Mundinger T O, Boyle M R, Taborsky G J
Department of Medicine, University of Washington, Seattle, USA.
J Auton Nerv Syst. 1997 Apr 14;63(3):153-60. doi: 10.1016/s0165-1838(97)00004-0.
To investigate the potential for neural regulation of liver function, we sought to determine whether hepatic sympathetic nerves are activated during stress. Hepatic norepinephrine spillover (HNESO) was measured in halothane-anesthetized dogs before, during and after glucopenia, hypoxia and hemorrhage. HNESO increased during 2-deoxyglucose (2-DG, 600 mg/kg plus 13.5 mg/kg/min, IV)-induced glucopenia from a baseline of 9 +/- 3 ng/min to 83 +/- 24 ng/min (delta = + 74 +/- 23 ng/min, p < 0.01). During hypoxia (partial pressure of oxygen in arterial blood = 23 +/- 2 mmHg), HNESO increased by 142 +/- 47 ng/min (p < 0.025), and HNESO increased by 84 +/- 22 ng/min (p < 0.01) during hemorrhage (mean arterial blood pressure = 40 +/- 1 mmHg), suggesting activation of hepatic sympathetic nerves during all three stresses. To validate the use of HNESO as an index of hepatic sympathetic nerve activity, we repeated the stresses of hypoxia and hemorrhage in dogs following chemical sympathetic denervation of the liver induced by prior intraportal 6-hydroxy-dopamine infusion. Hepatic denervation reduced the HNESO responses to hypoxia and hemorrhage by more than 90%. In addition to hepatic neural responses to stress, the sympathetic responses of the adrenal medulla and of systemic sympathetic nerves were monitored using changes in the arterial concentration of epinephrine and norepinephrine, respectively. Arterial epinephrine and norepinephrine increased by varying degrees during all three stresses, suggesting general sympatho-adrenal activation. As expected, 6-hydroxydopamine pretreatment did not alter the epinephrine response to hypoxia or hemorrhage. The arterial norepinephrine responses to hypoxia and hemorrhage were modestly reduced in hepatically sympathectomized animals, suggesting a small hepatic contribution to the elevated arterial level of norepinephrine during these stresses. We conclude that: (1) the stresses of glucopenia, hypoxia and hemorrhage activate the sympathetic nerves of the liver and (2) HNESO is a valid index of hepatic sympathetic nerve activity. Finally, we speculate that such activation may influence liver function.
为研究神经调节肝功能的可能性,我们试图确定在应激期间肝交感神经是否被激活。在氟烷麻醉的犬中,于低血糖、低氧和出血前、期间及之后测量肝去甲肾上腺素溢出量(HNESO)。在2-脱氧葡萄糖(2-DG,600mg/kg加13.5mg/kg/分钟,静脉注射)诱导的低血糖期间,HNESO从基线的9±3ng/分钟增加至83±24ng/分钟(差值=+74±23ng/分钟,p<0.01)。在低氧期间(动脉血氧分压=23±2mmHg),HNESO增加142±47ng/分钟(p<0.025),在出血期间(平均动脉血压=40±1mmHg)HNESO增加84±22ng/分钟(p<0.01),提示在所有这三种应激期间肝交感神经被激活。为验证将HNESO用作肝交感神经活动指标的有效性,我们在先前经门静脉注入6-羟基多巴胺诱导肝化学性交感神经去节后的犬中重复低氧和出血应激。肝去神经支配使对低氧和出血的HNESO反应降低超过90%。除了肝对应激的神经反应外,分别利用肾上腺素和去甲肾上腺素动脉浓度的变化监测肾上腺髓质和全身交感神经的交感反应。在所有这三种应激期间,动脉肾上腺素和去甲肾上腺素均有不同程度增加,提示全身交感-肾上腺激活。正如预期,6-羟基多巴胺预处理未改变对低氧或出血的肾上腺素反应。在肝交感神经切除的动物中,对低氧和出血的动脉去甲肾上腺素反应略有降低,提示在这些应激期间肝脏对动脉去甲肾上腺素水平升高有小部分贡献。我们得出结论:(1)低血糖、低氧和出血应激激活肝脏的交感神经,(2)HNESO是肝交感神经活动的有效指标。最后,我们推测这种激活可能影响肝功能。