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The influence of organophosphorus compound dimethyldichlorovinyl phosphate, agonist of α7n-Acetylcholine receptor GTS-21, and epinephrine on concentration of proinflammatory cytokines in blood and mortality of mice in sepsis

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Abstract

Experiments on outbred albino mice showed that the effects of organophosphorus compound DDVP (dmethyldichlorovinyl phosphate), agonist of α7n-Acetylcholine receptor GTS-21 in a single dose of 0.15 LD50 (5 mg/kg daily for 4 days) and epinephrine in a dose of 0.3 mg/kg (s.c. once daily for 4 days) in 4 h after sepsis modeling (intraperitoneal injexctioo of 24-h B. coli culture 2.5 l0 microbial bodies) significantly reduced the mortality of mice within 4 and 24 h and the blood levels of TNT-cs, 11.-l 9 and IL-6 as compared to the parameters in sepsis without the use of drugs. The DDVP-induced decrease of mortality from sepsis in mice is associated with a decrease in the concentration of blood-α, IL-Iβ and IL-6 and is due both to the implementation of the cholinergic anti-iifflammatory pathways, particularly with the activation of ce7n-Acetylcholine receptors and excitation of the sympathetic nervous system.
ÈÌÌÓÍÎÔÀÐÌÀÊÎËÎÃÈß
ÂËÈßÍÈÅ ÔÎÑÔÎÐÎÐÃÀÍÈ×ÅÑÊÎÃÎ ÑÎÅÄÈÍÅÍÈß
ÄÈÌÅÒÈËÄÈÕËÎÐÂÈÍÈËÔÎÑÔÀÒÀ, ÀÃÎÍÈÑÒÀ
í-ÕÎËÈÍÎÐÅÖÅÏÒÎÐÎÂ GTS-21 È ÀÄÐÅÍÀËÈÍÀ
ÍÀ ÊÎÍÖÅÍÒÐÀÖÈÞ ÏÐÎÂÎÑÏÀËÈÒÅËÜÍÛÕ ÖÈÒÎÊÈÍÎÂ
 ÊÐÎÂÈ È ÂÛÆÈÂÀÅÌÎÑÒÜ ÌÛØÅÉ ÏÐÈ ÑÅÏÑÈÑÅ
Ï. Ô. Çàáðîäñêèé, Â. Â. Ìàñëÿêîâ, Ì. Ñ. Ãðîìîâ1
 ýêñïåðèìåíòå íà íåèíáðåäíûõ áåëûõ ìûøàõ óñòàíîâëåíî, ÷òî ôîñôîðîðãàíè÷å-
ñêîå ñîåäèíåíèå (ÔÎÑ ÄÄÂÔ) â äîçå 0,15 LD50 (âíóòðèìûøå÷íî îäíîêðàòíî, åæå-
äíåâíî, â òå÷åíèå 4 ñóò), àãîíèñò í-õîëèíîðåöåïòîðîâ (GTS-21) â äîçå 5 ìã/êã (ïîäêîæ-
íî, îäíîêðàòíî, åæåäíåâíî, â òå÷åíèå 4 ñóò) è àäðåíàëèí â äîçå 0,3 ìã/êã (îäíîêðàòíî,
ïîäêîæíî, åæåäíåâíî â òå÷åíèå 4 ñóò) ÷åðåç 4 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà (âíóòðè-
áðþøèííîå ââåäåíèå 2,5 ×109ñóòî÷íîé êóëüòóðû ìèêðîáíûõ òåë E. coli ) ñóùåñòâåííî
ñíèæàëè ëåòàëüíîñòü, ïî ñðàâíåíèþ ñ åå óðîâíåì ïðè ñåïñèñå áåç ïðèìåíåíèÿ ïðåïà-
ðàòîâ, ñîîòâåòñòâåííî íà 26; 19,4 è 21,7 % îíòðîëü 36,0 %), à ÷åðåç 24 ÷ íà 30;
23,4 è 27,4 % (êîíòðîëü 90 %), ñîîòâåòñòâåííî (p< 0,05), à òàêæå êîíöåíòðàöèè â
êðîâè ÔÍÎ-a, ÈË-1bè ÈË-6 ïî ñðàâíåíèþ c ïîêàçàòåëÿìè ïðè ñåïñèñå áåç ïðèìåíå-
íèÿ ïðåïàðàòîâ. Ïðè âîçäåéñòâèè ÔÎÑ ñíèæåíèå ëåòàëüíîñòè ìûøåé îò ñåïñèñà ñâÿ-
çàíî ñ óìåíüøåíèåì êîíöåíòðàöèè â êðîâè ÔÍÎ-a, ÈË-1bè ÈË-6 è îáóñëîâëåíî êàê
ðåàëèçàöèåé õîëèíåðãè÷åñêîãî ïðîòèâîâîñïàëèòåëüíîãî ïóòè, â ÷àñòíîñòè, àêòèâà-
öèåé í-õîëèíîðåöåïòîðîâ, òàê è âîçáóæäåíèåì ñèìïàòè÷åñêîé íåðâíîé ñèñòåìû àä-
ðåíîðåöåïòîðîâ.
Êëþ÷åâûå ñëîâà: ôîñôîðîðãàíè÷åñêèå ñîåäèíåíèÿ; àäðåíàëèí; í-õîëèíîðåöåïòîð;
ñåïñèñ; ïðîâîñïàëèòåëüíûå öèòîêèíû; ìûøè.
