[The role of desensitization of glucocorticoid receptors in the development of vascular resistance to endogenous vasoconstrictors in traumatic shock].

The fact that the activity of cytosol glucocorticoid receptors decreases in shock have been shown before [Golikov P. P. et al., 2001]. The connection between the development of vascular hyporeactivity to endogenous vasoconstrictors and desensitization of glucocorticoid receptors was studied in this investigation. On Kenton traumatic model in a rat experiment, it was shown that the strength of the isometric constriction of the isolated aorta in response to angiotensin II, endothelin-1, phenylephrine, noradrenaline, and vasopressin falls on the second day after a severe mechanical injury (3.3, 2.1, 1.7, 1.6, and 1.5 times, respectively; p < 0.01). On the contrary, the strength of the constriction in response to serotonin increases more then twice. Artificial desensitization of glucocorticoid receptors by long-term administration of dexamethasone (3 mg per kg during five days) results in similar changes of vascular reactivity i.e. a 2.5, 2, 7, and 1.4-fold decrease in the strength of aortal constriction in response to angiotensin II, vasopressin, and endothelin-1, respectively. The strength of the constriction in response to serotonin tended to increase as well. Carbahol-induced relaxation of the aorta pre-constricted with noradrenaline did not change compared with control, being 70 to 80%, both in shock and after desensitization of glucocorticoid receptors with dexamethasone. Presumably, the pathogenetic mechanism of pressor reaction suppression, connected with a decrease in cytosol glucocorticoid receptor activity and thus with inhibition of glucocorticoid-induced expression of the membrane receptors of endogenous vasoconstrictors, is realized in traumatic shock together with other mechanisms.