Haemodynamics as a determinant of the pharmacokinetics of and the plasma catecholamine responses to isoprenaline

Summary The total body clearance and fractional extraction of isoprenaline (ISO) have been determined, and the relation between these parameters and cardiac output established. Whether desipramine, an inhibitor of neuronal uptake, altered the plasma catecholamine response to ISO was also investigated.Seven healthy subjects were given i.v., infusions of ISO in two, consecutive 25-min periods, at constant dose rates of 31–43 and 80–124 pmol·kg^–1·min^–1, respectively. The total-body (ER), pulmonary (ER_p) and forearm (ER_f) fractional extractions and the total body clearance (CL) of ISO were obtained from measurements of cardiac output and the steady-state ISO concentration in mixed central venous, arterial and forearm venous plasma.ISO-induced increases in cardiac output resulted in increases in CL, decreases in ER and no consistent change in ER_f. ER_p did not differ from zero. ISO also produced a dose-dependent increase in the mixed venous plasma concentrations of noradrenaline and 3,4-dihydroxyphenylglycol (DOPEG), and a decrease in that of adrenaline. Pretreatment with desipramine did not alter any of the pharmacokinetic parameters of ISO. Desipramine, however, reduced the mixed venous baseline plasma levels of noradrenaline (47%) and DOPEG (40%), and tended to reduce that of adrenaline (34%). It enhanced the plasma noradrenaline response 2.4-fold, abolished the plasma DOPEG response and did not alter the plasma adrenaline response to ISO.Hence, owing to its haemodynamic effects, ISO modifies its own pharmacokinetics which involve non-neuronal removal processes only. The increased DOPEG in plasma resulting from the ISO-induced increase in noradrenaline release was presynaptic in origin. Desipramine appears to reduce sympathetic activity. The enhancement by desipramine of the ISO-induced increase in plasma noradrenaline points towards recapture by neuronal uptake of at least 58% of the noradrenaline released in response to ISO.     

淫羊藿总黄酮对肾上腺素β_1受体的特异性阻断作用

为探讨淫羊藿总黄酮（ＴＦＥ）对肾上腺素受体的作用，本实验用离体兔心房肌、主动脉及豚鼠气管观察了ＴＦＥ对肾上腺素全体的作用，结果ＴＦＥ（０．１３ｇ／Ｌ）抑制心房肌肌力和频率，并使异丙肾上腺素（ＩＳＯ）对心房肌正性频率作用的量效曲线平行右移，但无钙拮抗作用及Ｍ受体激动效应，且不影响ＩＳＯ对豚鼠气管条的负性肌力作用及去甲肾上腺囊（ＮＥ）对兔主动脉条的收缩作用。提示ＴＦＥ选择性阻断肾上腺素β_１受体。     

葛根素对异丙肾上腺素诱导大鼠心肌损伤的保护作用

采用异丙肾上腺素造成大鼠急性心肌缺血模型 ,观察葛根素对大鼠心电图、血清磷酸肌酸激酶 (CPK)、心肌组织超氧化物歧化酶 (SOD)和脂质过氧化物丙二醛 (MDA)的影响。发现葛根素可对抗异丙肾上腺素所致心肌缺血大鼠的心电图ST段的异常升高 ,使血清CPK降低 ,并可增加心肌组织SOD的活力 ,减少MDA生成。提示 :葛根素对大鼠心肌缺血有保护作用     

In-vivo quantification of myocardial Na-K pump rate during β-adrenergic stimulation of intact pig hearts