ÂÂÅÄÅÍÈÅ
Ôîñôîðîðãàíè÷åñêèå ñîåäèíåíèÿ (ÔÎÑ) øèðîêî
ïðèìåíÿþòñÿ â ñåëüñêîì õîçÿéñòâå, ïðîìûøëåííîñòè
è áûòó, ñïîñîáíû âûçûâàòü çàãðÿçíåíèå îêðóæàþùåé
ñðåäû, à òàêæå îñòðûå è õðîíè÷åñêèå èíòîêñèêàöèè.
Ñëåäóåò îòìåòèòü, ÷òî àíòèõîëèíýñòåðàçíûå ïðåïàðà-
òû, èñïîëüçóåìûå â ìåäèöèíå, îáëàäàþò ïðàêòè÷åñêè
òàêîé æå òîêñèêîäèíàìèêîé, êàê ÔÎÑ [3, 7, 13]. Íå èñ-
êëþ÷åíà âîçìîæíîñòü ïðèìåíåíèÿ ÔÎÑ â ëîêàëüíûõ
âîîðóæåííûõ êîíôëèêòàõ, â òåððîðèñòè÷åñêèõ è êðè-
ìèíàëüíûõ öåëÿõ [3, 6]. Îñòðûå è õðîíè÷åñêèå îòðàâ-
ëåíèÿ ÔÎÑ ñíèæàþò ãóìîðàëüíûå è êëåòî÷íûå èì-
ìóííûå ðåàêöèè [3]. Çàñëóæèâàåò âíèìàíèÿ äàëüíåé-
øåå èçó÷åíèå ìåõàíèçìîâ ðåàëèçàöèè óñòàíîâëåííîãî
â 1987 ã. “ïàðàäîêñàëüíîãî ýôôåêòà” ÔÎÑ, ïðè êîòî-
ðîì õîëèíåðãè÷åñêàÿ ñòèìóëÿöèÿ ñóùåñòâåííî ñíèæà-
ëà ëåòàëüíîñòü áåëûõ ìûøåé îò ñåïñèñà [1]. Â ïîñëå-
äóþùåì äîêàçàíà öåëåñîîáðàçíîñòü ïðèìåíåíèÿ õîëè-
íîìèìåòèêîâ äëÿ ýêñòðåííîé àêòèâàöèè íåñïåöèôè÷å-
ñêîé ïðîòèâîìèêðîáíîé ðåçèñòåíòíîñòè îðãàíèçìà)
[2], à âûÿâëåííûé ôåíîìåí [1] è åãî ìåõàíèçìû ñòàëè
íàçûâàòü “õîëèíåðãè÷åñêèì ïðîòèâîâîñïàëèòåëüíûì
ïóòåì” (cholinergic anti-inflammatory pathway) [2, 3,
9, 11, 12].
Õîëèíåðãè÷åñêèé ïðîòèâîâîñïàëèòåëüíûé ïóòü
âêëþ÷àåò: 1) àêòèâàöèþ àöåòèëõîëèíîì ì-õîëèíîðå-
öåïòîðîâ 1 òèïà (m1AChR) ãîëîâíîãî ìîçãà, ìîäóëè-
ðóþùèõ èììóíîðåãóëÿòîðíóþ ôóíêöèþ áëóæäàþøå-
ãî íåðâà; 2) âîçáóæäåíèå ýôôåðåíòíûõ âîëîêîí n.
vagus; 3) äåéñòâèå àöåòèëõîëèíà íà í-õîëèíîðåöåïòî-
ðû (a7nAChR) êëåòîê ìîíîöèòàðíî-ìàêðîôàãàëüíîé
ñèñòåìû ñ ïîñëåäóþùèì èíãèáèðîâàíèåì ïðîäóêöèè
ýòèìè êëåòêàìè ïðîâîñïàëèòåëüíûõ öèòîêèíîâ
ÔÍÎ-a, ÈË-1b, ÈË-6 [3,4, 5, 14, 15]èâðåçóëüòàòå—
ñíèæåíèå âîñïàëåíèÿ è ëåòàëüíîñòè æèâîòíûõ îò ñåï-
ñèñà íà ôîíå àêòèâàöèè ïàðàñèìïàòè÷åñêîé èìïóëüñà-
öèè [1, 2, 3, 8].
Ïðè ðåàëèçàöèè õîëèíåðãè÷åñêîãî ïðîòèâîâîñïà-
ëèòåëüíîãî ïóòè, êðîìå îïèñàííûõ ýôôåêòîâ, ïðîèñ-
õîäèò: à) àêòèâàöèÿ í-õîëèíîðåöåïòîðîâ ìîçãîâîãî âå-
ùåñòâà íàäïî÷å÷íèêîâ è ñèìïàòè÷åñêèõ ãàíãëèåâ, ÷òî
ïðèâîäèò ê ñåêðåöèè àäðåíàëèíà è íîðàäðåíàëèíà, êî-
òîðûå âîçáóæäàþò àäðåíîðåöåïòîðû êëåòîê ìîíîöè-
òàðíî-ìàêðîôàãàëüíîé ñèñòåìû è ñíèæàþò ïðîäóê-
öèþ èìè ïðîâîñïàëèòåëüíûõ öèòîêèíîâ [11]; á) n.
vagus, âûñâîáîæäåíèå àöåòèëõîëèíà â ÷ðåâíîì ãàíã-
Ýêcïåpèìåíòàëüíàÿ è êëèíè÷åcêàÿ ôàpìàêîëîãèÿ 2017 Òîì 80 ¹ 10 Ñ. 25 28
© 2017 Êîëëåêòèâ àâòîðîâ 25
1Ñàðàòîâñêèé ôèëèàë Ñàìàðñêîãî ìåäèöèíñêîãî èíñòèòóòà
“ÐÅÀÂÈÇ”, Ðîññèÿ, 410076, Ñàðàòîâ, Äåãòÿðíàÿ ïëîùàäü,
ä. 1À.
