Kirstetter P, Lagneau F, Lucas O, Krupa Y, Marty J
Department of Anaesthesia, Hôpital Beaujon, Clichy, France.
Br J Anaesth. 1997 Jul;79(1):84-7. doi: 10.1093/bja/79.1.84.
The mechanisms by which endothelium attenuates vasodilation caused by isoflurane are not well understood. We examined the role of endothelium-derived substances, nitric oxide (NO), endothelium-derived hyperpolarizing factors (EDHF), prostanoids and endothelins in the response to isoflurane in rat thoracic aorta. Increasing cumulative concentrations of isoflurane were administered to aortic rings suspended in Hepes solution and preconstricted with either phenylephrine 10(-6) mol litre-1 or KCl 40 mmol litre-1 (which inhibit EDHF). Rings were intact, denuded or incubated with an inhibitor of nitric oxide synthesis (N omega-nitro-L-arginine (LNNA 5 x 10(-5) mol litre-1), an inhibitor of prostanoid synthesis (indomethacin 10(-5) mol litre-1) or a blocker of the vascular receptors to endothelins (cyclo (-D-trp-D-Asp-Pro-D-Val-Leu (BQ 123 10(-5) mol litre-1)- Endothelium attenuated isoflurane-induced vasodilation in KCl-constricted rings at concentrations of 4% (mean 95 (SEM 4)% vs 72 (4)%; P = 0.0005) and 5% (100 (4)% vs 80 (4)%; P = 0.0008) and in phenylephrine constricted rings at concentrations of 4% (54 (8)% vs 35 (3)%; P = 0.04) and 5% (78 (10)% vs 49 (5)%; P = 0.03). Relaxation was significantly greater in rings treated with LNNA than in intact rings at concentrations of 4% (85 (4)% vs 72 (4)%; P = 0.0005) and 5% (90 (4)% vs 80 (4)%; P = 0.0008). Indomethacin and BQ 123 did not alter isoflurane-induced vasodilation. We conclude that endothelium attenuated the vasodilator effect of isoflurane by a mechanism which was abolished by inhibition of nitric oxide. We hypothesize that isoflurane inhibits the release of nitric oxide, leading to a relative vasoconstriction counter-balancing its vasodilator effect. In contrast, EDHF, prostanoids and endothelins were not involved in the attenuation of isoflurane-induced vasodilatation.
内皮细胞减弱异氟烷引起的血管舒张的机制尚未完全明确。我们研究了内皮衍生物质、一氧化氮(NO)、内皮衍生超极化因子(EDHF)、前列腺素和内皮素在大鼠胸主动脉对异氟烷反应中的作用。将累积浓度不断增加的异氟烷给予悬浮在赫氏溶液中并用10⁻⁶摩尔/升去氧肾上腺素或40毫摩尔/升氯化钾(抑制EDHF)预收缩的主动脉环。血管环分为完整、去内皮或用一氧化氮合成抑制剂(Nω-硝基-L-精氨酸(LNNA 5×10⁻⁵摩尔/升))、前列腺素合成抑制剂(吲哚美辛10⁻⁵摩尔/升)或内皮素血管受体阻滞剂(环(-D-色氨酸-D-天冬氨酸-脯氨酸-D-缬氨酸-亮氨酸(BQ 123 10⁻⁵摩尔/升))孵育。在内皮完整的情况下,4%(平均95(标准误4)%对72(4)%;P = 0.0005)和5%(100(4)%对80(4)%;P = 0.0008)浓度的异氟烷使氯化钾预收缩的血管环舒张减弱,在4%(54(8)%对35(3)%;P = 0.04)和5%(78(10)%对49(5)%;P = 0.03)浓度时使去氧肾上腺素预收缩的血管环舒张减弱。在4%(85(4)%对72(4)%;P = 0.0005)和5%(90(4)%对80(4)%;P = 0.0008)浓度时,用LNNA处理的血管环比完整血管环舒张明显更大。吲哚美辛和BQ 123未改变异氟烷引起的血管舒张。我们得出结论,内皮细胞通过一氧化氮抑制所消除的机制减弱异氟烷的血管舒张作用。我们推测异氟烷抑制一氧化氮释放,导致相对血管收缩以抵消其血管舒张作用。相比之下,EDHF、前列腺素和内皮素不参与异氟烷引起的血管舒张减弱过程。