Maintenance of adequate electrical activity of the heart depends critically on the ability of the Na-K pump to compensate for normal passive sodium and potassium fluxes. Using sudden injections of [³H]ouabain into the left coronary artery in anaesthetized open-chest pigs, we monitored transient changes in myocardial potassium balance by PVC-valinomycin mini-electrodes. When related to the number of pumps blocked and fractional inhibition, these data provided estimates of total Na-K pump capacity as well as actual pump rate and perturbations of the Na-K balance. Experiments were performed in hearts with and without intracoronary isoprenaline infusion (2.5 nmol min^-1). After injection of 120 nmol [³H]ouabain into the left coronary artery, myocardial [³H]ouabain concentrations were 118 (74–178) and 103 (76–145) pmol g^-1 and total concentrations of [³H]oubain binding sites were 893 (752–1076) and 785 (691–877) pmol g^-1 (median, 95% confidence interval) in isoprenaline-treated and control hearts respectively (differences not significant). The [³H]ouabain injection caused a net potassium release of 81 (56–132) and 43 (23–75) μcool 100 g^-1 (median, 95% confidence interval) in isoprenaline-treated and control hearts respectively (n= 6–8; significance of difference, P= 0.03). Na–K pump rate estimated from mono-exponential release curves was 6363 (3942–10,858) K⁺ ions min^-1 site^-1 during β-adrenoceptor stimulation and 2514 (1380–4322) in control (significance of difference, P= 0.03). This corresponds to 40 and 16%, respectively, of the maximum possible pump rate determined from ATP hydrolysis. Comparison of accumulated potassium release and relative Na-K pump rate indicates that catecholamines enhance the sensitivity of the Na-K pump for intracellular sodium.     

Comparison between isoprenaline infusions and bolus injections to assess β-adrenoceptor function in man,with special reference to cardiac contractility and the influence of autonomic reflexes

The present study was performed to characterize cardiovascular responses to isoprenaline and the influence of autonomic reflexes on these reponses. Nine healthy volunteers received infusions and bolus injections of isoprenaline before and after ‘autonomic blockade’ produced by intravenous atropine 0.04 mg kg^-1 and clonidine 300 μg. Heart rate, blood pressures, systolic time intervals and various echocardiographic measures of cardiac contractility were registered. No significant differences in responsiveness to isoprenaline were seen when infusions were repeated on the same day without ‘autonomic blockade’. After ‘blockade’, Δ responses at 1 nmol 1^-1 isoprenaline (infusions) were increased for diastolic blood pressure and decreased for systolic blood pressure and stroke volume. Bolus injections of 2 μg isoprenaline caused enhanced Δ responses after ‘autonomic blockade’ of diastolic blood pressure, left ventricular diameter in systole, ventricular circumferential fibre shortening, mean posterior wall velocity (V_{mean pw}), stroke volume, systemic vascular resistance, electromechanical systole (QS₂) and pre-ejection period. Systolic blood pressure decreased, in contrast to a small increase without ‘blockade’. These findings are explained by differences in haemodynamic effects of isoprenaline and by the dependence of responses on reflexes when isoprenaline is administered in different ways. When heart rate was increased by bolus doses of atropine, in the presence of β-blockade (propranolol), pre-ejection period and left ventricular diameter in systole were unaffected, and V_{mean pw} and ventricular circumferential fibre shortening showed only small increases (compared with alterations induced by isoprenaline). However, left ventricular ejection time, QS₂ and ejection time (by echocardiography), were markedly dependent on heart rate alterations. Thus, pre-ejection period, left ventricular diameter in systole V_{mean pw} and ventricular circumferential fibre shortening are parameters which can be useful in order to evaluate cardiac β-adrenoceptor sensitivity in vivo in man.     

肾上腺素、异丙肾上腺素及三磷酸腺苷对大鼠心肌细胞Cl-/HCO-3交换的增强作用及其意义

研究肾上腺素、异丙肾上腺素及三磷酸腺苷对大鼠心肌细胞阴离子交换蛋白Ｃｌ＾－／ＨＣＯ＾－３交换活性的影响,探讨其病理生理意义,方法计算机辅助微量荧光检测法测定培养的正常及心衰心肌细胞Ｃｌ＾－／ＨＣＯ３＾－交换活性。结果心衰心肌细胞ｐＨｉ的恢复斜率大于正常心肌细胞,肾上腺素、异丙肾上腺素及三磷酸腺苷对碱负载的正常及心衰心肌细胞ｐＨｉ的恢复斜率均分别显著大于对照。结论心衰心肌细胞Ｃｌ＾－／ＨＣＯ＾－３ｕ     

Involvement of cyclic nucleotide-dependent protein kinases in cyclic AMP-mediated vasorelaxation