ëèè âûçûâàåò âîçáóæäåíèå íåðâíûõ âîëîêîí ñåëåçåí-
êè, êîòîðûå ñåêðåòèðóþò íîðàäðåíàëèí; â) íîðàäðåíà-
ëèí àêòèâèðóåò àäðåíîðåöåïòîðû Ò-ëèìôîöèòîâ; ã)
Ò-ëèìôîöèòû ïðîäóöèðóþò àöåòèëõîëèí, êîòîðûé àê-
òèâèðóåò a7nAChR êëåòîê ìîíîöèòàðíî-ìàêðîôàãàëü-
íîé ñèñòåìû ñåëåçåíêè è âûçûâàåò ðåäóêöèþ ñèíòåçà
ïðîâîñïàëèòåëüíûõ öèòîêèíîâ [4, 11].
Èñõîäÿ èç èçëîæåííîãî, ïðåäñòàâëÿåò èíòåðåñ èçó-
÷åíèå âîçäåéñòâèÿ èíãèáèòîðîâ àöåòèëõîëèíýñòåðàçû
è àäðåíîìèìåòèêîâ íà âîñïàëåíèå íà ìîäåëè ñåïñèñà
ó æèâîòíûõ ñ îöåíêîé èõ âûæèâàåìîñòè, à òàêæå ïðî-
äóêöèè êëåòêàìè ìîíîöèòàðíî-ìàêðîôàãàëüíîé ñèñ-
òåìû ïðîâîñïàëèòåëüíûõ öèòîêèíîâ.
Öåëü ðàáîòû ñðàâíèòåëüíàÿ îöåíêà âëèÿíèÿ
ÔÎÑ (äèìåòèëäèõëîðâèíèëôîñôàòà; ÄÄÂÔ), àãîíè-
ñòà àëüôà7-íèêîòèíîâûõ àöåòèëõîëèíîâûõ ðåöåïòî-
ðîâ (GTS-21) è àäðåíàëèíà íà ëåòàëüíîñòü ìûøåé è ñî-
äåðæàíèå â èõ êðîâè ïðîâîñïàëèòåëüíûõ öèòîêèíîâ
ÔÍÎ-a, ÈË-1b, ÈË-6 ïðè ýêñïåðèìåíòàëüíîì ñåïñèñå.
ÌÅÒÎÄÛ ÈÑÑËÅÄÎÂÀÍÈß
Ýêñïåðèìåíòû ïðîâîäèëè íà 152 áåñïîðîäíûõ áå-
ëûõ ìûøàõ îáîåãî ïîëà ìàññîé 18 22 ã, ïîëó÷åííûõ
èç ïèòîìíèêà ÐÀÌÍ (ôèëèàë “Ñòîëáîâàÿ” ÃÓ ÍÖÁÌÒ
ÐÀÌÍ), ïîñëå 2-íåäåëüíîãî êàðàíòèíà â âèâàðèè èí-
ñòèòóòà. Æèâîòíûõ ñîäåðæàëè â óñëîâèÿõ âèâàðèÿ â
ñîîòâåòñòâèè ñ ñàíèòàðíûìè íîðìàìè, ïðåäóñìîòðåí-
íûìè “Ïðàâèëàìè ëàáîðàòîðíîé ïðàêòèêè” (ïðèêàç
Ìèíèñòåðñòâà çäðàâîîõðàíåíèÿ è ñîöèàëüíîãî ðàçâè-
òèÿ ÐÔ îò 23 àâãóñòà 2010 ã ¹ 708 í) ïðè ñâîáîäíîì
äîñòóïå ê âîäå è ñáàëàíñèðîâàííîìó ïî ïèòàòåëüíî-
ñòè áðèêåòèðîâàííîìó ãðàíóëèðîâàííîìó êîìáèêîðìó
ôèðìû “ÌÝÑÒ”. Ýêñïåðèìåíòàëüíûå ãðóïïû æèâîò-
íûõ ôîðìèðîâàëè ìåòîäîì ñëó÷àéíîé âûáîðêè ñ ó÷å-
òîì ìàññû òåëà â êà÷åñòâå îïðåäåëÿþùåãî ïîêàçàòåëÿ.
