Ming Z, Parent R, Lavallée M
Department of Physiology, Faculty of Medicine, Université de Montréal, Québec, Canada.
Circ Res. 1997 Dec;81(6):977-87. doi: 10.1161/01.res.81.6.977.
NO and prostacyclin formation cannot entirely account for receptor-operated endothelium-dependent dilation of coronary vessels, since vasodilator responses are not completely suppressed by inhibitors of these agents. Therefore, we considered that another factor, such as an endothelium-derived hyperpolarizing factor described in vitro, may participate in NO- and prostacyclin-independent coronary dilator responses. In conscious instrumented dogs, intracoronary acetylcholine (ACh, 30.0 ng.kg-1.min-1) increased the external epicardial coronary diameter (CD) by 0.18 +/- 0.03 mm (from 3.44 +/- 0.11 mm) when increases in coronary blood flow (CBF) were prevented and increased the CD by 0.20 +/- 0.05 when CBF was allowed to increase. After the administration of intracoronary N omega-nitro-L-arginine methyl ester (L-NAME), CBF responses to ACh were abolished, but CD responses (0.23 +/- 0.05 from 3.22 +/- 0.09 mm) were maintained. Blockade of NO formation was confirmed by reduced CD baselines and blunted flow-dependent CD responses caused by adenosine and transient coronary artery occlusions after L-NAME administration. ACh-induced CD increases resistant to L-NAME and indomethacin were reduced after the administration of intracoronary quinacrine, an inhibitor of phospholipase A2, or proadifen, an inhibitor of cytochrome P-450. Quinacrine or proadifen alone (without L-NAME) did not alter CD responses to ACh, but L-NAME given after proadifen blunted ACh-induced increases in CD. The increases in CD caused by arachidonic acid given after L-NAME + indomethacin were antagonized by proadifen but not altered by quinacrine. Thus, a cytochrome P-450 metabolite of arachidonic acid accounts for L-NAME-resistant and indomethacin-resistant dilation of large epicardial coronary arteries to ACh. Conversely, NO formation is the dominant mechanism of ACh-induced dilation after blockade of the cytochrome P-450 pathway.
一氧化氮(NO)和前列环素的生成并不能完全解释受体介导的冠状动脉内皮依赖性舒张,因为这些物质的抑制剂并不能完全抑制血管舒张反应。因此,我们认为可能有另一个因素,比如体外描述的内皮衍生超极化因子,参与了不依赖于NO和前列环素的冠状动脉舒张反应。在清醒的插管犬中,当冠状动脉血流量(CBF)增加被阻止时,冠状动脉内注射乙酰胆碱(ACh,30.0 ng·kg⁻¹·min⁻¹)可使心外膜冠状动脉外径(CD)增加0.18±0.03 mm(从3.44±0.11 mm开始),当允许CBF增加时,CD增加0.20±0.05。冠状动脉内注射Nⁿ-硝基-L-精氨酸甲酯(L-NAME)后,对ACh的CBF反应被消除,但CD反应(从3.22±0.09 mm增加0.23±0.05)仍得以维持。L-NAME给药后,通过降低CD基线以及减弱腺苷和短暂冠状动脉闭塞引起的流量依赖性CD反应,证实了NO生成被阻断。冠状动脉内注射喹那克林(一种磷脂酶A2抑制剂)或丙磺舒(一种细胞色素P-450抑制剂)后,ACh诱导的对L-NAME和吲哚美辛耐药的CD增加减少。单独使用喹那克林或丙磺舒(不使用L-NAME)不会改变对ACh的CD反应,但丙磺舒给药后给予L-NAME会减弱ACh诱导的CD增加。L-NAME + 吲哚美辛给药后给予花生四烯酸引起的CD增加被丙磺舒拮抗,但未被喹那克林改变。因此,花生四烯酸的细胞色素P-450代谢产物导致了大的心外膜冠状动脉对ACh产生对L-NAME和吲哚美辛耐药的舒张。相反,在细胞色素P-450途径被阻断后,NO生成是ACh诱导舒张的主要机制。