内毒素休克家兔脑区、脑脊液、血浆中脑啡肽含量的改变及纳洛酮的抗休克作用

本工作在戊巴比妥钠麻醉的家兔上进行。采用夹闭肠系膜上动脉阻断血流方法建立内毒紫休克的实验模型。用放射免疫分析法测定了休克前后脑区、脑脊液及血浆中脑啡肽含量的变化,并观察了脑室或静脉注射纳洛酮的抗休克效应。结果如下:1.休克时,下丘脑、延脑、桥脑的亮脑啡肽含量显著升高,中脑无明显变化、丘脑、纹状体下降。脑脊液和血浆中亮脑啡肽明显增加。外周静脉血与肾静脉血中无显著差别。2.侧脑室或静脉注射纳洛酮,均可使休克动物的血压回升,延长存活时间。脑室注射的升压数值略大,维持升压时间也较长。实验结果提示:脑啡肽参与内毒素休克过程。断阿片样物质的作用,可能是治疗内毒素休克的一个途径。     

大鼠内毒素血症不同时期血浆CGRP和背根神经节CGRP mRNA水平的变化

本文采用逆转录聚合酶链反应（RT－PCR）方法测定大鼠内毒素血症不同时期胸腰段背根神经节降钙素基因相关肽（CGRP）mRNA水平的改变,结合血浆CGRP水平的改变,以期全面了解大鼠内毒素血症不同时期CGRP释放与合成的变化。结果显示：注射内毒素（5mg／kg）后30min时,大鼠血浆CGRP开始增高,而背根神经节CGRPmRNA水平无明显变化;注射内毒素后3h时,血浆CGRP及背根神经节CGRPmRNA均明显增高．分别为142％和32％,8h时则进一步增高,分别为216％和85％。提示内毒素不仅刺激外周组织释放CGRP,而且还能通过某些机制激活背根神经节CGRPmRNA的转录,使CGRP合成增加,以作为CGRP大量释放的重要补充来源。     

吗啡和纳洛酮对损毁下丘脑诱致的大鼠胃粘膜损伤之影响

本实验观察了静注吗啡和纳洛酮对电解损毁后部下丘脑诱致的大鼠胃粘膜损伤的影响并观察了在静注吗啡、纳洛酮后和侧脑室注射纳洛酮后其胃酸分泌和血清胃泌素水平之变化。实验揭示,吗啡仅略为降低该神经源性胃粘膜损伤程度,而纳洛酮则明显地减少其胃粘膜损伤;静注吗啡能抑制后部下丘脑损毁后大鼠的胃酸分泌,增加其血清胃泌素水平,而静注纳络酮后,这种大鼠的胃酸分泌增加,但血清胃泌素水平无明显变化;侧脑室注射纳洛酮对后部下丘脑损毁后大鼠胃酸分泌和血清胃泌素水平无明显影响。本结果表明,胃酸可能是导致这种消化道损伤的条件之一,而不是最重要因素;静注纳洛酮对后部下丘脑损毀后大鼠胃粘膜变化有保护作用。后者提示,内源性阿片样肽可能参与这种神经源性胃粘膜损伤的形成。     

微电泳法给予吗啡对家兔延髓疑核区呼吸性单位放电的影响

用五管微电极在家兔疑核区记录单位活动并观察微电泳吗啡时对单位活动的影响。在54个呼吸性单位中,吗啡引起阻遏的有10个,兴奋的1个,其余43个活动无明显改变。在6个吗啡引起阻遏的单位中,有5个单位的吗啡效应可被纳洛酮对抗。在49个非呼吸性单位中,吗啡引起阻遏的有13个,兴奋的有10个,其余26个活动无明显改变。在6个吗啡引起阻遏的单位中,有5个单位的吗啡效应可被纳洛酮对抗;在7个吗啡引起兴奋的单位中,吗啡的兴奋效应均不能被纳洛酮对抗。本实验观察到疑核区的呼吸性单位有一部分能被吗啡阻遏,但呼吸性单位对谷氨酸和吗啡敏感的比例均明显地比非呼吸性单位的比例低。     