Ìûøè êîíòðîëüíîé ãðóïïû îíòðîëüíàÿ ãðóïïà 1,
n= 7) ïîëó÷àëè ïîäêîæíî èçîòîíè÷åñêèé ðàñòâîð õëî-
ðèäà íàòðèÿ (0,5 ìë) îäíîêðàòíî åæåäíåâíî â òå÷åíèå
4 ñóò, ÷åðåç 2 ÷ ïîñëå ïîñëåäíåé èíúåêöèè âíóòðèáðþ-
øèííî ââîäèëè 2 ìë èçîòîíè÷åñêîãî ðàñòâîðà õëîðèäà
íàòðèÿ. Æèâîòíûì âòîðîé ãðóïïû (êîíòðîëüíàÿ ãðóï-
ïà 2, n= 50) ââîäèëè ïîäêîæíî îäíîêðàòíî èçîòîíè÷å-
ñêèé ðàñòâîð õëîðèäà íàòðèÿ (0,5 ìë), åæåäíåâíî â òå-
÷åíèå 4 ñóò. ×åðåç 2 ÷ ïîñëå ïîñëåäíåãî ââåäåíèÿ äàí-
íîãî ðàñòâîðà ìûøè ïîëó÷àëè âíóòðèáðþøèííî
2,5 ×109ñóòî÷íîé êóëüòóðû ìèêðîáíûõ òåë E. coli
(øòàìì ¹ 675, ïîëó÷åííûé èç Ñàðàòîâñêîãî ÂÈÁÕÁ)
â 2 ìë èçîòîíè÷åñêîãî ðàñòâîðà õëîðèäà íàòðèÿ (ìîäå-
ëèðîâàíèå ñåïñèñà) [1]. Ìûøàì òðåòüåé ãðóïïû
(n= 30) ââîäèëè âíóòðèìûøå÷íî îäíîêðàòíî åæå-
äíåâíî â òå÷åíèå 4 ñóò ÄÄÂÔ (Sigma-Aldrich) â äîçå
0,15 LD50 â îáúåìå 0,5 ìë 0,25 % âîäíîãî ðàñòâîðà äè-
ìåòèëñóëüôîêñèäà ÄÌÑÎ (ÄÄÂÔ ðàñòâîðÿëè â äè-
ìåòèëñóëüôîêñèäå, ãîòîâèëè 0,25 % âîäíûé ðàñòâîð
ÄÌÑÎ, ñîäåðæàùèé òîêñèêàíò). LD50 ÄÄÂÔ ñîñòàâ-
ëÿëà (52,5 ±3,3) ìã/êã. Ìûøè ÷åòâåðòîé ãðóïïû
(n= 30) ïîëó÷àëè àãîíèñò a7nAChR ïðåïàðàò GTS-21
[3-(2,4-dimethoxybenzylidene)anabaseine dihydrochlori-
de] (Sigma-Aldrich) ïîäêîæíî îäíîêðàòíî â äîçå
5 ìã/êã â 0,5 ìë ôèçèîëîãè÷åñêîãî ðàñòâîðà, åæåäíåâ-
íî â òå÷åíèå 4 ñóò, ó÷èòûâàÿ ïåðèîä ïîëóâûâåäåíèÿ
GTS-21, ñîñòàâëÿþùèé 12 24 ÷ [10, 14]. Ìûøè ïÿ-
òîé ãðóïïû (n= 35) ïîëó÷àëè ðàñòâîð àäðåíàëèíà ãèä-
ðîõëîðèäà (Sigma-Aldrich) ïîäêîæíî îäíîêðàòíî â
äîçå 0,3 ìã/êã â 0,5 ìë ôèçèîëîãè÷åñêîãî ðàñòâîðà
åæåäíåâíî â òå÷åíèå 4 ñóò. Ó ìûøåé â ãðóïïàõ 3,4è5
÷åðåç 2 ÷ ïîñëå ïîñëåäíåãî ââåäåíèÿ ïðåïàðàòîâ ìîäå-
ëèðîâàëè ñåïñèñ. Ðåãèñòðàöèþ ëåòàëüíîñòè ìûøåé
(ãðóïïû 2 5) ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà ïðîâîäè-
ëè ÷åðåç4è2.
Êîíöåíòðàöèþ ÔÍÎ-a, ÈË-1bè ÈË-6 èññëåäîâàëè
â ïëàçìå êðîâè ìûøåé âñåõ ãðóïï ìåòîäîì ôåðìåíò-
íîãî èììóíîñîðáåíòíîãî àíàëèçà (ELISA), èñïîëüçóÿ
íàáîðû (ELISA Kits MyBioSoure) â ñîîòâåòñòâèè ñ èí-
ñòðóêöèÿìè èçãîòîâèòåëÿ. Äëÿ îïðåäåëåíèÿ êîíöåí-
òðàöèè ïðîâîñïàëèòåëüíûõ öèòîêèíîâ ïðèìåíÿëè ìî-
íîêëîíàëüíûå àíòèòåëà MyBioSoure (ÔÍÎ-a, ÈË-1b,
ÈË-6). Êðîâü äëÿ èññëåäîâàíèé çàáèðàëè èç ðåòðîîð-
áèòàëüíîãî âåíîçíîãî ñèíóñà â îáúåìå 0,5 ìë ÷åðåç 4 è
24 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà. Ïîëó÷åííûå äàí-
íûå îáðàáàòûâàëè ñòàòèñòè÷åñêè ñ èñïîëüçîâàíèåì
t-êðèòåðèÿ Ñòüþäåíòà. Ïîðîã ñòàòèñòè÷åñêîé çíà÷èìî-
ñòè áûë óñòàíîâëåí íà óðîâíå p= 0,05.
ÐÅÇÓËÜÒÀÒÛ È ÈÕ ÎÁÑÓÆÄÅÍÈÅ
Ïðèìåíåíèå ÔÎÑ (ÄÄÂÔ), GTS-21 è àäðåíàëèíà çà
2 ÷ äî ìîäåëèðîâàíèÿ ñåïñèñà âûçûâàëî óìåíüøåíèå
(p< 0,05) ëåòàëüíîñòè ìûøåé ÷åðåç 4 ÷ ïî ñðàâíåíèþ
ñ êîíòðîëüíîé ãðóïïîé 2 (ñåïñèñ) ñîîòâåòñòâåííî â
3,6; 2,2 è 2,5 ðàç (p< 0,05) (íà 26,0; 19,4 è 21,7 %), à ÷å-
ðåç 24 ÷ â 1,5; 1,3 è 1,4 ðàçà (íà 30,0; 23,4 è 27,4 %)
(p< 0,05), ñîîòâåòñòâåííî (òàáë. 1).
