Rixen D, Neugebauer E, Lechleuthner A, Buschauer A, Nagelschmidt M, Thoma S, Rink A
Department of Surgery, University of Colonge, Germany.
Shock. 1994 Jul;2(1):47-52.
Although histamine release is generally considered harmful in endotoxic shock, several data exist to doubt this view. Own previous studies in rats let us assume a possible beneficial effect only with H1-antagonists, however a detrimental effect on survival with H2-antagonists. Consequently H1- and H2-agonists and antagonists were studied to prove the hypothesis of a beneficial H2-agonistic and H1-antagonistic effect. Two randomized studies were performed in a standardized rat endotoxic shock model (45 mg of Escherichia coli endotoxin/kg body weight (b.w.)). In both, methylprednisolone (50 mg/kg b.w.) and saline were used as positive and negative controls, respectively. Study I compared the effects of H1- and H2-agonists (betahistine, .1 mg/kg/h, and impromidine, 100 micrograms/kg/h) with H1- and H2-antagonists (astemizole and famotidine both 1 mg/kg b.w.; 20 rats/dose). Study II was performed to estimate the dose-response relationship of a new, highly potent H2-agonist with additional H1-antagonistic features (BU-E 75: .01, .1, 1.0, 10, and 100 micrograms/kg/h; 20 rats/dose). Animals receiving impromidine or BU-E 75 all received omeprazole (1 mumol/kg b.w.) to suppress gastric acid secretion. In study I impromidine significantly increased the survival-time and -course compared to famotidine treated animals (p = .01 and p < .05). Study II showed a positive dose-response relationship of BU-E 75 with an increase in survival rates from 30% (.01 microgram/kg/h) to 70% (100 micrograms/kg/h). These data strongly support the hypothesis of a beneficial effect of H2-agonism and H1-antagonism on survival parameters in rat endotoxic shock.
尽管组胺释放在内毒素休克中通常被认为是有害的,但有一些数据对此观点提出了质疑。我们之前在大鼠身上进行的研究表明,只有H1拮抗剂可能具有有益作用,而H2拮抗剂对生存率有不利影响。因此,我们研究了H1和H2激动剂及拮抗剂,以验证H2激动和H1拮抗具有有益作用这一假设。我们在标准化的大鼠内毒素休克模型(45毫克大肠杆菌内毒素/千克体重)中进行了两项随机研究。在这两项研究中,分别使用甲基强的松龙(50毫克/千克体重)和生理盐水作为阳性和阴性对照。研究I比较了H1和H2激动剂(倍他司汀,0.1毫克/千克/小时,和英普咪定,100微克/千克/小时)与H1和H2拮抗剂(阿司咪唑和法莫替丁均为1毫克/千克体重;每剂量20只大鼠)的效果。进行研究II是为了评估一种具有额外H1拮抗特性的新型高效H2激动剂(BU-E 75:0.01、0.1、1.0、10和100微克/千克/小时;每剂量20只大鼠)的剂量反应关系。接受英普咪定或BU-E 75的动物均接受奥美拉唑(1微摩尔/千克体重)以抑制胃酸分泌。在研究I中,与法莫替丁治疗的动物相比,英普咪定显著延长了生存时间和病程(p = 0.01和p < 0.05)。研究II显示BU-E 75呈正剂量反应关系,生存率从30%(0.01微克/千克/小时)提高到70%(100微克/千克/小时)。这些数据有力地支持了H2激动和H1拮抗对大鼠内毒素休克生存参数具有有益作用这一假设。