Drescher P, Madsen P O
Department of Radiology, Medical College of Wisconsin, Milwaukee 53226, USA.
Acad Radiol. 1997 Dec;4(12):788-94. doi: 10.1016/s1076-6332(97)80254-1.
The authors studied the role of the endothelium and associated endothelial pathways in contrast material-induced renal vasoconstriction.
Isometric contractions in human and rabbit renal artery rings with intact and denuded endothelium were stimulated with phenylephrine and increasing concentrations of the ionic contrast material diatrizoate, the nonionic contrast materials iopamidol and iomeprol, and the dimeric contrast material iodixanol in a tissue perfusion bath. Rings with intact endothelium were incubated with endothelium-stimulating compounds such as the NO synthetase inhibitor Ng nitro-L-arginine methyl ester (L-NAME) to study the endothelium-mediated vasomotor regulation and the NO-liberating substances molsidomine (SIN-1) and nitroprusside (NPR) to study the endothelial-mediated vasorelaxation before being stimulated with contrast material.
Contrast material-induced, dose-dependent, reversible renal artery contractions are dependent on the type of contrast material. No differences in the contractions were found between intact and denuded rings. L-NAME had no effect on contrast material-induced contractions. Contractions were inhibited by the NO donors SIN-1 and NPR. SIN-1 was the most potent inhibitor.
Contrast material-induced renal vasoconstriction is endothelium-independent. Selective pharmacologic stimulation of the endothelium by NO donors, however, may still be useful in the prophylaxis of contrast material-induced renal vasoconstriction and, thus, potentially nephrotoxicity.
作者研究了内皮及相关内皮途径在造影剂诱导的肾血管收缩中的作用。
在组织灌注浴中，用去氧肾上腺素以及浓度递增的离子型造影剂泛影葡胺、非离子型造影剂碘帕醇和碘美普尔，还有二聚体造影剂碘克沙醇刺激有完整内皮和去内皮的人及兔肾动脉环，使其产生等长收缩。对有完整内皮的动脉环，在用造影剂刺激之前，先与内皮刺激化合物如一氧化氮合酶抑制剂Nω-硝基-L-精氨酸甲酯（L-NAME）孵育，以研究内皮介导的血管舒缩调节，还与释放一氧化氮的物质吗多明（SIN-1）和硝普钠（NPR）孵育，以研究内皮介导的血管舒张。
造影剂诱导的、剂量依赖性、可逆性肾动脉收缩取决于造影剂的类型。完整和去内皮的动脉环之间在收缩方面未发现差异。L-NAME对造影剂诱导的收缩无影响。收缩受到一氧化氮供体SIN-1和NPR的抑制。SIN-1是最有效的抑制剂。
造影剂诱导的肾血管收缩不依赖于内皮。然而，一氧化氮供体对内皮的选择性药理刺激可能仍有助于预防造影剂诱导的肾血管收缩，从而可能预防肾毒性。
