두개내압상승에 의한 혈압상승작용과 중추 GABA계 및 중추 ${\alpha}_{2}$-아드레날린 수용체와의 관계

Studies on Involvement of Central GABAergic Mechanism and Central ${\alpha}_{2}-Adrenoceptors$ in Pressor Responses to Raised Intracranial Pressure

GABA계가 뇌내의 교감신경계기능에 영향을 주어서 혈압조절에 관여함이 알려져 있다. 본 연구에서는 마취가토에서 GABA계가 두개내압증가에 의한 혈압상승에 관여하는가를 조사하였다. 두개내압증가에 의한 승압은 측뇌실내 muscimol (GABA 작용약)이나 clonidine $({\alpha}_2$-작용약) 전처리후에는 볼 수 없었다. 측뇌실내 yohimbine $({\alpha}_2$-길항약)으로 일으킨 고혈압은 두개내압증가를 하여도 더 이상 상승하지 않았으나, 측뇌실내 bicuculline (GABA 길항약)으로 일으킨 고혈압은 두개내압증가로 더욱 상승하였다. Bicuculline은 muscimol이나 clonidine 저혈압에서는 승압을 일으켰으나 yohimbine이나 두개내압증가에 의한 고혈압에서는 무효였다. Yohimbine은 clonidine 저혈압은 상승시켰으나 muscimol 저혈압에 있어서는 무효였다. Yohimbine은 두개내압증가에 따른 승압상태는 더 올리지 못하였으나 bicuculline 승압상태는 더욱 상승시켰다. Muscimol은 bicuculline과의 길항성이외에 yohimbine 승압을 억제함을 알았으며 yohimbine 승압에 GABA계가 관여함을 추측할 수 있었다. 이러한 실험결과로 두개내압증가에 따른 승압상승은 (1) ${\alpha}_{2}$-수용체, (2) bicuculline-감수성 GABA 수용체, (3) yohimbine-감수성인 clonidine이 작용하는 GABA계 부위의 세가지 방법으로 억제성인 교감신경기능을 불활성화하여 일어나는 것으로 추론하였다.

Recent studies have shown that a GABAergic mechanism in the brain modulates arterial blood pressure (BP) through alterations of sympathetic activity in the brain. The purpose of the present study was to determine if this modulation is involved in the pressor response to raised intracranial pressure (ICP). The pressor response to raised ICP was abolished by pretreatment of anesthetized rabbits with intracerebroventricular (icv) muscimol (a GABA agonist) as well as with icv clonidine $(an\;{\alpha}_2-agonist)$. Raising ICP in the hypertensive state after icv yohimbine $(an\;{\alpha}_2-antagonist)$ did not cause an additional increase in the BP, whereas raising ICP in the hypertensive state following icv bicuculline (a GABA antagonist) produced a further increase. Bicuculline produced an increase of the BP which had been lowered by muscimol or by clonidine, whereas it failed to increase the hypertensive state induced by either previous yohimbine or raised ICP. Yohimbine reversed the BP which had been made low by clonidine but was incapable of raising the hypotensive state after muscimol. Yohimbine failed to increase the heightened BP due to raised ICP, whereas bicuculline-induced pressor state was further elevated by yohimbine. Muscimol, besides the bicuculline-antagonizing property, inhibited the pressor response to yohimbine, suggesting participation of a GABAergic mechanism in the pressor action of yohimbine. From these results it was inferred that there were three ways in which BP could be increased via raised ICP: inactivation of the inhibitory sympathetic activity through (1) ${\alpha}_{2}-adrenoceptors$, (2) bicuculline-sensitive GABA receptors, (3) yohimbine-sensitive, clonidine-acting GABAergic sites.