Ferchland A, Rettkowski O, Pönicke K, Deuber H J, Osten B, Brodde O E
Institute of Pharmacology and Toxicology, Martin Luther University of Halle-Wittenberg, Halle, Germany.
Nephron. 1998 Sep;80(1):46-50. doi: 10.1159/000045124.
Responsiveness of adrenergic receptors is decreased in patients on maintenance hemodialysis. In this study we investigated whether uremic plasma might affect adrenergic receptors. For this purpose we determined the effects of uremic plasma obtained from 10 patients on hemodialysis treatment (mean age 61 +/- 3 years, dialysis frequency 3 x 4 h/week, duration of treatment 3 +/- 1 years) before and at the end of the 4-hour dialysis treatment on binding of radioligands to beta1- and beta2- as well as alpha1- and alpha2-adrenoceptors. Plasma from 6 healthy volunteers served as control; the plasmas were studied in three dilutions: undiluted, 1:1 (v/v) and 1:4 (v/v) with saline diluted. Plasma from healthy control did not significantly affect the number of beta1- and beta2- or alpha1- and alpha2-adrenoceptors. On the other hand, uremic plasma significantly decreased the number of beta1- and beta2-adrenoceptors; this inhibitory effect was also observed when plasma obtained at the end of the 4-hour dialysis treatment was investigated. On the other hand, uremic plasma did not significantly decrease the number of alpha1- and alpha2-adrenoceptors. We conclude that in patients on maintenance hemodialysis, the presence of inhibitory substance(s) in uremic plasma could be - at least partly - responsible for the beta-adrenoceptor hyporesponsiveness; the mechanism leading ot alpha-adrenoceptor hyporesponsiveness, however, remains to be elucidated.
维持性血液透析患者的肾上腺素能受体反应性降低。在本研究中，我们调查了尿毒症血浆是否会影响肾上腺素能受体。为此，我们测定了从10例血液透析患者（平均年龄61±3岁，透析频率为每周3次，每次4小时，治疗时间3±1年）在4小时透析治疗前及结束时获取的尿毒症血浆对放射性配体与β1和β2以及α1和α2肾上腺素能受体结合的影响。6名健康志愿者的血浆作为对照；对血浆进行三种稀释度研究：未稀释、用生理盐水按1:1（v/v）和1:4（v/v）稀释。健康对照者的血浆对β1和β2或α1和α2肾上腺素能受体的数量没有显著影响。另一方面，尿毒症血浆显著降低了β1和β2肾上腺素能受体的数量；在研究4小时透析治疗结束时获取的血浆时也观察到了这种抑制作用。另一方面，尿毒症血浆并未显著降低α1和α2肾上腺素能受体的数量。我们得出结论，在维持性血液透析患者中，尿毒症血浆中抑制物质的存在可能至少部分导致了β肾上腺素能受体反应性降低；然而，导致α肾上腺素能受体反应性降低的机制仍有待阐明。