1. The involvement of cyclic AMP-dependent protein kinase (PKA) and cyclic GMP-dependent protein kinase (PKG) in the effects of cyclic AMP-elevating agents on vascular smooth muscle relaxation, cyclic nucleotide dependent-protein kinase activities and ATP-induced calcium signalling ([Ca²⁺]_i) was studied in rat aorta. Cyclic AMP-elevating agents used were a β-adrenoceptor agonist (isoprenaline), a phosphodiesterase 3 (PDE3) inhibitor (SK&F 94120) and a PDE4 inhibitor (rolipram).
2. In rat intact aorta, the relaxant effect induced by isoprenaline (0.01–0.3 μM) was decreased by a specific inhibitor of PKA, H-89, whereas a specific inhibitor of PKG, Rp-8-Br-cyclic GMPS, was without effect. No significant difference in PKA and PKG activity ratios was detected in aortic rings when isoprenaline 10 μM was used. At the same concentration, isoprenaline did not modify ATP-induced changes in [Ca²⁺]_i in smooth muscle cells. Neither H-89 nor Rp-8-Br-cyclic GMPS modified this response. These findings suggest that PKA is only involved in the relaxant effect induced by low concentrations of isoprenaline (0.01–0.3 μM), whereas for higher concentrations, other mechanisms independent of PKA and PKG are involved.
3. The relaxant effects induced by SK&F 94120 and rolipram were inhibited by Rp-8-Br-cyclic GMPS with no significant effect of H-89. Neither SK&F 94120, nor rolipram at 30 μM significantly modified the activity ratios of PKA and PKG. Rolipram inhibited the ATP-induced transient increase in [Ca²⁺]_i. This decrease was abolished by Rp-8-Br-cyclic GMPS whereas H-89 had no significant effect. These results suggest that PKG is involved in the vascular effects induced by the inhibitors of PDE3 and PDE4. Moreover, since it was previously shown that PDE3 and PDE4 inhibitors only increased cyclic AMP levels with no change in cyclic GMP level, these data also suggest a cross-activation of PKG by cyclic AMP in rat aorta.
4. The combination of 5 μM SK&F 94120 with rolipram markedly potentiated the relaxant effect of rolipram. This relaxation was decreased by H-89 and not significantly modified by Rp-8-Br-cyclic GMPS. Moreover, the association of the two PDE inhibitors significantly increased the activity ratio of PKA without changing the PKG ratio. The present findings show that PKA rather than PKG is involved in this type of vasorelaxation. The differences in the participation of PKA vs PKG observed when inhibitors of PDE3 and PDE4 were used alone or together could be due to differences in the degree of accumulation of cyclic AMP, resulting in the activation of PKA or PKG which are differently localized in the cell.
5. These findings support a role for both PKA and PKG in cyclic AMP-mediated relaxation in rat aorta. Their involvement depends on the cellular pathway used to increase the cyclic AMP level.

     

Hydrogen peroxide-induced impairment of reactivity in rat isolated aorta: potentiation by 3-amino-1,2,4-triazole

1. In this study the impairment induced by hydrogen peroxide of vascular reactivity and the role of endogenous catalase in protection against this impairment was assessed in isolated rings of rat aorta.
2. Incubation with hydrogen peroxide at 1 mM, but not at 0.1 mM, for 15, 30 or 60 min followed by washout depressed, in a time-dependent manner, the subsequent ability of endothelium-containing and endothelium-denuded rings to contract to phenylephrine.
3. Incubation with 3-amino-1,2,4-triazole (50 mM, 90 min, followed by washout) to inhibit endogenous catalase had no effect by itself on subsequent phenylephrine-induced contraction. However, pretreatment with 3-amino-1,2,4-triazole did lead to a profound enhancement of the ability of hydrogen peroxide (1 mM, present for the final 30 min of the 90 min incubation, followed by washout) to depress phenylephrine-induced contraction in both endothelium-containing and endothelium-denuded rings.
4. Incubation with hydrogen peroxide at 1 mM, but not at 0.1 mM, for 15, 30 or 60 min followed by washout inhibited, in a time-dependent manner, the subsequent ability of acetylcholine (10 nM–3 μM) to induce endothelium-dependent relaxation. Furthermore, incubation with hydrogen peroxide 1 mM (30 min, followed by washout) also inhibited relaxation induced by glyceryl trinitrate (1–100 nM) or isoprenaline (10 nM–3 μM) in endothelium-denuded rings.
5. Incubation with 3-amino-1,2,4-triazole (50 mM, 90 min, followed by washout) had no effect by itself on relaxation induced by acetylcholine, glyceryl trinitrate or isoprenaline. In contrast, pretreatment with 3-amino-1,2,4-triazole led to profound enhancement of the ability of hydrogen peroxide (1 mM, present for final 30 min of the 90 min incubation) to block relaxation to acetylcholine, glyceryl trinitrate or isoprenaline.
6. On the basis of the actions of 3-amino-1,2,4-triazole, it is likely that endogenous catalase plays an important role in the protection of vascular reactivity of rat aorta against oxidant damage by high (1 mM) but not lower (0.1 mM) concentrations of hydrogen peroxide. The data are consistent with the promotion of non-selective damage to the vascular smooth muscle cells by hydrogen peroxide, but endothelial damage may also be sustained.

