Plenary Lecture
The Central Histaminergic System - An Essential Part of
Circulatory Homeostatic Mechanisms in Haemorrhagic
Shock?
Associate Professor Jerzy Jochem
Department of Basic Medical Sciences
Medical University of Silesia
Piekarska 18, 41-902 Bytom
Poland
E-mail:
jjochem@poczta.onet.pl
Abstract:
The histaminergic system consists of neurons
concentrated in the tuberomammillary nucleus of the
posterior hypothalamus and send innervation to almost
all parts of the brain, including the cardiovascular
complex. Recent hypotheses suggest that the system is
implicated in the response to adverse or potentially
dangerous stimuli, including dehydration, changes in
blood pressure, nociceptive stimuli and other kinds of
stress. In these conditions, there is an increase in the
release or turnover of neuronal histamine leading to
activation of compensatory mechanisms. The purpose of
the study was to examine cardiovascular effects of
endogenous central histamine in haemorrhage-shocked
rats. Moreover, compensatory mechanisms activated by
histamine were investigated. Studies were carried out in
anaesthetized male Wistar rats subjected to a critical
irreversible hypotension (mean arterial pressure [MAP]
20-25 mmHg). The protocol was approved by local ethics
committee. Both histamine precursor L-histidine (intraperitoneally
[ip]) and histamine N-methyltransferase (HNMT)
inhibitors - SKF 91488 and metoprine (intracerebroventricularly
[icv]) led to an increase in endogenous histamine
concentrations in the cerebral cortex by 20-23%,
hypothalamus by 25-27% and medulla oblongata by 23-29%
in comparison to the control groups. L-histidine
produced dose-dependent increases in MAP, heart rate
(HR) and a survival rate of 2 h, whereas in normotensive
animals it did not influence cardiovascular parameters.
The effect was inhibited by (S)-á-fluoromethylhistidine,
an irreversible inhibitor of L-histidine decarboxylase.
SKF 91488 and metoprine evoked dose-dependent rises in
MAP and HR, which were significantly higher than those
in normotensive animals, and the improvement of survival
rates at 2 h after treatment. The action was inhibited
by H1 receptor antagonist chlorpheniramine (icv), while
neither ranitidine (icv) nor thioperamide (icv), H2 and
H3/H4 receptor blockers, respectively, influenced the
effect. Metoprine-induced resuscitating action was
accompanied by 2.7- and 1.7-fold higher plasma levels of
noradrenaline and adrenaline, 2.5-fold higher
concentration of arginine vasopressin (AVP), 2.9-fold
higher level of angiotensin II, 3.3-fold higher level of
ACTH and 1.7-fold higher level of á-MSH. In metoprine-treated
animals, nicotinic cholinoceptor antagonist
hexamethonium (intravenously [iv]) decreased MAP and HR
changes, whereas muscarinic cholinoceptor blocker
methylatropine (iv) inhibited only the pressor effect.
Metoprine-induced MAP and regional haemodynamic effects
were also reduced by á1- and á2-adrenoceptor antagonists
prazosin (iv) and yohimbine (iv), while â-adrenoceptor
blocker propranolol (iv) diminished only HR changes. V1a
receptor antagonist
[â-mercapto-â,â-cyclopentamethylenepropionyl1,O-me-Tyr2,Arg8]AVP
(iv), but not V1b and V2 receptor blockers - SSR149415 (ip)
and
[adamantaneacetyl1,O-Et-D-Tyr2,Val4,aminobutyryl6,Arg8,9]AVP
(iv), respectively, inhibited metoprine-induced
haemodynamic effects, without influence on survival at 2
h. Moreover, angiotensin type 1 (AT1) receptor
antagonist ZD 7155 (iv) and angiotensin-converting
enzyme inhibitor captopril (iv) decreased regional
vascular resistance and inhibited metoprine-induced
increase in MAP, whereas AT2 receptor blocker PD 123319
(iv) had no effect. Finally, melanocortin type 4 (MC4)
receptor antagonist HS014 (icv) inhibited metoprine-induced
increase in MAP, which resulted from decreased regional
vascular resistance; however, it did not affect HR and
the survival at 2 h. In conclusion, an increase in
endogenous central histamine concentrations after
loading with L-histidine or inhibition of HNMT activity
leads to rises in central histamine concentration and
the reversal of haemorrhagic hypotension. The
resuscitating action of central histamine results from
H1 receptor activation. The study demonstrates an
involvement of the sympathetic nervous system, AVP, the
renin-angiotensin system and proopiomelanocortin-derived
peptides in endogenous central histamine-induced
resuscitating action. Present data confirm the
hypothesis concerning the role of the histaminergic
system in regulation of central homeostatic mechanisms
in haemorrhagic shock.
Brief Biography of the Speaker:
Jerzy Jochem (MD, PhD) is an associate professor at
Department of Basic Medical Sciences, Medical University
of Silesia, Katowice, Poland, where he is also the
Institutional Coordinator of the LLP-Erasmus Program. He
is a specialist in internal medicine and cardiology. His
main research interests concern cardiovascular
physiology and cardiology, especially the central and
peripheral mechanisms involved in the cardiovascular
regulation in hypotension. In these fields, he authored
or co-authored over 70 scientific papers published in
reviewed journals and over 80 communications presented
at international conferences. Dr. Jochem has received
Polish Prime Minister Habilitation Award (2006) and the
National Education Committee Award (2007). Since 2005 he
is a vice-president of the Polish Histamine Research
Society.
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