Kim Y C, Davies M G, Lee T H, Hagen P O, Carson C C
Sexual Dysfunction Laboratory, University of North Carolina School of Medicine, Chapel Hill.
J Urol. 1995 Feb;153(2):506-10. doi: 10.1097/00005392-199502000-00072.
Widespread clinical use of H2 antagonists for peptic ulcer disease has been associated with reports of impotence. Histamine is a vasoactive amine which is endogenously produced in many organs including the penis. To date, 3 histamine receptor subtypes (H1, H2 and H3) have been identified. However, the role and function of histamine in the corpus cavernosal physiology are poorly understood. This study evaluates the in vitro functional characteristics of the 3 histamine receptor subtypes in the isolated corpus cavernosal strips from New Zealand White rabbits. The isometric responses to histamine and specific histamine receptor subtype agonists were assessed, following cyclooxygenase (indomethacin, 10(-5) M.), adrenergic (guanethidine, 5 x 10(-6) M.) and cholinergic (atropine, 5 x 10(-6) M.) blockade, at resting tension and after submaximal precontraction with norepinephrine (NE, 2 x 10(-5) M.). Histamine (10(-8) M. to 10(-3) M.) produced concentration-dependent contraction from basal and precontracted states and did not relax precontracted tissue. The H1 agonist, 2-(2-thiazolyl)ethylamine (10(-8) M. to 10(-3) M.), produced a contractile response from both basal and precontracted states, while the corporal tissue did not respond to either dimaprit, an H2 agonist (10(-8) M. to 10(-5) M.) or R(-)-alpha-methyl-histamine, an H3 agonist (10(-8) M. to 10(-5) M.). The response to histamine was progressively attenuated by an H1 antagonist (mepyramine; 10(-8) M. to 10(-5) M.), while neither an H2 antagonist (cimetidine; 10(-4)M.) nor an H3 antagonist (thioperamide; 10(-4)M.) had any inhibitory effects. H1 antagonism enhanced relaxation induced by electrical field stimulation (neurally mediated). Such relaxation increased after preincubation with 10(-6) M. or greater of mepyramine (p < 0.05). This study suggests that the principal histamine receptor subtype that mediates smooth muscle cell contraction in the corpus cavernosum is the H1 subtype. Since histamine H1 receptor antagonism increased NANC neurally mediated corporal relaxation, it possesses potential as an intracavernosal pharmacotherapeutic agent for the treatment of erectile dysfunction. This study, therefore, strongly indicates that H2 receptor antagonists are unlikely to have direct effects on penile erection.
H2拮抗剂在消化性溃疡疾病中的广泛临床应用与阳痿的报道有关。组胺是一种血管活性胺,在包括阴茎在内的许多器官中内源性产生。迄今为止,已鉴定出3种组胺受体亚型(H1、H2和H3)。然而,组胺在海绵体生理学中的作用和功能尚不清楚。本研究评估了来自新西兰白兔的离体海绵体条中3种组胺受体亚型的体外功能特性。在环氧化酶(吲哚美辛,10(-5)M)、肾上腺素能(胍乙啶,5×10(-6)M)和胆碱能(阿托品,5×10(-6)M)阻断后,在静息张力下以及用去甲肾上腺素(NE,2×10(-5)M)进行次最大预收缩后,评估对组胺和特定组胺受体亚型激动剂的等长反应。组胺(10(-8)M至10(-3)M)在基础状态和预收缩状态下产生浓度依赖性收缩,并且不会使预收缩组织松弛。H1激动剂2-(2-噻唑基)乙胺(10(-8)M至10(-3)M)在基础状态和预收缩状态下均产生收缩反应,而海绵体组织对H2激动剂二甲双胍(10(-8)M至10(-5)M)或H3激动剂R(-)-α-甲基组胺(10(-8)M至10(-5)M)均无反应。H1拮抗剂(美吡拉敏;10(-8)M至10(-5)M)可逐渐减弱对组胺的反应,而H2拮抗剂(西咪替丁;10(-4)M)和H3拮抗剂(硫代哌酰胺;10(-4)M)均无任何抑制作用。H1拮抗作用增强了电场刺激(神经介导)诱导的松弛。在用10(-6)M或更高浓度的美吡拉敏预孵育后,这种松弛增加(p<0.05)。本研究表明,介导海绵体平滑肌细胞收缩的主要组胺受体亚型是H1亚型。由于组胺H1受体拮抗作用增加了非肾上腺素能非胆碱能(NANC)神经介导的海绵体松弛,它具有作为海绵体内药物治疗勃起功能障碍的潜力。因此,本研究强烈表明H2受体拮抗剂不太可能对阴茎勃起有直接影响。