26 Ï. Ô. Çàáðîäñêèé è äð.
Òàáëèöà 1. Âëèÿíèå ïðîôèëàêòè÷åñêîãî ïðèìåíåíèÿ ÄÄÂÔ
0,15 LD50 âíóòðèìûøå÷íî åæåäíåâíî â òå÷åíèå 4 ñóò, GTS-21
5 ìã/êã ïîäêîæíî åæåäíåâíî â òå÷åíèå 4 ñóò è àäðåíàëèíà ãèäðî-
õëîðèäà 0,3 ìã/êã ïîäêîæíî åæåäíåâíî â òå÷åíèå 4 ñóò íà ëåòà-
ëüíîñòü ìûøåé îò ñåïñèñà (̱m)
Ñåðèÿ îïûòîâ
Ëåòàëüíîñòü ìûøåé ïîñëå
ââåäåíèÿ E. coli,%
2
Êîíòðîëüíàÿ ãðóïïà 1 (èíòàêò-
íûå ìûøè n=7)
00
Ñåïñèñ (êîíòðîëüíàÿ ãðóïïà 2,
n=50
36,0 ±6,8 90,0 ±4,2
ÄÄÂÔ + ñåïñèñ (ãðóïïà 3,
n= 30)
10,0 ±5,5* 60,0 ±8,9*
GTS-21 + ñåïñèñ (ãðóïïà 4,
n= 30)
16,6 ±6,9* 66,6 ±8,6*
Àäðåíàëèí + ñåïñèñ (ãðóïïà 5,
n= 35)
14,3 ±5,9* 62,6 ±8,2*
*p< 0,05 ïî ñðàâíåíèþ ñ êîíòðîëåì.
Ïðè èñïîëüçîâàíèè ÔÎÑ, àãîíèñòà a7nAChR
(GTS-21) è àäðåíàëèíà ÷åðåç 2 ÷ ïîñëå ìîäåëèðîâàíèÿ
ñåïñèñà (ãðóïïû 3, 4, 5) ñóùåñòâåííàÿ ðàçíèöà â ëå-
òàëüíîñòè ìûøåé îòñóòñòâîâàëà. Ýòî ïîçâîëÿò ïîëà-
ãàòü, ÷òî ïðè äåéñòâèè ÔÎÑ àöåòèëõîëèí àêòèâèðóåò
a7nAChR êëåòîê ìîíîöèòàðíî-ìàêðîôàãàëüíîé ñèñ-
òåìû ïðèáëèçèòåëüíî â òàêîé æå ñòåïåíè, êàê è àãî-
íèñò ýòèõ ðåöåïòîðîâ ïðåïàðàò GTS-21. Ýôôåêò àäðå-
íàëèíà îáóñëîâëåí âîçáóæäåíèåì àäðåíîðåöåïòîðîâ
ìàêðîôàãîâ è ìîíîöèòîâ (äåéñòâèå àöåòèëõîëèíà íà
í-õîëèíîðåöåïòîðû ìîçãîâîãî âåùåñòâà íàäïî÷å÷íè-
êîâ) [3, 4, 9].
Ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà (êîíòðîëüíàÿ ãðóïïà
2) â êðîâè ìûøåé ÷åðåç 4 ÷ ñóùåñòâåííî óâåëè÷èâà-
ëîñü ñîäåðæàíèå öèòîêèíîâ ÔÍÎ-a, ÈË-1bè ÈË-6 ïî
ñðàâíåíèþ ñ êîíòðîëüíîé ãðóïïîé 1 (èíòàêòíûå æè-
âîòíûå), ñîîòâåòñòâåííî, â 19,9; 21,8 è 68,5 ðàçà
(p< 0,05), ÷åðåç 24 ÷ êîíöåíòðàöèÿ äàííûõ öèòîêèíîâ
â êðîâè çíà÷èòåëüíî ñíèæàëàñü, òåì íå ìåíåå ïðåâû-
øàÿ ïàðàìåòðû ãðóïïû 1 â 1,6 (p > 0,05), 4,7 è 8,6 ðàçà
(p< 0,05), ñîîòâåòñòâåííî (òàáë. 2).
Ââåäåíèå ìûøàì ÔÎÑ (ÄÄÂÔ) ñíèæàëî ÷åðåç 4 ÷
ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà (ãðóïïà 3) êîíöåíòðà-
öèè â êðîâè ÔÍÎ-a, ÈË-1bè ÈË-6, ïî ñðàâíåíèþ c
ïîêàçàòåëÿìè êîíòðîëüíîé ãðóïïû 2 (ñåïñèñ áåç ïðè-
ìåíåíèÿ ïðåïàðàòîâ) ñîîòâåòñòâåííî â 2,8; 2,1 è 6,5
ðàçà (p< 0,05). Ïðè ýòîì ñîäåðæàíèå ïðîâîñïàëèòåëü-
íûõ öèòîêèíîâ â êðîâè äîñòîâåðíî (p< 0,05) ïðåâû-
øàëî ñîîòâåòñòâóþùèå ïîêàçàòåëè êîíòðîëüíîé ãðóï-
ïû 1. ×åðåç 24 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà ñîäåð-
æàíèå ÔÍÎ-a, ÈË-1bè ÈË-6 óìåíüøàëîñü ïî ñðàâíå-
íèþ ñ äàííûìè ïàðàìåòðàìè ÷åðåç 4 ÷, îñòàâàÿñü
íèæå çíà÷åíèé ãðóïïû 2 â 1,4 (p > 0,05), 2,3 è 2,5 ðàçà
(p< 0,05), ñîîòâåòñòâåííî.
