Goadsby P J, Adner M, Edvinsson L
Insitute of Neurology, National Hospital for Neurology and Neurosurgery, London, U.K.
J Cereb Blood Flow Metab. 1996 Jul;16(4):698-704. doi: 10.1097/00004647-199607000-00021.
The changes in cerebral blood flow that accompany spreading depression are well-described, as are parallel changes in cellular activity, with a wave of hyperemia followed by a prolonged oligemic phase. In this study, a cat model of the CBF changes associated with spreading depression and in vitro pharmacology were used to determine if there is a role for the powerful peptide vasoconstrictor endothelin in this response. For the pharmacological studies, the middle cerebral artery was harvested from cats postmortem. For the physiological studies, cats were anesthetized with halothane induction and alpha-chloralose (60 mg/kg, intraperitoneal loading; 20 mg/kg i.v. 2-h maintenance). CBF was monitored continuously in the parietal cortex using laser Doppler flowmetry (CBFLDF) after exposure of the dura mater. The in vitro work demonstrated that endothelin-1 (ET-1) mediates a strong and potent contraction of cerebral vessels. Both the selective ETA receptor antagonist FR139317 and the combined ETA and ETB receptor antagonist Bosentan caused a rightward shift of the concentration-response curve without attenuation of the maximum effect. The calculated pA2 values were 6.28 and 6.90, respectively. The slope did not differ from unity, suggesting that the ET-1-mediated contraction is evoked by a single population of ETA receptors, which were effectively antagonized by these compounds. Spreading depression was induced with a needle stick injury to the cortex. Local administration of the endothelin antagonists FR139317 (10 microM) and Bosentan (10 microM) did not affect resting blood flow in the cortex. Induction of spreading depression following local administration of FR139317 and Bosentan resulted in responses no different from those in control cortex. These data demonstrate that endothelin does not play a significant role in the vasoconstrictor portion of the CBF change seen in spreading depression, nor does it affect resting flow. Since it is widely held that spreading depression, or a very similar mechanism, underlies the aura phase of migraine, it may be suggested from these studies that endothelin antagonists are unlikely to be useful in migraine.
伴随扩散性抑制出现的脑血流量变化已得到充分描述,细胞活动的平行变化也是如此,先是出现充血波,随后是长时间的缺血期。在本研究中,采用与扩散性抑制相关的脑血流量变化的猫模型和体外药理学方法,以确定强效肽血管收缩剂内皮素在这种反应中是否起作用。对于药理学研究,在猫死后采集大脑中动脉。对于生理学研究,用氟烷诱导麻醉猫,并用α-氯醛糖(60mg/kg,腹腔注射负荷量;20mg/kg静脉注射,维持2小时)。在硬脑膜暴露后,使用激光多普勒血流仪(CBFLDF)连续监测顶叶皮质的脑血流量。体外研究表明,内皮素-1(ET-1)介导脑血管强烈而有效的收缩。选择性ETA受体拮抗剂FR139317和ETA与ETB受体联合拮抗剂波生坦均使浓度-反应曲线向右移动,而最大效应未减弱。计算出的pA2值分别为6.28和6.90。斜率与1无差异,表明ET-1介导的收缩是由单一群体的ETA受体引起的,这些化合物可有效拮抗该受体。通过针刺皮质诱导扩散性抑制。局部给予内皮素拮抗剂FR139317(10μM)和波生坦(10μM)不影响皮质的静息血流量。局部给予FR139317和波生坦后诱导扩散性抑制,其反应与对照皮质无差异。这些数据表明,内皮素在扩散性抑制所见的脑血流量变化的血管收缩部分中不起重要作用,也不影响静息血流。由于普遍认为扩散性抑制或非常相似的机制是偏头痛先兆期的基础,从这些研究中可以推测,内皮素拮抗剂不太可能用于治疗偏头痛。