Tao Q F, Hollenberg N K, Graves S W
Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Hypertension. 1999 Nov;34(5):1168-74. doi: 10.1161/01.hyp.34.5.1168.
Both hypertension and cataract formation have been associated with reductions in sodium pump activity, possibly as a result of an endogenous inhibitor. The objective of the present study was to answer 4 closely related questions: (1) Is the lens sodium pump effectively inhibited by a labile, digitalis-like factor we have identified in the peritoneal dialysate from hypertensive patients in end-stage renal failure? (2) How does that inhibition compare to that induced by ouabain? (3) Does sodium pump isoform distribution determine the degree of lens sodium pump inhibition? (This question was precipitated by the unanticipated finding that the labile DLF was more effective in inhibiting lens sodium pump than was anticipated.) (4) Is sodium pump activity altered in lens in response to increased salt intake, a maneuver known to increase endogenous digitalis-like factor? We found that whereas ouabain produced equivalent or significantly less inhibition of lens Na(+), K(+)-ATPase from calf or rabbit, respectively, compared with brain, labile digitalis-like factor preferentially inhibited lens compared with brain. Analysis of whole-lens preparations from rabbit, calf, and normal human lens revealed substantial alpha2- and alpha3-isoforms of the sodium pump but little alpha1-isoform. Ouabain inhibition of whole-lens Na(+),K(+)-ATPase from rabbit and calf were comparable: for rabbit lens, K(i)=5.2x10(-7) mol/L; for calf lens, K(i)=1.0x10(-6) mol/L. Limited quantities of labile digitalis-like factor prohibited similar determinations; however, its concentration-activity profile paralleled that of ouabain. Na(+), K(+)-ATPase activity, measured in the 3 major anatomic regions of lens and normalized to nucleus, was greatest in epithelium (56. 9+/-17.9) compared with cortex (5.8+/-1.4) and nucleus (1.0+/-0.0; P=0.01). Immunohistochemistry of rabbit lens found abundant alpha2- and alpha3-isoforms in epithelium and limited alpha3 but undetectable alpha1 in cortex and nucleus. Finally, rats randomized to a high Na diet showed significantly reduced lens Na(+), K(+)-ATPase activity compared with those on a low Na diet, consistent with the effects of a sodium pump inhibitor. In conclusion, the present study suggests that digitalis-like factor may provide a link between hypertension and cataract formation.
高血压和白内障的形成都与钠泵活性降低有关,这可能是内源性抑制剂作用的结果。本研究的目的是回答4个密切相关的问题:(1)我们在终末期肾衰竭高血压患者的腹膜透析液中发现的一种不稳定的、类洋地黄因子是否能有效抑制晶状体钠泵?(2)这种抑制作用与哇巴因诱导的抑制作用相比如何?(3)钠泵同工型分布是否决定晶状体钠泵的抑制程度?(这个问题是由一个意外发现引发的,即不稳定的类洋地黄因子对晶状体钠泵的抑制作用比预期的更强。)(4)盐摄入量增加(一种已知会增加内源性类洋地黄因子的操作)是否会改变晶状体中的钠泵活性?我们发现,与脑相比,哇巴因分别对小牛或兔子晶状体Na⁺,K⁺-ATP酶的抑制作用相当或明显较弱,而不稳定的类洋地黄因子与脑相比则优先抑制晶状体。对兔子、小牛和正常人晶状体的全晶状体标本分析显示,钠泵有大量的α2和α3同工型,但α1同工型很少。哇巴因对兔子和小牛全晶状体Na⁺,K⁺-ATP酶的抑制作用相当:兔子晶状体的Ki = 5.2×10⁻⁷mol/L;小牛晶状体的Ki = 1.0×10⁻⁶mol/L。不稳定的类洋地黄因子数量有限,无法进行类似的测定;然而,其浓度-活性曲线与哇巴因相似。在晶状体的3个主要解剖区域测量并以细胞核为标准归一化后的Na⁺,K⁺-ATP酶活性,在上皮细胞中最高(56.9±17.9),而皮质(5.8±1.4)和细胞核(1.0±0.0;P = 0.01)中较低。对兔子晶状体的免疫组织化学分析发现,上皮细胞中有丰富的α2和α3同工型,皮质和细胞核中有有限的α3同工型,但未检测到α1同工型。最后,随机分配到高钠饮食组的大鼠与低钠饮食组相比,晶状体Na⁺,K⁺-ATP酶活性显著降低,这与钠泵抑制剂的作用一致。总之,本研究表明类洋地黄因子可能在高血压和白内障形成之间提供了一种联系。