Barnard M L, Olivera W G, Rutschman D M, Bertorello A M, Katz A I, Sznajder J I
Columbia Michael Reese Hospital and Medical Center, Pulmonary Research Laboratory, Chicago, IL 60616, USA.
Am J Respir Crit Care Med. 1997 Sep;156(3 Pt 1):709-14. doi: 10.1164/ajrccm.156.3.9610013.
Pulmonary edema clearance is driven primarily by active sodium transport out of the alveoli, mediated predominantly by apical sodium channels and the basolateral NA,K-ATPase. We postulated that dopamine, analogous to its effects in other transporting epithelia, could regulate these sodium transport mechanisms and affect lung liquid clearance. We therefore studied the effects of dopamine on sodium transport and liquid clearance in isolated perfused rat lungs. Instillation of dopamine into the airways caused a dose-dependent increase in liquid clearance from isolated rat lungs of up to 33% above control values at 10(-8) to 10(-4) M concentrations. 10(-6) M amiloride, which selectively inhibits apical sodium channels, decreased basal liquid clearance by 34% but did not inhibit the dopamine-mediated stimulation of lung liquid clearance. Instillation of 10(-4) M amiloride into rat airways, which inhibits other sodium transport mechanisms non-selectively, decreased basal lung liquid clearance by 49% and inhibited the dopamine-mediated stimulation of lung liquid clearance. Perfusion of rat lungs with 5 x 10(-4) M ouabain to specifically inhibit Na,K-ATPase reduced both basal clearance (by 55%) and the dopamine-stimulated increase in lung fluid clearance. Conceivably, the stimulation of lung liquid clearance by dopamine is due to a modulation of Na,K-ATPase in the pulmonary epithelium.
肺水肿的清除主要由肺泡内主动的钠转运驱动,主要由顶端钠通道和基底外侧钠钾ATP酶介导。我们推测,多巴胺与其在其他转运上皮中的作用类似,可能调节这些钠转运机制并影响肺液清除。因此,我们研究了多巴胺对离体灌注大鼠肺中钠转运和液体清除的影响。向气道内滴注多巴胺导致离体大鼠肺的液体清除呈剂量依赖性增加,在10^(-8)至10^(-4) M浓度下,比对照值高出33%。10^(-6) M的氨氯地平选择性抑制顶端钠通道,使基础液体清除率降低34%,但不抑制多巴胺介导的肺液体清除刺激作用。向大鼠气道内滴注10^(-4) M氨氯地平非选择性抑制其他钠转运机制,使基础肺液体清除率降低49%,并抑制多巴胺介导的肺液体清除刺激作用。用5×10^(-4) M哇巴因灌注大鼠肺以特异性抑制钠钾ATP酶,降低了基础清除率(降低55%)和多巴胺刺激的肺液清除增加。可以想象,多巴胺对肺液体清除的刺激作用是由于对肺上皮中钠钾ATP酶的调节。