     

Thiopentone inhibits beta-adrenergic responses in myocardial tissue

The purpose of this study was to determine the importance of inhibition of beta-adrenergic function in thiopentone-induced myocardial depression. Using an isolated, electrically stimulated rat left atria model, contractile dose-response curves to thiopentone (200 μM, 400 μM, 600 μM, 800 μM) were shifted to the right in preparations treated with 10^{− 3} M dibutyryl cyclic adenosine monophosphate (cAMP) compared with atria stimulated with 10^{− 6} M isoprenaline, demonstrating that inhibition of beta-adrenergic mechanisms by thiopentone is physiologically important. Depression by thiopentone was similar in atria treated with 10^{− 5} M forskolin compared with preparations stimulated with 10^{− 6} M isoprenaline, indicating that thiopentone does not block beta-adrenergic receptors. It is concluded that thiopentone depresses myocardial function by several mechanisms, one of which involves inhibition of the adenyl cyclase cascade. The adenyl cyclase enzyme is a likely site where thiopentone inhibits the system; however, other components of the cascade may also be involved. L’objectif de cette étude consiste à déterminer l’influence de l’inhibition de l’activité β-adrenergique sur la dépression myocardique induite par le thiopentone. A l’aide d’un modèle constitué d’une oreillette gauche de rat stimulée électriquement, la relation dose-effet du thiopentone sur la contractilité (200 μM, 400 μM, 600 μM, 800 μM) se déplace vers la droite dans des préparations traitées avec de l’adénosine monophosphorique cyclique (cAMP) 10^{− 3} M comparativement à des oreillettes stimulées avec de l’isoprénaline 10^{− 6} M, ce qui démontre que l’inhibition β-adrénergique provoquée par le thiopentone est physiologiquement importante. La dépression de l’oreillette provoquée par le thiopentone est identique à celle que produit la forskoline 10^{− 5} M comparativement à celle de l’isoprénaline 10^{− 6} M, ce qui indique que le thiopentone n’inhibe pas les récepteurs β-adrénergiques. Les auteurs concluent que le thiopentone déprime la fonction myocardique par plusieurs mécanismes qui impliquent l’inhibition de la cascade de l’adényl cyclase. L’inhibition du système se produit vraisemblablement au niveau de l’enzyme adényl cyclase; cependant, il est possible que d’autres éléments de la cascade de l’adényl cyclase soient impliqués.     

Adrenergic receptors in the forehead microcirculation

The presence of - and -adrenoceptors in the forehead microcirculation was investigated in 49 healthy subjects. Local vascular responses to noradrenaline, isoprenaline and adrenergic antagonists, administered transcutaneously by iontophoresis, were monitored via laser Doppler flowmetry. Iontophoresis of the -adrenergic antagonist phentolamine induced a persistent increase in skin blood flow, whereas iontophoresis of saline induced a minor increase in skin blood flow which subsided rapidly. Skin blood flow increased moderately after the iontophoresis of the -adrenergic antagonist propranolol. Pretreatment of the experimental site with phentolamine blocked the normal vasoconstrictor response to noradrenaline, and unmasked a minor vasodilator component of response in some subjects. Iontophoresis of the -adrenergic agonist isoprenaline induced dose-dependent vasodilatation which was antagonised by propranolol. These findings indicate that -adrenoceptors in the forehead microcirculation normally mediate a vasoconstrictor response to iontophoretically-applied noradrenaline. In addition, -adrenoceptors appear to mediate a minor vasodilator component of response.