Êîíöåíòðàöèè ÔÍÎ-a, ÈË-1bè ÈË-6 â êðîâè ìû-
øåé ïðè ïðèìåíåíèè àãîíèñòà a7nAChR GTS-21 ÷å-
ðåç 4 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà (ãðóïïà 4) ñíè-
æàëèñü ïî ñðàâíåíèþ ñ ïàðàìåòðàìè êîíòðîëüíîé
ãðóïïû 2 ñîîòâåòñòâåííî â 3,6; 2,5 è 8,4 ðàçà (p< 0,05).
Âûÿâëåíî óìåíüøåíèå ñîäåðæàíèÿ â êðîâè ïðîâîñïà-
ëèòåëüíûõ öèòîêèíîâ ÷åðåç 24 ÷ ïîñëå ìîäåëèðîâàíèÿ
ñåïñèñà ïî ñðàâíåíèþ ñ ñîîòâåòñòâóþùèìè çíà÷åíèÿ-
ìè ÷åðåç 4 ÷, ïðè ýòîì êîíöåíòðàöèè ÔÍÎ-a, ÈË-1bè
ÈË-6 îñòàâàëèñü íèæå ïîêàçàòåëåé ãðóïïû 2 ñîîòâåò-
ñòâåííî â 1,7; 2,2 è 2,9 ðàçà (p< 0,05).
Ïðè èñïîëüçîâàíèè ÄÄÂÔ è àãîíèñòà a7nAChR
(GTS-21) ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà (ãðóïïû3è4)
ñóùåñòâåííîé ðàçíèöû èññëåäîâàííûõ ïàðàìåòðîâ â
êðîâè ìûøåé âûÿâëåíî íå áûëî.
Ïðè âîçäåéñòâèè àäðåíàëèíà êîíöåíòðàöèè
ÔÍÎ-a,ÈË-1bèÈË-6 â êðîâè ìûøåé ÷åðåç4÷ïîñëå
ìîäåëèðîâàíèÿ ñåïñèñà (ãðóïïà 5) óìåíüøàëèñü ïî
ñðàâíåíèþ ñ ïîêàçàòåëÿìè êîíòðîëüíîé ãðóïïû 2
(ñåïñèñ) ñîîòâåòñòâåííî â 3,9; 2,9 è 8,0 ðàç (p< 0,05).
×åðåç 24 ÷ ñîäåðæàíèå â êðîâè äàííûõ öèòîêèíîâ
ñóùåñòâåííî ñíèæàëîñü ïî ñðàâíåíèþ ñî çíà÷åíèÿìè
÷åðåç 4 ÷, à ïî ñðàâíåíèþ ñ ñîîòâåòñòâóþùèì ïàðà-
ìåòðîì ãðóïïû 2 êîíöåíòðàöèÿ ÔÍÎ-aäîñòîâåðíî íå
îòëè÷àëàñü. Îòìå÷àëîñü ñíèæåíèå ÈË-1bè ÈË-6 â
ãðóïïå 5 ïî ñðàâíåíèþ ñ äàííûìè ïîêàçàòåëÿìè â
ãðóïïå 2 ñîîòâåòñòâåííî â 2,9 è 3,2 ðàçà (p< 0,05). Ñî-
äåðæàíèå ïðîâîñïàëèòåëüíûõ öèòîêèíîâ â ãðóïïàõ 3,
4 è 5 áûëî ñòàòèñòè÷åñêè çíà÷èìî (p< 0,05) ìåíüøå
ñîîòâåòñòâóþùèõ çíà÷åíèé êîíòðîëüíîé ãðóïïû 1.
Óðîâíè ÔÍÎ-a, ÈË-1bè ÈË-6 ïðè ââåäåíèè ÔÎÑ
(ÄÄÂÔ), àãîíèñòà a7nAChR (GTS-21) è àäðåíàëèíà
ïðè ìîäåëèðîâàíèè ñåïñèñà (ãðóïïû 3, 4, 5) ñíèæà-
ëèñü ïðèáëèçèòåëüíî â ðàâíîé ñòåïåíè, ïî ñðàâíåíèþ
ñ èõ çíà÷åíèÿìè ïðè ñåïñèñå áåç ïðèìåíåíèÿ ïðåïàðà-
òîâ (ãðóïïà 2).