吗啡和纳洛酮对酸化十二指肠引起狗胰液分泌的影响

本工作用制备 Thomas 胰瘘和胃痿的5条狗进行慢性实验。实验时用0.1N 盐酸灌入十二指肠以刺激胰液分泌,并分別注射吗啡或/和纳洛酮,观察它们对胰液分泌和对胰液中碳酸氢盐和蛋白质浓度的影响。另外我们还观察了吗啡和纳洛酮对6条狗离体胰主导管紧张性的影响。结果表明:(1)吗啡抑制了胰液分泌量,对胰液中碳酸氢盐和蛋白质浓度无影响,由于分泌量减少故两者的排出量显著减少(P<0.05),(2)纳洛酮本身对胰液分泌量和碳酸氢盐及蛋白质浓度均无影响;(3)纳洛酮可以加强吗啡抑制胰液分泌的作用(P<0.01);(4)吗啡能增加狗的离体胰主导管肌条的紧张性,纳洛酮不能阻断或翻转吗啡的这一效应,相反能加强其效应。本工作表明,吗啡抑制酸化十二指肠所引起的胰碳酸氢盐和蛋白质排出量,其机制可能是吗啡刺激胰导管收缩,而纳洛酮则加强吗啡的这种抑制效应。     

失血性休克早期白细胞介素1活性升高的机制——内毒素与白细胞介素1

本文观察了失血性休克条件下大鼠白细胞介素１（ＩＬ－１）与内毒素的关系。结果表明：失血性休克早期血浆ＩＬ－１及ＥＴ均明显升高,前者升高在先;无菌大鼠失血性休克后ＩＬ－１活性也升高,但ＥＴ无明显变化;预先给大鼠口服乳果糖以清洁肠道,或静注内毒素抗体,休克后血浆ＩＬ－１活性仍然明显升高,而血浆ＥＴ无明显升高;大鼠失血后１ｈ将失血回输再灌注后５ｄ血浆ＩＬ－１与ＥＴ呈平行性变化,乳果糖或抗内毒素抗体治疗后,     

大鼠烫伤后不同时程侧脑室注射强啡肽A(1—13)抗血清对烫伤休克的影响

近年来的研究工作表明,内源性阿片肽与休克密切相关。在内毒素性休克、低血容量性休克和脊髓损伤性休克时,血浆和脑脊液中内源性阿片肽有不同程度的升高,应用阿片肽受体拮抗剂纳洛酮可对抗休克。我们在烫伤休克的研究中观察到,大鼠烫伤后,某些脑区和血浆中强啡肽A(1-13)[DynA(1-13)]免疫活性物质的含量有显著变化,烫后外周静脉给予DynA(1～13)抗血清,可改善大鼠心血管功能,延长存     

吗啡和纳洛酮对豚鼠离体胆囊肌条活动的作用

5种浓度的吗啡对胆囊肌条的自动节律性收缩,均有明显加强作用。阿片受体拮抗剂——纳洛酮可阻断和翻转吗啡对胆囊肌条的作用,说明豚鼠的胆囊壁有阿片受体。乙酰胆碱显著地加强胆囊肌条的收缩,此效应可被阿托品阻断,而且阿托品也使吗啡对胆囊肌条的作用明显减弱。异丙肾上腺素和去甲肾上腺素分别抑制和加强胆囊肌条的运动,前者的效应可被心得宁阻断,后者则被酚妥拉明阻断,但两者的效应均不受纳洛酮的影响。而心得宁和酚妥拉明不影响吗啡对胆囊肌条的作用。本实验似能表明,吗啡对胆囊肌条运动的调节是通过阿片受体而起作用的。但吗啡对胆囊肌条的作用与肾上腺素能α和β受体无关。     

用微电泳方法给予吗啡对家兔脑桥结合臂旁内侧核区呼吸性单位活动的影响

在家兔延髓曾观察到,孤束区和疑核区的呼吸性单位对微电泳给予吗啡的敏感性并不相同,本实验进一步观察微电泳给予吗啡对脑桥呼吸调整中枢(结合臂旁内侧核区)呼吸性单位放电的影响。在67个呼吸性单位中,微电泳给予吗啡引起兴奋的有40个,阻遏的4个,其余23个活动无明显改变。在18个吗啡引起兴奋的呼吸性单位中,有12个单位的吗啡效应可被纳洛酮对抗。6个微电泳给予吗啡引起兴奋的呼吸性单位,在静脉给予吗啡时也出现兴奋效应;这种兴奋效应能被微电泳或静脉给予纳洛酮所对抗。本工作说明,脑桥呼吸调整中枢的呼吸性单位对吗啡很敏感,而且主要起兴奋反应。     

