実験的Triamcinolone myopathyの組織学的・組織化学的所見

SOME FEATURES OF HISTOLOGICAL AND HISTOCHEMICAL OBSERVATIONS UPON EXPERIMENTAL TRIAMCINOLONE MYOPATHY OF RABBIT

I．はじめに

　muscle weaknessがfludro-cortisoneの副作用のうち注目すべきもののひとつであることは1959年Heberden Medical Association^1）において報告されて以来衆知の事実となつている。その臨床例についてはWilliams^2）（1959），McLean^3）（1959），　Perkoff^4）（1960）らにより，また本邦では里吉^5）らにより報告されているがそのgenesisに関しては種々論議のあるところで，いずれも明確な説明にとぼしい。

　副腎皮質ホルモンの筋組織代謝におよぼす影響に関する基礎的データはきわめて数が少なく，また組織変化の所見も，コーチゾン大量投与による家免骨格筋組織に関するEllis^6）の報告が実験面で見あたるにすぎない。しかしこれも形態的変化にかぎられており，組織化学的所見の報告はない。いずれにしても本剤の作用機序が多角的かつ有機的である点よりそのgenesisを追及するには広範な精査を必要とすることは当然であるが，その一端を知る上で組織化学的に検査することも意味のあることと考えられる。

Some finding upon the experimental Triamcinolone myopathy of rabbits were reported histologically and hystochemically.

The experimental animals were treated with intra-muscular injection of Triamcinolone (Kenacort-A-Sankyo) at the rate of 5 mg/kg daily.

Among the histological changes, the fat tissue infilt-ration into the connective tissue were notable, but the cellular infiltration and phagocytosis were not so remarkable as Ellis' Cortison treated rabbits muscle. It is not obvious, however, whether histological dif-ferences between this experiment and Ellis' Cortison treated rabbit muscle are owing to the structural specificity of Triamcinolone having F atom at 9-α in its molecule.

The histochemical findings were 1) the decrease of glycogen showing simultaneous decreasing tendency to phosphorylase activity in the muscle fibre, 2) mar-ked decrease of ATP-ase activity on sarcolemma and slight decrease on sarcoplasma exhibbiting very abberant staining feature, 3) increase of Alk. phos-phatase activity in capilaries and infiltrating cells without any changes on ground substances of connective tissue and muscle fibre itself, and 4) slight reduction of Succinic dehydrogenase activity.

The histochemical findings mentioned above were not necessarily consistent with the atrophy of fibre, therefore these changes may be concerned to muscle weakness rather than wasting of muscle. Concerning to muscle atrophy the other factors must be taken into consideration. Regarding to the interstitial tissue, it was affected at earlier stage than the affection of muscle fibre itself, showing such a change as increas-ing of PAS reaction and ATP-ase activity simul-taneously and / or fat tissue infiltration, therefore, the changes of interstitial tissue were considered to have very significant meaning in the Triamcinolone myopathy.