Van Buren T, Kasbergen C M, Gispen W H, De Wildt D J
Department of Medical Pharmacology, Rudolf Magnus Institute for Neurosciences, Medical Faculty, Utrecht University, Netherlands.
Cardiovasc Res. 1998 Jun;38(3):763-71. doi: 10.1016/s0008-6363(98)00038-8.
Abnormalities of the cardiovascular system, e.g. impaired vasoreactivity and changes in baroreflex control of heart rate, are known to occur in experimental diabetes. It is not clear whether these cardiovascular dysfunctions are direct consequences of cardiovascular deficits and/or have autonomic neuropathy as a cause.
To differentiate between cardiovascular deficits or neuronal impairment as a cause for these cardiovascular dysfunctions, we tested the effects of the ACTH4-9 analogue, Org 2766, a neurotrophic compound without cardiovascular effects, on arterial pressure, heart rate and baroreflex control of heart rate. At 15 weeks, rats were made diabetic by injection of streptozotocin, and from 0-6, 6-12 or 12-18 weeks thereafter 3 groups of rats were treated with Org 2766. These effects were evaluated during phenylephrine-induced increases, and sodium nitroprusside-induced decreases, in blood pressure, in rats that had been diabetic for various periods (2-42 weeks).
Throughout, both depressor response and maximal vasodilator activity in response to sodium nitroprusside were significantly (P < 0.05) reduced as compared to those of the non-diabetic controls. The pressor response of the diabetic rats to phenylephrine was only significantly (P < 0.05) reduced at 4, 6 and 12 weeks, and at 18 weeks, the diabetic rats were either hypo- or normoresponsive; Org 2766 did not restore the disturbed pressor response. From weeks 4 to 42 both maximal decrease in heart rate and sensitivity of baroreflex-mediated bradycardia in the diabetic rats were significantly less (P < 0.05) than those in the non-diabetic controls. Org 2766 restored the diminished baroreflex-mediated bradycardia of diabetic rats to non-diabetic control levels at 6 weeks, had an ameliorating effect at 12 weeks and no effect at 18 weeks.
Time-dependent decreases in baroreflex sensitivity in diabetic rats was demonstrated and a much less steep decline of baroreflex sensitivity occurred in non-diabetic control rats. The ACTH4-9 analogue, Org 2766, when given immediately upon the induction of diabetes seem to delay the development of autonomic neuropathy, which suggests that cardiovascular factors appear to be of minor importance.
已知实验性糖尿病会出现心血管系统异常,如血管反应性受损和压力反射对心率控制的改变。目前尚不清楚这些心血管功能障碍是心血管缺陷的直接后果和/或自主神经病变所致。
为区分心血管缺陷或神经元损伤是这些心血管功能障碍的原因,我们测试了促肾上腺皮质激素4-9类似物Org 2766(一种无心血管作用的神经营养化合物)对动脉血压、心率和压力反射对心率控制的影响。15周时,通过注射链脲佐菌素使大鼠患糖尿病,此后从0 - 6周、6 - 12周或12 - 18周,3组大鼠用Org 2766治疗。在不同糖尿病病程(2 - 42周)的大鼠中,在去氧肾上腺素引起血压升高和硝普钠引起血压降低期间评估这些作用。
总体而言,与非糖尿病对照组相比,对硝普钠的降压反应和最大血管舒张活性均显著降低(P < 0.05)。糖尿病大鼠对去氧肾上腺素的升压反应仅在4周、6周和12周时显著降低(P < 0.05),18周时,糖尿病大鼠反应低下或正常;Org 2766未能恢复受干扰的升压反应。从4周到42周,糖尿病大鼠心率的最大降幅和压力反射介导的心动过缓敏感性均显著低于非糖尿病对照组(P < 0.05)。Org 2766在第6周时将糖尿病大鼠减弱的压力反射介导的心动过缓恢复到非糖尿病对照水平,在第12周时有改善作用,在第18周时无作用。
证实糖尿病大鼠压力反射敏感性随时间降低,非糖尿病对照大鼠压力反射敏感性下降幅度小得多。促肾上腺皮质激素4-9类似物Org 2766在糖尿病诱导后立即给药似乎可延缓自主神经病变的发展,这表明心血管因素似乎不太重要。