中脑导水管周围灰质在侧脑室注入微量吗啡或纳洛酮所引起的镇痛或拮抗镇痛中的作用

本工作进一步探索中脑导水管周围灰质(PAG)在吗啡镇痛与纳洛酮拮抗吗啡镇痛中的作用。实验在清醒受限制的大鼠上进行,以电刺激鼠尾出现的甩尾和嘶叫为痛反应指标。结果表明:(1)侧脑室注射微量纳洛酮后,可使电刺激 PAG 或注射微量吗啡于 PAG 所引起的镇痛效应受到明显拮抗;(2)损毀 PAG 或注射微量纳洛酮于 PAG 后,可使由侧脑室注入微量吗啡所引起的镇痛效应显著减弱。由此可见 PAG 既是侧脑室注射吗啡镇痛作用的重要中枢部位,又是侧脑室注射纳洛酮拮抗吗啡镇痛的重要中枢部位。     

炎症介质在内毒素引起大鼠肠系膜血管床降钙素基因相关肽释放中的作用

本研究在离体大鼠肠系膜血管床灌流模型上,采用特异放免法测定灌流液中的降钙素基因相关肽（ＣＧＲＰ）,观察几种常见炎症介质在内毒素引起ＣＧＲＰ释放中的作用。结果显示：前列腺素合成酶抑制剂地塞米松、布洛芬与消炎痛,缓激肽受体Ｂ２拮抗剂ＨＯＥ１４０,血小板激活因子拮抗剂ＷＥＢ２０８６,组胺Ｈ１受体拮抗剂苯海拉明以及和组胺Ｈ２受体拮抗剂西咪替丁,均能明显抑剂制内毒素引起的ＣＧＲＰ释放,５羟色胺受体拮抗剂ＩＣＳ２０５９３０却无明显作用。从而提示：内毒素引起ＣＧＲＰ释放是通过炎症介质前列腺素、缓激肽、血小板激活因子和组胺介导的,阻断或减少炎症介质的产生可望减轻内毒素血症时ＣＧＲＰ的过量释放。     

Indomethacin and ibuprofen induce Hsc70 nuclear localization and activation of the heat shock response in HeLa cells

It has been established that non-steroidal anti-inflammatory drugs (NSAIDs), such as sodium salicylate, sulindac, ibuprofen, and indomethacin, induce anti-inflammatory and anti-proliferative effects independent of cyclooxygenase. These cyclooxygenase-independent pharmacodynamic effects appear to regulate several signaling pathways involving proliferation, apoptosis, and heat shock response. However, the mechanisms of these actions remain an area of ongoing investigation. Hsc70 is a cytoplasmic chaperone protein involved in folding and trafficking of client proteins to different subcellular compartments, plays roles in signal transduction and apoptosis processes, and translocates to the nucleus following exposure to heat shock. Since NSAIDs induce some aspects of the heat shock response, we hypothesized that they may also induce Hsc70 nuclear translocation. Western immunoblotting and indirect cellular immunofluorescence showed that indomethacin and ibuprofen induce Hsc70 nuclear translocation at concentrations previously shown to induce HSF DNA-binding activity. Chemical inhibition of both p38(MAPK) and Erk42/44 had no effect on localization patterns. In addition, while indomethacin has been shown to behave as an oxidative stressor, the radical scavenging agent, N-acetyl cysteine, did not inhibit nuclear translocation. These results indicate that induction of the heat shock response by NSAIDs occurs at concentrations fivefold greater than those required to inhibit cyclooxygenase activity, suggesting a cyclooxygenase-independent mechanism, and in the presence or absence of kinase inhibitors and a free radical scavenger, suggesting independence of Erk42/44 or p38(MAPK) activities and intracellular oxidoreductive state.     

Early postnatal ibuprofen and indomethacin effects in suckling and weanling rat kidneys

The use of indomethacin in preterm newborn infants with symptomatic patent ductus arteriosus is associated with compromised renal function. Ibuprofen has been shown to be as effective as indomethacin with fewer renal side effects. We examined the hypothesis that early postnatal ibuprofen has less adverse effects on neonatal rat renal prostanoids, COX-2 expression, and angiotensin II than indomethacin. Newborn rats received IP injections of human therapeutic doses of ibuprofen or indomethacin on the first 3 days of life. Control rats were treated with equivalent volume saline. Kidneys were assessed in suckling and weanling rats for prostanoids, COX-2 expression, and angiotensin II. In suckling rats, indomethacin suppressed PGE(2) and COX-2 expression, and increased PGF(2alpha), whereas ibuprofen increased COX-2 and angiotensin II. Although both NSAIDs suppressed 6-ketoPGF(1alpha) and TxB(2) levels in suckling rats, the effect was sustained in weanling rats with indomethacin. Our findings demonstrate that indomethacin exhibits more potent suppressive effects on renal COX-2 and vasodilator prostanoids which are important regulators of renal development and function. These long-term, sustained effects may explain in part, why indomethacin exerts more severe adverse renal effects than ibuprofen, when administered during early postnatal life.     

