Tally K J, Hrnjez B J, Smith J A, Mun E C, Matthews J B
Department of Surgery, Beth Israel Hospital, Boston, Mass. 02215, USA.
Surgery. 1996 Aug;120(2):248-54. doi: 10.1016/s0039-6060(96)80295-9.
Adenosine released by cells during ischemia typically serves as a feedback inhibitor of further organ work. However, in ischemic intestine, adenosine appears to act via stimulatory A2b receptors to increase work in the form of chloride ion (Cl-) secretion. This unusual response may contribute to luminal fluid sequestration in intestinal ischemia. In nonischemic cells feed-forward activation of Cl- secretion does not occur despite the fact that adenosine may be continuously generated during normal cell metabolism. Thus we postulated that intestinal epithelia normally control the disposition of adenosine to prevent inappropriate activation of secretion.
Model T84 intestinal epithelia were studied by means of electrophysiologic and isotopic techniques.
Dipyridamole and nitrobenzylthioinosine (inhibitors of nucleoside transport) and iodotubercidin (an inhibitor of adenosine kinase) caused adenosine to accumulate extracellularly and induced a Cl- secretory response that was prevented by adenosine receptor blockade. Uptake of exogenous adenosine was restricted to the basolateral compartment and was blocked by nucleoside transport inhibitors.
Adenosine released from nonischemic intestinal epithelial cells is scavenged by a basolaterally restricted adenosine transporter. This system maintains extracellular adenosine levels below the prosecretory threshold and thus limits adenosine-elicited activation of Cl- secretion (and hence diarrhea) under normal conditions).
细胞在缺血期间释放的腺苷通常作为进一步器官活动的反馈抑制剂。然而,在缺血肠中,腺苷似乎通过刺激性A2b受体起作用,以增加氯离子(Cl-)分泌形式的活动。这种异常反应可能导致肠缺血时肠腔内液体潴留。在非缺血细胞中,尽管在正常细胞代谢过程中可能持续产生腺苷,但Cl-分泌的前馈激活并不发生。因此,我们推测肠上皮细胞通常控制腺苷的处置,以防止分泌的不适当激活。
采用电生理和同位素技术研究T84肠上皮细胞模型。
双嘧达莫和硝基苄硫肌苷(核苷转运抑制剂)以及碘结核菌素(腺苷激酶抑制剂)使腺苷在细胞外积聚,并诱导Cl-分泌反应,该反应可被腺苷受体阻断所阻止。外源性腺苷的摄取仅限于基底外侧区室,并被核苷转运抑制剂阻断。
非缺血肠上皮细胞释放的腺苷被基底外侧受限的腺苷转运体清除。该系统将细胞外腺苷水平维持在促分泌阈值以下,从而在正常情况下限制腺苷引起的Cl-分泌激活(进而限制腹泻)。