Wang S Y, VanderMeer T J, Fink M P, Sellke F W
Department of Surgery, Beth Israel Hospital, Boston, MA 02215.
Surgery. 1994 Aug;116(2):307-12.
Cardiovascular responses to the adrenergic stimulation are depressed in clinical and experimental endotoxemia. However, the effect of Escherichia coli endotoxemia on coronary microvascular beta-adrenergic function remains to be determined. The purpose of the present study was to test the hypothesis that endotoxemia impairs the beta-adrenoceptor- and adenosine 3'5'-cyclic monophosphate-mediated relaxation in the porcine coronary microcirculation.
Coronary arterioles (80 to 170 microns internal diameter) were isolated from pigs 3 hours after intravenous administration of E. coli endotoxin (150 micrograms/kg, over 1 hour, n = 8) or Ringer's lactate (control, n = 8). Arterioles were studied in vitro in a pressurized, partially contracted, no-flow state by videomicroscopy.
Precontracted (30% to 50% of baseline diameter with acetylcholine) control coronary arterioles dilated in response to either the nonselective beta-adrenoceptor agonist, isoproterenol, the Gs-protein activator, sodium fluoride, or the adenylate cyclase activator, forskolin. After 3 hours of endotoxemia, the relaxation responses to isoproterenol and sodium fluoride were significantly reduced, but the relaxation response to forskolin was preserved. The beta 2-adrenoceptor blocker, ICI-118, 551, markedly reduced the relaxation of control microvessels induced by isoproterenol, whereas the beta 1-adrenoceptor blocker, atenolol, caused only a slight reduction in isoproterenol-induced relaxation.
beta 2-Adrenoceptors appear to predominate over beta 1-adrenoceptors in the coronary microcirculation. E. coli endotoxemia impairs beta 2-adrenoceptor-mediated relaxation in the porcine coronary microcirculation, apparently because of changes proximal to adenylate cyclase in the signal transduction pathway.
在临床和实验性内毒素血症中,心血管系统对肾上腺素能刺激的反应会受到抑制。然而,大肠杆菌内毒素血症对冠状动脉微血管β-肾上腺素能功能的影响仍有待确定。本研究的目的是验证内毒素血症会损害猪冠状动脉微循环中β-肾上腺素能受体和腺苷3',5'-环磷酸介导的舒张功能这一假说。
在静脉注射大肠杆菌内毒素(150微克/千克,持续1小时,n = 8)或乳酸林格液(对照组,n = 8)3小时后,从猪身上分离出冠状动脉小动脉(内径80至170微米)。通过视频显微镜在体外对处于加压、部分收缩、无血流状态的小动脉进行研究。
预先用乙酰胆碱使(基线直径的30%至50%)收缩的对照冠状动脉小动脉,对非选择性β-肾上腺素能受体激动剂异丙肾上腺素、Gs蛋白激活剂氟化钠或腺苷酸环化酶激活剂福斯可林均有舒张反应。内毒素血症3小时后,对异丙肾上腺素和氟化钠的舒张反应显著降低,但对福斯可林的舒张反应仍保留。β2-肾上腺素能受体阻滞剂ICI-118,551显著降低了异丙肾上腺素诱导的对照微血管舒张,而β1-肾上腺素能受体阻滞剂阿替洛尔仅使异丙肾上腺素诱导的舒张略有降低。
在冠状动脉微循环中,β2-肾上腺素能受体似乎比β1-肾上腺素能受体占主导。大肠杆菌内毒素血症损害了猪冠状动脉微循环中β2-肾上腺素能受体介导的舒张,显然是由于信号转导途径中腺苷酸环化酶近端的变化。