Ïðè âîçäåéñòâèè ÔÎÑ, êàê óæå óïîìèíàëîñü,
âñëåäñòâèå âîçäåéñòâèÿ àöåòèëõîëèíà íà í-õîëèíîðå-
öåïòîðû, íàäïî÷å÷íèêè è ýôôåðåíòíûå âîëîêíà ñèì-
ïàòè÷åñêîé íåðâíîé ñèñòåìû ïðîäóöèðóþò àäðåíàëèí
è íîðàäðåíàëèí [3, 4]. Àêòèâàöèÿ áëóæäàþùåãî íåðâà
âûçûâàåò ñèíòåç àöåòèëõîëèíà â ÷ðåâíîì ãàíãëèè, âîç-
áóæäàÿ ñåëåçåíî÷íûé íåðâ, ýôôåðåíòíûå âîëîêíà êî-
òîðîãî â ñåëåçåíêå âûäåëÿþò íîðàäðåíàëèí, äåéñò-
âóþùèé íà Ò-ëèìôîöèòû. Ýòè êëåòêè ïðîäóöèðóþò
àöåòèëõîëèí [9]. Ïðîèñõîäèò àêòèâàöèÿ ýòèì ìåäèàòî-
Âëèÿíèå ôîñôîðîðãàíè÷åñêîãî ñîåäèíåíèÿ 27
Òàáëèöà 2. Âëèÿíèå ïðîôèëàêòè÷åñêîãî ââåäåíèÿ ÄÄÂÔ 0,15 LD50 âíóòðèìûøå÷íî åæåäíåâíî â òå÷åíèå 4 ñóò, GTS-21 5 ìã/êã ïîä-
êîæíî åæåäíåâíî â òå÷åíèå 4 ñóò è àäðåíàëèíà 0,3 ìã/êã ïîäêîæíî åæåäíåâíî â òå÷åíèå 4 ñóò íà êîíöåíòðàöèþ ïðîâîñïàëèòåëüíûõ
öèòîêèíîâ â êðîâè ìûøåé ÷åðåç4è24÷ïîñëåìîäåëèðîâàíèÿ ñåïñèñà, ïã/ìë (̱m)
Ñåðèÿ îïûòîâ
ÔÍÎ-aÈË-1bÈË-6
2 2 2
Êîíòðîëüíàÿ ãðóïïà 1 29 ±5 (7) 31 ±6 (7) 20 ±4 (7) 24 ±5 (7) 27 ±6 (7) 22 ±4 (7)
Ñåïñèñ (êîíòðîëüíàÿ ãðóïïà 2) 577 ±79a(7) 49 ±7ñ(5) 435 ±60a(7) 112 ±19 (5) 1850 ±220a
(7)
190 ±32 (5)
ÄÄÂÔ + ñåïñèñ (ãðóïïà 3) 205 ±27ab (7) 35 ±5ñ(6) 205 ±26ab (7) 48 ±6abñ (6) 283 ±35ab (7) 77 ±8abñ (6)
GTS-21 + ñåïñèñ (ãðóïïà 4) 159 ±21ab (7) 29 ±5 (7) 174 ±18ab (7) 51 ±7abñ (7) 220 ±27ab (6) 65 ±9abñ (7)
Àäðåíàëèí + ñåïñèñ (ãðóïïà 5) 148 ±20ab (6) 44 ±6ñ(7) 150 ±28ab (7) 38 ±6abñ (7) 232 ±27ab (6) 60 ±10abñ (7)
Ïðèìå÷àíèå:4è24÷—âðåìÿ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà; â ñêîáêàõ ÷èñëî æèâîòíûõ; ap< 0,05 ïî ñðàâíåíèþ ñ êîíòðîëåì (ãðóïïà 1);
bp< 0,05 ïî ñðàâíåíèþ ñ ñîîòâåòñòâóþùèì ïàðàìåòðîì ïðè ñåïñèñå (êîíòðîëüíîé ãðóïïû 2); ñp< 0,05 ïî ñðàâíåíèþ ñ àíàëîãè÷íûì ïîêàçàòåëåì
÷åðåç 4 ÷.
ðîì a7nAChR êëåòîê ìîíîöèòàðíî-ìàêðîôàãàëüíîé
ñèñòåìû ñåëåçåíêè è ðåäóêöèÿ ñèíòåçà ïðîâîñïàëè-
òåëüíûõ öèòîêèíîâ. Äàííûå ëèòåðàòóðû ïîçâîëÿþò
ïîëàãàòü, ÷òî äåéñòâèå àäðåíàëèíà è íîðàäðåíàëèíà
íà ìàêðîôàãè è ìîíîöèòû âûçûâàåò àíàëîãè÷íûé ýô-
ôåêò [4, 11].
Òàêèì îáðàçîì, ñíèæåíèå ëåòàëüíîñòè ìûøåé îò
ñåïñèñà è óìåíüøåíèå êîíöåíòðàöèè â êðîâè ïðîâîñ-
ïàëèòåëüíûõ öèòîêèíîâ ïðè âîçäåéñòâèè ÔÎÑ îáó-
ñëîâëåíî êàê ðåàëèçàöèåé õîëèíåðãè÷åñêîãî ïðîòèâî-
âîñïàëèòåëüíîãî ïóòè, â ÷àñòíîñòè, àêòèâàöèåé
a7nAChR êëåòîê ìîíîöèòàðíî-ìàêðîôàãàëüíîé ñèñ-
òåìû [1, 3, 10, 11], òàê è ñâÿçàííûì ñ ýòèì ïóòåì (åãî
çâåíüÿìè) âîçáóæäåíèåì ñèìïàòè÷åñêîé íåðâíîé ñèñ-
òåìû è äåéñòâèåì àäðåíàëèíà è íîðàäðåíàëèíà íà àä-
ðåíîðåöåïòîðû ìàêðîôàãîâ è ìîíîöèòîâ [4, 9].
Èíãèáèòîðû àöåòèëõîëèíýñòåðàçû, í-õîëèíîìèìå-
òèêè è àäðåíîìèìåòèêè ìîãóò ðàññìàòðèâàòüñÿ êàê
ïåðñïåêòèâíûå ïðåïàðàòû, íàðÿäó ñ äðóãèìè ëåêàðñò-
âåííûìè ñðåäñòâàìè, äëÿ òåðàïèè ñåïòè÷åñêèõ ñî-
ñòîÿíèé, âîñïàëèòåëüíûõ çàáîëåâàíèé êèøå÷íèêà è
äðóãèõ èíôåêöèîííûõ çàáîëåâàíèé [2, 3, 4, 11, 14].
