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内皮素及其拮抗剂波生坦对肝硬化大鼠肝脏血流动力学及微血管交换的影响。

The effect of endothelin and its antagonist Bosentan on hemodynamics and microvascular exchange in cirrhotic rat liver.

作者信息

Reichen J, Gerbes A L, Steiner M J, Sägesser H, Clozel M

机构信息

Department of Clinical Pharmacology, University of Berne, Switzerland.

出版信息

J Hepatol. 1998 Jun;28(6):1020-30. doi: 10.1016/s0168-8278(98)80352-8.

Abstract

BACKGROUND/AIMS: To characterize the effects of endothelin-1 and of Bosentan, a mixed endothelin antagonist, on hepatic hemodynamics in cirrhotic animals in vivo and on hepatic microvascular exchange in the perfused rat liver.

METHODS

Biliary cirrhosis was induced by bile duct ligation, and micronodular cirrhosis by chronic exposure to phenobarbital/CCl4 in male rats. Hepatic hemodynamics were studied under basal conditions and after administration of Bosentan (3-30 mg/kg) by the microsphere technique. Microvascular exchange was assessed in the in situ perfused rat liver by the multiple indicator dilution technique.

RESULTS

Bosentan lowered portal pressure in a dose-dependent fashion; at the highest dose tested, this decrease averaged -29+/-11 and -26+/-8% in biliary and micronodular cirrhosis, respectively (p<0.01). This was achieved mainly via a marked decrease in hepatic arterial flow. In the perfused liver, endothelin-1 induced a dose-dependent vasoconstriction; up to 10(-9) mol/l; this was not associated with any effect on viability. At this dose, endothelin-1 markedly decreased extravascular albumin space in both controls and micronodular cirrhosis; this could be antagonized by Bosentan 10(-5) mol/l.

CONCLUSIONS

Endothelin-1 affects hepatic microvascular exchange, presumably by a direct effect on hepatic sinusoidal endothelial cells. A mixed endothelin antagonist lowers portal pressure in vivo, presumably by acting on hepatic stellate cells, and counteracts the microvascular effects of endothelin-1 in vitro. These properties could prove useful in treatment of portal hypertension.

摘要

背景/目的:研究内皮素-1及混合内皮素拮抗剂波生坦对肝硬化动物体内肝血流动力学及灌注大鼠肝脏肝微血管交换的影响。

方法

雄性大鼠通过胆管结扎诱导胆汁性肝硬化,通过长期给予苯巴比妥/四氯化碳诱导小结节性肝硬化。采用微球技术在基础状态及给予波生坦(3 - 30mg/kg)后研究肝血流动力学。采用多指示剂稀释技术在原位灌注大鼠肝脏中评估微血管交换。

结果

波生坦以剂量依赖方式降低门静脉压力;在最高测试剂量时,胆汁性肝硬化和小结节性肝硬化中门静脉压力的降低分别平均为-29±11%和-26±8%(p<0.01)。这主要是通过肝动脉血流的显著减少实现的。在灌注肝脏中,内皮素-1诱导剂量依赖性血管收缩,直至10^(-9)mol/L;这与对生存能力无任何影响相关。在此剂量下,内皮素-1在对照组和小结节性肝硬化中均显著降低血管外白蛋白间隙;这可被10^(-5)mol/L的波生坦拮抗。

结论

内皮素-1可能通过直接作用于肝窦内皮细胞影响肝微血管交换。混合内皮素拮抗剂在体内降低门静脉压力,可能是通过作用于肝星状细胞,并在体外抵消内皮素-1的微血管效应。这些特性可能在门静脉高压的治疗中有用。

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