Epstein A, Beall A, Wynn J, Mulloy L, Brophy C M
Department of Surgery, Medical College of Georgia, Augusta 30912, USA.
Surgery. 1998 Apr;123(4):456-60.
Cyclosporine immunosuppression for organ transplantation is associated with hypertension and nephrotoxicity. Because the effects of cyclosporine as an immunosuppressant are mediated by the effect of cyclosporine as a phosphatase inhibitor, and phosphatase inhibitors are potent vascular smooth muscle contractile agents, we hypothesized that cyclosporine might induce contraction of the renal artery vascular smooth muscle directly.
Strips of bovine renal, carotid, superior mesenteric, or coronary arteries were obtained fresh from an abattoir. The strips were equilibrated in a muscle bath, and the contractile responses to cyclosporine and FK506 were determined.
Cyclosporine (50 to 5000 micrograms/ml), but not FK506, induced rapidly developing, sustained contractions of renal and coronary artery smooth muscle. The magnitude of the cyclosporine-induced contractions of carotid and superior mesenteric artery smooth muscles was significantly less. The magnitude of renal artery smooth muscle contractions induced by cyclosporine was enhanced in the presence of an intact endothelium.
Although these effects occurred in vitro to relatively high doses of cyclosporine, these data suggest that cyclosporine may selectively induce renal artery smooth muscle contraction through activation of the Ca(2+)-dependent phosphatase (calcineurin) in the smooth muscle, and these contractions may be enhanced by the release of endothelial-derived contracting factors.
器官移植中使用环孢素进行免疫抑制与高血压和肾毒性有关。由于环孢素作为免疫抑制剂的作用是通过其作为磷酸酶抑制剂的作用介导的,且磷酸酶抑制剂是强力的血管平滑肌收缩剂,我们推测环孢素可能直接诱导肾动脉血管平滑肌收缩。
从屠宰场新鲜获取牛的肾动脉、颈动脉、肠系膜上动脉或冠状动脉条。将这些条带在肌肉浴中平衡,并测定对环孢素和FK506的收缩反应。
环孢素(50至5000微克/毫升)可诱导肾动脉和冠状动脉平滑肌迅速出现持续收缩,但FK506无此作用。环孢素诱导的颈动脉和肠系膜上动脉平滑肌收缩幅度明显较小。在内皮完整的情况下,环孢素诱导的肾动脉平滑肌收缩幅度增强。
尽管这些效应是在体外对相对高剂量的环孢素产生的,但这些数据表明环孢素可能通过激活平滑肌中依赖钙的磷酸酶(钙调神经磷酸酶)选择性地诱导肾动脉平滑肌收缩,且这些收缩可能因内皮源性收缩因子的释放而增强。