The antagonism by anti-inflammatory analgesics of prostaglandin F2α-induced contractions of human and rabbit myometrium

The anti-inflammatory analgesic drugs, aspirin, indomethacin, phenylbutazone, mefenamic acid, ibuprofen and flurbiprofen are shown to inhibit in a dose-dependent manner the force of contraction of isolated human pregnant myometrial strips which have been stimulated to contract by adding prostaglandin (PG) F_2α to the tissue bath. These drugs and also flufenamic acid and salicin show a similar antagonism of the action of PGF_2α with isolated rabbit non-pregnant myometrium. The ratio of the inhibitory concentration to the maximum plasma level after a normal dose suggests that phenylbutazone and possibly ibuprofen may be capable of inhibiting human uterine contractions . Patients who were treated with aspirin during induction of abortion using PGF_2α during the second trimester of pregnancy showed no significant change in the induction-abortion interval compared with patients not taking aspirin.     

Effects of nimesulide, a preferential cyclooxygenase-2 inhibitor, on carrageenan-induced pleurisy and stress-induced gastric lesions in rats

Intrapleural injection of carrageenan in rats increased prostaglandin E₂ (PGE₂) production and induced newly synthesized cyclooxygenase-2 (COX-2) in pleural exudate cells without affecting COX-1 levels. Nimesulide, a preferential inhibitor of COX-2, reduced pleural PGE₂ production and was almost as active as indomethacin and 10 times more active than ibuprofen. Only COX-1, and no COX-2, was detected in gastric mucosal cells, and PGE₂ concentration of gastric mucosa was significantly decreased by indomethacin and ibuprofen. The decrease in gastric PGE₂ production induced by indomethacin and ibuprofen was enhanced in stressed rats, resulting in aggravation of stress-induced gastric lesions at anti-inflammatory doses. However, nimesulide did not produce stress-induced gastric lesions even at 30 times the anti-inflammatory dose. This supports the hypothesis that inhibition of COX-1 causes unwanted side effects and inhibition of COX-2 produces anti-inflammatory effects.     

The antagonism by anti-inflammatory analgesics of prostaglandin F2α-induced contractions of human and rabbit myometrium in vitro

The anti-inflammatory analgesic drugs, aspirin, indomethacin, phenylbutazone, mefenamic acid, ibuprofen and flurbiprofen are shown to inhibit in a dose-dependent manner the force of contraction of isolated human pregnant myometrial strips which have been stimulated to contract by adding prostaglandin (PG) F_2α to the tissue bath. These drugs and also flufenamic acid and salicin show a similar antagonism of the action of PGF_2α with isolated rabbit non-pregnant myometrium. The ratio of the inhibitory concentration in vitro to the maximum plasma level after a normal dose in vivo suggests that phenylbutazone and possibly ibuprofen may be capable of inhibiting human uterine contractions in vivo. Patients who were treated with aspirin during induction of abortion using PGF_2α during the second trimester of pregnancy showed no significant change in the induction-abortion interval compared with patients not taking aspirin.     

Calcitonin gene-related peptide can attenuate or augment pancreatic damage in caerulein-induced pancreatitis in rats.

