Increased jejunal prostaglandin E2 concentrations in patients with acute cholera.
Increased jejunal prostaglandin E2 concentrations in patients with acute cholera.
复制标题
急性霍乱患者空肠前列腺素 E2 浓度增加。
作者：
P. Speelman;G. Rabbani;K. Bukhave;J. Rask
超生理剂量的前列腺素（PGs）模拟霍乱毒素和cAMP在小肠中的作用，但并非所有观察结果都可以用PGs与cAMP联系起来的理论来解释。由于没有关于人类霍乱中内源性前列腺素的数据，我们测量了9名高度净化霍乱患者近端空肠缓慢标记物灌注期间空肠液中PGE 2的浓度和PGE 2的空腹肠道流速。9例处于恢复期的霍乱或其他水样腹泻患者作为对照。在急性霍乱中，PGE 2浓度显著升高（p <0.001）（172-1435（n = 9）vs 60-270（n = 9）pg/ml），并与腹泻发作后的时间呈负相关（r = 0.71; p <0.05）。此外，PGE 2的空腹空肠流速显著（p <0.005）增加（0.77-8.22（n = 7）vs 0.21-0.92（n = 6）ng/min），与粪便排出量（2.9-9.5 ml/min）呈正相关（r = 0.84; p <0.01）。通过外推法，在正常排便量下，空腹空肠PGE 2流速等于恢复期测量的流速。结果支持的概念，PGs，除了cAMP，可能发挥病理生理作用，在人类霍乱。由于在霍乱急性期和恢复期晚期测量的最高值的中位数之间的比率至少为15，在完全爆发的霍乱中局部肠PGE 2形成应导致粘膜PGE 2浓度高于最大分泌反应所需的浓度。这一观察结果可能解释了为什么常规剂量的阿司匹林和吲哚美辛在临床试验中没有显著的抗炎作用。
Supraphysiologic doses of prostaglandins (PGs) mimic the effect of cholera toxin and cAMP in the small intestine, but not all observations are explicable in terms of the theory that links PGs to cAMP. Because no data exist on endogenous PGs in human cholera we measured PGE2 concentrations in jejunal fluids and fasting intestinal flow rates of PGE2 during slow marker perfusion of proximal jejunum in nine patients with high purging cholera. Nine patients in the recovery phase of cholera or other watery diarrhoeas served as controls. In acute cholera PGE2 concentrations were significantly (p less than 0.001) raised (172-1435 (n = 9) vs 60-270 (n = 9) pg/ml) and negatively correlated (r = 0.71; p less than 0.05) to the time following onset of diarrhoea. Also fasting jejunal flow rates of PGE2 were significantly (p less than 0.005) increased (0.77-8.22 (n = 7) vs 0.21-0.92 (n = 6) ng/min), and positively correlated (r = 0.84; p less than 0.01) to stool output (2.9-9.5 ml/min). By extrapolation, at normal stool output fasting jejunal flow rates of PGE2 equalled those measured during convalescence. The results support the notion that PGs, in addition to cAMP, may play a pathophysiologic role in human cholera. As the ratio between the medians of the highest values measured during the acute phase of cholera and in late convalescence was at least 15, local intestinal PGE2 formation in full blown cholera should result in mucosal PGE2 concentrations above those required for a maximal secretory response. This observation might explain why conventional doses of aspirin and indomethacin had no significant antidiarrhoeal effect in clinical trials.
吲哚美辛对家兔回肠粘膜的体外抗分泌作用。
影响因子：
29.4
作者：
Smith,PL;Blumberg,JB;Stoff,JS;Field,M
通讯作者：
Field,M