Kakoki M, Hirata Y, Hayakawa H, Suzuki E, Nagata D, Nishimatsu H, Kimura K, Goto A, Omata M
Department of Internal Medicine, University of Tokyo, Japan.
Hypertens Res. 2000 Sep;23(5):527-33. doi: 10.1291/hypres.23.527.
Ischemic acute renal failure is associated with vascular endothelial dysfunction. We examined whether vasodilatory antihypertensive agents would improve endothelial function in rats with ischemia/reperfusion renal injury. Rat kidneys were isolated and perfused after clipping of the bilateral renal arteries for 45 min and reperfusion for 24 h, and renal perfusion pressure and nitric oxide concentration in the venous effluent (chemiluminescence assay) were monitored. Preischemic administration of celiprolol (a beta-blocker; 100 mg/kg p.o.), benidipine (a calcium channel blocker; 1 mg/kg p.o.), or imidapril (an angiotensin converting-enzyme inhibitor; 3 mg/kg p.o.) restored endothelial function in rats subjected to acute renal ischemia (deltarenal perfusion pressure [10(-8) M acetylcholine]: sham -42+/-3%, ischemia -31+/-1%, ischemia +celiprolol -39+/-1%, ischemia+benidipine -38+/-2%, ischemia+imidapril -42+/-2%*; *p<0.05 vs. ischemia). Serum urea nitrogen and creatinine levels were also lower in the treated groups. Furthermore, ischemia-induced decreases in the response to acetylcholine and renal excretory function were smaller in SHR than in deoxycorticosterone-salt hypertensive rats, in which endothelial damage was marked. These results suggest that preischemic endothelial function may influence the degree of ischemic renal injury. Calcium channel blockers, converting-enzyme inhibitors, and endothelial NO synthase-activating beta-blockers had beneficial effects on renovascular endothelial dysfunction due to ischemia.
缺血性急性肾衰竭与血管内皮功能障碍有关。我们研究了血管舒张性抗高血压药物是否能改善缺血/再灌注肾损伤大鼠的内皮功能。分离大鼠肾脏,夹闭双侧肾动脉45分钟后再灌注24小时,然后进行灌注,并监测肾灌注压和静脉流出液中的一氧化氮浓度(化学发光法)。缺血前给予塞利洛尔(一种β受体阻滞剂;口服100mg/kg)、贝尼地平(一种钙通道阻滞剂;口服1mg/kg)或咪达普利(一种血管紧张素转换酶抑制剂;口服3mg/kg)可恢复急性肾缺血大鼠的内皮功能(肾灌注压变化[10(-8)M乙酰胆碱]:假手术组-42±3%,缺血组-31±1%,缺血+塞利洛尔组-39±1%,缺血+贝尼地平组-38±2%,缺血+咪达普利组-42±2%*;*与缺血组相比,p<0.05)。治疗组的血清尿素氮和肌酐水平也较低。此外,与内皮损伤明显的脱氧皮质酮-盐高血压大鼠相比,自发性高血压大鼠缺血诱导的对乙酰胆碱反应和肾排泄功能的降低较小。这些结果表明,缺血前内皮功能可能影响缺血性肾损伤的程度。钙通道阻滞剂、转换酶抑制剂和激活内皮型一氧化氮合酶的β受体阻滞剂对缺血所致的肾血管内皮功能障碍有有益作用。