We have recently shown that treatment with calcitonin gene-related peptide (CGRP) before and during induction of acute pancreatitis exhibits a protective effect against pancreatic damage evoked by overdose of caerulein. Studies in the stomach have shown that administration of CGRP exhibits dual action on gastric mucosa, CGRP administration before induction of gastric lesions, protects gastric mucosa against damage, whereas treatment with this peptide after development of gastric ulcer exacerbates mucosal injury. These observations prompt us to determine the influence of CGRP administrated before and after induction of pancreatitis on development and evolution of pancreatic tissue damage. METHODS: Acute pancreatitis was induced by s.c. infusion of caerulein (10 microg/kg/h) for 5 h. CGRP was administrated (10 microg/kg s.c. per dose) 30 min prior to caerulein infusion and 3 h later during caerulein infusion or at the time 1 h, 4 h and 7 h after the end of caerulein infusion. Rats were sacrificed at the time 0 h, 3 h or 9 h after cessation of caerulein administration. The pancreatic blood flow (PBF), plasma activity of amylase, plasma interleukin-1beta concentration, cell proliferation, biochemical and morphological signs of pancreatitis were examined. RESULTS: Caerulein-induced pancreatitis (CIP) led to 42% decrease in DNA synthesis, 30% inhibition of PBF, as well as, a significant increase in pancreatic weight, plasma amylase activity, plasma interleukin-1beta concentration, and development of the histological signs of pancreatic damage (edema, leukocyte infiltration and vacuolization). Treatment with CGRP prior and during induction of CIP attenuated the pancreatic damage what was manifested by partial reversion of the drop in DNA synthesis (40.9+1.7 v. 34.2+2.0 dpm/microg DNA) and PBF (83+3% v. 70+3%). Increases in pancreatic weight and plasma interleukin-1beta were reduced. Morphology showed improvement of pancreatic integrity. Administration of CGRP after induction of CIP aggravated pancreatic damage what was manifested by additional decrease in PBF and DNA synthesis. Also pancreatic weight as well as histological signs of pancreatic damage were increased. CONCLUSIONS: (1) Administration of CGRP before and during induction of pancreatitis protects pancreas against pancreatic damage. (2) Treatment with CGRP after development of CIP aggravates pancreatic damage.     

The antagonism by anti-inflammatory analgesics of prostaglandin f 2 alpha-induced contractions of human and rabbit myometrium in vitro.

The anti-inflammatory analgesic drugs, aspirin, indomethacin, phenylbutazone, mefenamic acid ibuprofen and flurbiprofen are shown to inhibit in a dose-dependent manner the force of contraction of isolated human pregnant myometrial strips which have been stimulated to contract by adding prostaglandin (PG) F2alpha to the tissue bath. These drugs and also flufenamic acid and salicin show a similar antagonism of the action of PGF2alpha with isolated rabbit non-pregnant myometrium. The ratio of the inhibitory concentration in vitro to the maximum plasma level after a normal dose in vivo suggests that phenylbutazone and possibly ibuprofen may be capable of inhibiting human uterine contractions in vivo. Patients who were treated with aspirin during induction of abortion using PGF2alpha during the second trimester of pregnancy showed no significant change in the induction-abortion interval compared with patients not taking aspirin.     

The small intestine plays an important role in upregulating CGRP during sepsis

Although studies have indicated that calcitonin gene-related peptide (CGRP), a potent vasodilatory peptide, is upregulated after endotoxic shock, it remains controversial whether this peptide increases during sepsis and, if so, whether the gut is a significant source of CGRP under such conditions. To study this, polymicrobial sepsis was induced by cecal ligation and puncture (CLP) followed by fluid resuscitation. Plasma levels of CGRP were measured at 2, 5, and 10 h after CLP (i.e., early, hyperdynamic sepsis) and at 20 h after CLP (late, hypodynamic sepsis). The results indicate that plasma CGRP did not increase at 2--5 h but increased by 177% at 10 h after CLP (P < 0.05). At 20 h after the onset of sepsis, however, the elevated plasma CGRP returned to the sham level. To determine the source of the increased plasma CGRP, the liver, spleen, small intestine, lungs, and heart were harvested, and tissue CGRP was assayed at 10 h after CLP in additional animals. Only the small intestine showed a significant increase in tissue levels of CGRP (by 129%, P < 0.05). Determination of portal vs. systemic levels of CGRP indicates that portal CGRP was 65.7 +/- 22.7% higher than the systemic level at 10 h after CLP, whereas portal CGRP in sham-operated rats was only 4.9 +/- 2.1% higher. Immunohistochemistry examination revealed that CGRP-positive stainings increased in the intestinal tissue but not in the liver at 10 h after the onset of sepsis. The distribution of CGRP stainings was associated with intestinal nerve fibers. These results, taken together, demonstrate that upregulation of CGRP occurs transiently during the progression of sepsis (at the late phase of the hyperdynamic sepsis), and the gut appears to be a major source of such an increase in circulating levels of this peptide.