SYMPATHOADRENAL FUNCTION IN HEALTH AND DISEASE

交感肾上腺系统是最强大和最迅速的行动之一， 身体的“压力”系统。我们的目标是更好地理解 这个系统是如何调节的，它的功能是如何与 有助于维持内部环境的其他系统， 以及它是否以及如何在神经心脏病中发挥病理生理作用。 疾病在过去的一年里，我们开发了正电子发射断层扫描技术， (PET)扫描提供了第一种非侵入性的体内检查方法， 心脏交感神经支配和功能。我们还在体内开发了 微透析以检查浓度之间的关系 大脑中的神经递质和交感肾上腺流出。的 微透析液将由一种新的多电极阵列检测器进行分析 （神经化学分析仪）。我们获得了进一步的证据， 内源性血浆多巴与多巴胺生物合成的关系 交感神经递质去甲肾上腺素（NE），并观察到异常 盐敏感患者尿多巴排泄增加 高血压我们采用了一种方法，包括直接记录交感神经 研究抗高血压药物在体内的突触前作用。的 交感神经活动与局部放电的密切关系 在人类和大鼠中证实了NE进入血液。我们获得 交感肾上腺高反应性的证据，如育亨宾所示 激发试验，在一些高血压患者中;通过 微透析显示育亨宾在大鼠脑中释放NE;并显示 通过直接神经记录育亨宾增加交感神经 交通和增强区域释放NE在心脏和四肢， 人类PET扫描、神经化学分析和直接交感神经 录音可以用来回答长期存在的问题， 交感肾上腺系统在健康、压力和疾病中的作用。

The sympathoadrenal system is one of the most powerful and rapidly-acting of the body's "stress" systems. Our goals have been to understand better how this system is regulated, how its function is integrated with that of other systems contributing to the maintenance of the internal environment, and whether and how it plays a pathophysiologic role in neurocardiologic diseases. During the past year we developed positron emission tomographic (PET) scanning to provide the first non-invasive, in vivo means to examine cardiac sympathetic innervation and function. We also developed in vivo microdialysis to examine relationships between concentrations of neurotransmitters in the brain and sympathoadrenal outflow. The microdialysates will be analyzed by a new multi-electrode array detector (neurochemical analyzer). We obtained further evidence suggesting a relationship between endogenous plasma dopa and biosynthesis of the sympathetic neurotransmitter, norepinephrine (NE), and noted abnormally increased urinary excretion of dopa in patients with salt-sensitive hypertension. We used a method including direct sympathetic nerve recording to examine pre-synaptic actions of anti-hypertensive drugs in vivo. The close relationship between sympathetic nerve activity and regional release of NE into the bloodstream was confirmed in humans and rats. We obtained evidence of sympathoadrenal hyperreactivity, as indicated by a yohimbine challenge test, in some patients with hypertension; demonstrated by microdialysis that yohimbine releases NE in the brain in rats; and showed by direct nerve recording that yohimbine increases sympathetic nerve traffic and augments regional release of NE in the heart and limbs in humans. PET scanning, neurochemical analysis, and direct sympathetic nerve recording can be used to answer long-standing questions about the role of the sympathoadrenal system in health, stress, and disease.