ÂÛÂÎÄÛ
1. Ïðîôèëàêòè÷åñêîå ââåäåíèå ÄÄÂÔ â äîçå 0,15
LD50 (âíóòðèìûøå÷íî îäíîêðàòíî åæåäíåâíî â òå÷å-
íèå 4 ñóò), àãîíèñòà í-õîëèíîðåöåïòîðîâ (GTS-21) â
äîçå 5 ìã/êã (ïîäêîæíî îäíîêðàòíî åæåäíåâíî â òå÷å-
íèå 4 ñóò) è àäðåíàëèíà ãèäðîõëîðèäà â äîçå 0,3 ìã/êã
(ïîäêîæíî îäíîêðàòíî åæåäíåâíî â òå÷åíèå 4 ñóò) ÷å-
ðåç 4 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà ñóùåñòâåííî
ñíèæàëî ëåòàëüíîñòü ìûøåé ïî ñðàâíåíèþ ñ óðîâíåì
ëåòàëüíîñòè ïðè ñåïñèñå áåç ïðèìåíåíèÿ ïðåïàðàòîâ,
ñîîòâåòñòâåííî, íà 26,0; 19,4 è 21,7 % (êîíòðîëü
36,0 %), à ÷åðåç 24 ÷ íà 30,0; 23,4 è 27,4 % (êîí-
òðîëü 90,0 %) ñîîòâåòñòâåííî (p< 0,05).
2. Ïðîôèëàêòè÷åñêîå ââåäåíèå ìûøàì ÄÄÂÔ, àãî-
íèñòà í-õîëèíîðåöåïòîðîâ GTS-21 è àäðåíàëèíà ÷åðåç
4 ÷ ïîñëå ìîäåëèðîâàíèÿ ñåïñèñà óìåíüøàëî êîíöåí-
òðàöèþ â êðîâè ÔÍÎ-a, ÈË-1bè ÈË-6, ïî ñðàâíåíèþ
ñ ïîêàçàòåëÿìè ïðè ñåïñèñå áåç ïðèìåíåíèÿ ïðåïàðà-
òîâ â 3,6; 2,5 è 8,4 ðàçà, à ÷åðåç 24 ÷, ñîîòâåòñòâåííî,
â 1,7; 2,2 è 2,9 ðàçà (p< 0,05).
3. Ïðè âîçäåéñòâèè ÔÎÑ ñíèæåíèå ëåòàëüíîñòè
ìûøåé îò ñåïñèñà, ïî-âèäèìîìó, ñâÿçàíî ñ óìåíüøå-
íèåì êîíöåíòðàöèè â êðîâè ÔÍÎ-a, ÈË-1bè ÈË-6 è
îáóñëîâëåíî êàê ðåàëèçàöèåé õîëèíåðãè÷åñêîãî ïðî-
òèâîâîñïàëèòåëüíîãî ïóòè, â ÷àñòíîñòè, àêòèâàöèåé
í-õîëèíîðåöåïòîðîâ, òàê è âîçáóæäåíèåì ñèìïàòè÷å-
ñêîé íåðâíîé ñèñòåìû.
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Ïîñòóïèëà 30.01.17
THE INFLUENCE OF ORGANOPHOSPHORUS COMPOUND DIMETHYLDICHLOROVINYL
PHOSPHATE (AGONIST OF a7n-ACETYLCHOLINE RECEPTOR GTS-21)
AND EPINEPHRINE ON CONCENTRATION OF PROINFLAMMATORY CYTOKINES
IN BLOOD AND MORTALITY OF MICE IN SEPSIS
P. F. Zabrodskii, V. V. Maslyakov, and M. S. Gromov
Saratov Branch of the Medical Institute “REAVIZ” (Samara), Degtyarnaya ploshchad 1A, Saratov, 410076 Russia
Experiments on outbred albino mice showed that the effects of organophosphorus compound DDVP (dmethyldichlorovinyl phosphate, agonist of a7n-acetylc-
holine receptors GTS-21) in a single dose of 0.15 LD50 (5 mg/kg daily for 4 days) and epinephrine in a dose of 0.3 mg/kg (s.c. once daily for 4 days) in 4 h after
sepsis modeling (intraperitoneal injexction of 24-h E. coli culture 2.5 ×109microbial bodies) significantly reduced the mortality of mice within 4 and 24 h and
the blood levels of TNF-a, IL-1band IL-6 as compared to the parameters in sepsis without the use of drugs. The DDVP-induced decrease of mortality from
sepsis in mice is associated with a decrease in the concentration of blood TNF-a, IL-1band IL-6 and is due both to the implementation of the cholinergic an-
ti-inflammatory pathways, particularly with the activation of a7n-acetylcholine receptors and excitation of the sympathetic nervous system.
Keywords: organophosphorus compounds; epinephrine; a7n-acetylcholine receptor; sepsis; proinflammatory cytokines; sepsis; mice.
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This review outlines the mechanisms underlying the interaction between the nervous and immune systems of the host in response to an immune challenge. The main focus is the cholinergic anti-inflammatory pathway, which we recently described as a novel function of the efferent vagus nerve. This pathway plays a critical role in controlling the inflammatory response through interaction with peripheral a7 subunit-containing nicotinic acetylcholine receptors expressed on macrophages. We describe the modulation of systemic and local inflammation by the cholinergic anti-inflammatory pathway and its function as an interface between the brain and the immune system. The clinical implications of this novel mechanism also are discussed.
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