Effects of adenosine on intraocular pressure, optic nerve head blood flow, and choroidal blood flow in healthy humans
Effects of adenosine on intraocular pressure, optic nerve head blood flow, and choroidal blood flow in healthy humans
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DOI：
10.1167/iovs.02-1133
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发表时间：
2003-07-01
影响因子：
4.4
通讯作者：
Schmetterer, L
中科院分区：
文献类型：
--
作者：
Polska, E;Ehrlich, P;Schmetterer, L
目的.有来自各种动物研究的证据表明腺苷系统在控制眼内压（IOP）和眼血流中起作用。然而，腺苷对IOP、脉络膜和视神经血流的影响的人类数据不可用。在12名健康男性志愿者中进行的安慰剂对照双盲临床试验中，确定了腺苷剂量逐步增加（10、20和40 μ g/kg/min，每个输注步骤30分钟）对视神经乳头血流量、脉络膜血流量和IOP的影响。用激光多普勒血流仪测量视乳头和脉络膜的血流。此外，眼底搏动幅度在黄斑（FPAM）和视神经乳头（FPAO）进行了评估与激光干涉术。腺苷诱导了IOP的小但显著的降低（40 μ g/kg/min：12% +/- 13%），与安慰剂相比显著（P = 0.046）。此外，腺苷还能显著增加脉络膜血流量（P < 0.001）、视乳头血流量（P = 0.037）和FPAM（P = 0.0014），并有增加FPAO的趋势（P = 0.057）。在最高给药剂量下，对脉络膜血流动力学参数的影响在14%和17%之间，而对视神经血流动力学参数的影响在3%和11%之间。这些数据与腺苷诱导脉络膜和视神经乳头血管舒张并降低健康人的IOP一致。考虑到在先前动物实验中描述的腺苷的神经保护性质，腺苷系统是用于青光眼治疗方法的有吸引力的靶系统。
PURPOSE. There is evidence from a variety of animal studies that the adenosine system plays a role in the control of intraocular pressure (IOP) and ocular blood flow. However, human data on the effect of adenosine on IOP and choroidal and optic nerve blood flow are not available.METHODS. The effect of stepwise increases in doses of adenosine (10, 20, and 40 mug/kg per minute, 30 minutes per infusion step) on optic nerve head blood flow, choroidal blood flow, and IOP was determined in a placebo-controlled double-masked clinical trial in 12 healthy male volunteers. Blood flow in the optic nerve head and choroid was measured with laser Doppler flowmetry. In addition, fundus pulsation amplitude in the macula (FPAM) and the optic nerve head (FPAO) were assessed with laser interferometry.RESULTS. Adenosine induced a small but significant decrease in IOP (at 40 mug/kg per minute: 12% +/- 13%), which was significant versus placebo (P = 0.046). In addition, adenosine induced a significant increase in choroidal blood flow (P < 0.001) and optic nerve head blood flow (P = 0.037), and FPAM (P = 0.0014) and tended to increase FPAO(P = 0.057). At the highest administered dose, the effect on choroidal hemodynamic parameters between 14% and 17%, whereas the effect on optic nerve hemodynamic parameters was between 3% and 11%.CONCLUSIONS. These data are consistent with adenosine inducing choroidal and optic nerve head vasodilatation and reducing IOP in healthy humans, Considering the neuroprotective properties of adenosine described in previous animal experiments the adenosine system is an attractive target system for therapeutic approaches in glaucoma.