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T型选择性钙拮抗剂对肾微循环的影响:在离体灌注肾积水肾脏中的研究

Effect of T-type selective calcium antagonist on renal microcirculation: studies in the isolated perfused hydronephrotic kidney.

作者信息

Ozawa Y, Hayashi K, Nagahama T, Fujiwara K, Saruta T

机构信息

Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Hypertension. 2001 Sep;38(3):343-7. doi: 10.1161/01.hyp.38.3.343.

Abstract

Although calcium antagonists exert preferential vasodilation of renal afferent arterioles, we have recently demonstrated that nilvadipine and efonidipine, possessing both L-type and T-type calcium channel blocking action, reverse the angiotensin (Ang) II-induced afferent and efferent arteriolar constriction. In the present study, we investigated the role of T-type calcium channels in mediating the Ang II-induced efferent arteriolar tone using the selective T-type calcium channel blocker mibefradil. Isolated perfused hydronephrotic rat kidneys were used for direct visualization of renal microcirculation. Administration of Ang II (0.3 nmol/L) caused marked constriction of afferent (from 13.5+/-0.6 to 9.2+/-0.6 microm, P<0.01, n=6) and efferent (from 11.5+/-1.0 to 7.4+/-0.7 microm, P<0.01, n=5) arterioles. Mibefradil (1 micromol/L) dilated both vessels, with 82+/-11% and 72+/-7% reversal of afferent and efferent arterioles, respectively. Similarly, nickel chloride (100 micromol/L) caused dilation of both arterioles, similar in magnitude in afferent (68+/-10%, n=7) and efferent (80+/-7%, n=7) arterioles. To eliminate the possibility that the mibefradil-induced dilation was mediated by L-type channel blockade, mibefradil was administered in the presence of nifedipine (1 micromol/L). Thus, nifedipine caused modest efferent arteriolar dilation (30+/-6% reversal, n=9), and subsequent addition of mibefradil elicited further dilation of this vessel (80+/-4%, P<0.01 versus nifedipine). Furthermore, mibefradil reversed the Ang II-induced efferent arteriolar constriction even in the presence of nifedipine and phentolamine. These findings demonstrate that T-type calcium antagonists markedly dilate the Ang II-induced efferent arteriolar constriction, but the action is not mediated by inhibition of catecholamine release. This potent activity would contribute to the efferent arteriolar response to nilvadipine and efonidipine and may offer benefit in light of glomerular hemodynamics.

摘要

尽管钙拮抗剂可优先使肾入球小动脉血管舒张,但我们最近证实,兼具L型和T型钙通道阻滞作用的尼伐地平与依福地平可逆转血管紧张素(Ang)II诱导的入球和出球小动脉收缩。在本研究中,我们使用选择性T型钙通道阻滞剂米贝地尔,研究了T型钙通道在介导Ang II诱导的出球小动脉张力中的作用。采用分离灌注的肾积水大鼠肾脏直接观察肾微循环。给予Ang II(0.3 nmol/L)可导致入球小动脉(从13.5±0.6微米缩窄至9.2±0.6微米,P<0.01,n=6)和出球小动脉(从11.5±1.0微米缩窄至7.4±0.7微米,P<0.01,n=5)显著收缩。米贝地尔(1 μmol/L)可使两种血管舒张,入球和出球小动脉的舒张程度分别为82±11%和72±7%。同样,氯化镍(100 μmol/L)可使两种小动脉舒张,入球小动脉(68±10%,n=7)和出球小动脉(80±7%,n=7)的舒张幅度相似。为排除米贝地尔诱导的舒张是由L型通道阻滞介导的可能性,在硝苯地平(1 μmol/L)存在的情况下给予米贝地尔。因此,硝苯地平可使出球小动脉适度舒张(舒张30±6%,n=9),随后加入米贝地尔可使该血管进一步舒张(80±4%,与硝苯地平相比P<0.01)。此外,即使在硝苯地平和酚妥拉明存在的情况下,米贝地尔也可逆转Ang II诱导的出球小动脉收缩。这些发现表明,T型钙拮抗剂可显著舒张Ang II诱导的出球小动脉收缩,但其作用并非由抑制儿茶酚胺释放介导。这种强大的活性可能有助于出球小动脉对尼伐地平和依福地平的反应,并可能鉴于肾小球血流动力学而带来益处。

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