R, Laurie N, Andrawis N S
Department of Medicine, Brown University School of Medicine, Providence, R.I., USA.
Clin Pharmacol Ther. 1995 Sep;58(3):328-34. doi: 10.1016/0009-9236(95)90250-3.
The physiologic role of endothelin-1 is not well established; however, it may have a role in modulation of peripheral vascular tone complimentary to angiotensin II. In vitro and animal studies suggested an interrelationship between angiotensin II and endothelin-1 vasoconstriction. We hypothesized that local vascular or systemic renin-angiotensin II systems must be intact for endothelin-1-mediated vasoconstriction in humans.
To test this hypothesis, responses to brachial artery infusion of endothelin-1 alone and endothelin-1 plus local low-dose infusion of enaliprilat were studied in seven healthy male and seven healthy female volunteers.
In these subjects, baseline forearm vascular resistance (mean +/- SEM; 24 +/- 3.5 mm Hg.ml/dl forearm vol/min) increased with a 38.2 ng/min endothelin-1 infusion (61.8 +/- 6.8 mm Hg.ml/dl forearm vol/min; p < 0.01). Forearm vascular resistance decreased when 38.2 ng/min endothelin-1 was infused concomitantly with a local 5 micrograms/min infusion of enaliprilat (45.5 +/- 5.9 mm Hg.ml/dl forearm vol/min; p < 0.01 compared with endothelin-1 alone).
These data indicate that an endothelin-1-induced increase in forearm vascular resistance is inhibited by local forearm angiotensin-converting enzyme inhibition.
内皮素-1的生理作用尚未完全明确;然而,它可能在调节外周血管张力方面发挥作用,与血管紧张素II相辅相成。体外和动物研究表明血管紧张素II与内皮素-1介导的血管收缩之间存在相互关系。我们推测,人体中内皮素-1介导的血管收缩需要局部血管或全身肾素-血管紧张素II系统保持完整。
为验证这一假设,我们对7名健康男性和7名健康女性志愿者进行了研究,观察他们对单独肱动脉输注内皮素-1以及内皮素-1加局部低剂量输注依那普利拉的反应。
在这些受试者中,基础前臂血管阻力(平均值±标准误;24±3.5mmHg·ml/前臂容积/分钟)在输注38.2ng/分钟内皮素-1时升高(61.8±6.8mmHg·ml/前臂容积/分钟;p<0.01)。当38.2ng/分钟内皮素-1与局部5μg/分钟依那普利拉同时输注时,前臂血管阻力降低(45.5±5.9mmHg·ml/前臂容积/分钟;与单独输注内皮素-1相比,p<0.01)。
这些数据表明,局部前臂血管紧张素转换酶抑制可抑制内皮素-1引起的前臂血管阻力增加。