Kern C, Bernards C M
Department of Anesthesiology, University of Washington, Seattle 98195, USA.
Anesthesiology. 1997 Feb;86(2):405-9. doi: 10.1097/00000542-199702000-00015.
The spinal menings have previously been shown to contain catechol-o-methyl transferase (COMT), the enzyme that metabolizes epinephrine to the inactive metabolite metanephrine. The authors of this study aimed to quantitate the metabolism of epinephrine traversing the spinal meninges and to determine if that metabolism could be inhibited. In addition, they tried to determine the meningeal permeability of epinephrine.
Macca nemestrina spinal meninges were mounted in a diffusion cell and epinephrine was added to the donor reservoir at time 0. Three hundred minutes later, all buffer in the recipient reservoir was collected and analyzed for epinephrine metabolites. The experiments were conducted with either ascorbic acid (1 mM) or sodium metabisulfite (5.3 mM) added as antioxidants.
In the presence of sodium metabisulfite, 60 +/- 6% of the epinephrine traversing the meningeal specimens was metabolized by COMT. In contrast, in the presence of ascorbic acid, less than 3% of the epinephrine traversing the spinal meninges was metabolized by COMT (P = 0.0001). The meningeal permeability coefficient for epinephrine was 0.38 +/- 0.08 cm/min x 10(-3).
Epinephrine permeability through the spinal meninges is low, and meningeal COMT markedly reduces the bioavailability of what little epinephrine can traverse the meninges. However, a clinically relevant concentration of ascorbic acid, a competitive inhibitor of COMT, almost completely blocks epinephrine metabolism and increases the bioavailability of epinephrine.
先前已证明脊髓膜中含有儿茶酚 - O - 甲基转移酶(COMT),该酶可将肾上腺素代谢为无活性的代谢产物甲氧基肾上腺素。本研究的作者旨在定量穿越脊髓膜的肾上腺素代谢情况,并确定该代谢是否可被抑制。此外,他们试图测定肾上腺素的脑膜通透性。
将豚尾猕猴的脊髓膜安装在扩散池中,在时间0时将肾上腺素添加到供体储液器中。300分钟后,收集受体储液器中的所有缓冲液并分析肾上腺素代谢产物。实验在添加抗坏血酸(1 mM)或焦亚硫酸钠(5.3 mM)作为抗氧化剂的情况下进行。
在焦亚硫酸钠存在的情况下,穿越脑膜标本的肾上腺素中有60±6%被COMT代谢。相比之下,在抗坏血酸存在的情况下,穿越脊髓膜的肾上腺素中只有不到3%被COMT代谢(P = 0.0001)。肾上腺素的脑膜渗透系数为0.38±0.08 cm/min×10⁻³。
肾上腺素通过脊髓膜的通透性较低,脑膜COMT显著降低了少量能够穿越脑膜的肾上腺素的生物利用度。然而,临床上相关浓度的抗坏血酸作为COMT的竞争性抑制剂,几乎完全阻断了肾上腺素的代谢并增加了肾上腺素的生物利用度。