Saito T, Higashiyama M, Nagasaka S, Sasaki S, Saito T, Ishikawa S E
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical School, Tochigi, Japan.
Kidney Int. 2001 Oct;60(4):1266-76. doi: 10.1046/j.1523-1755.2001.00965.x.
In a state of chronic arginine vasopressin (AVP) excess, the action of antidiuresis has been attenuated, resulting in some water diuresis. This state has been termed an "AVP escape" phenomenon. The present study was designed to determine what mechanisms underlie this attenuation in renal concentrating ability, which is found in chronic AVP excess, both in the presence and absence of volume expansion.
Two groups of experimental rats were established. One group received solid chow with water ad libitum. The second group received chow, which was offered as a liquid diet. Both groups received subcutaneous administration of 1-deamino-8-D-arginine vasopressin (dDAVP) at 5 ng/h for the entire observation period of one week. Over the course of the observation period, tissue levels of aquaporin-2 (AQP-2) mRNA and protein were measured. Levels of AVP V2 receptor were monitored, both by measuring mRNA levels and by ligand-binding studies using [3H]AVP. Tissue levels of cAMP also were determined.
Experimental rats with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) had severe hyponatremia below 120 mmol/L, and impaired urinary concentrating ability, during the seven-day observation period. In contrast, the dDAVP-excess rats, given solid chow, maintained maximally concentrated urine and normal levels of serum sodium. The down-regulation of AVP V2 receptor function was comparable in the two groups. The maximal binding capacity (Bmax) fell to the nadir on day 2 and was thereafter suppressed at approximately 60% of control rats during the experiment. Up-regulation of AQP-2 mRNA expression was found, but this up-regulation was significantly less in the SIADH rats compared with the dDAVP-excess rats (153.5 +/- 29.8% vs. 323.7 +/- 23.8% on day 7, P < 0.05). This differential response between these two groups was affirmed by measured differences in AQP-2 protein levels, both in tissue and in urinary excretion.
These results indicate that the attenuated regulation of the AQP-2 gene leads to the decrease in urinary concentrating ability in the experimental SIADH rats, suffering from hypervolemic state, compared with the normonatremic rats receiving AVP. Either hypervolemia or hypotonicity may diminish the post-receptor signaling of AVP in renal collecting duct cells, under the chronic AVP excess state found in SIADH.
在慢性精氨酸加压素(AVP)分泌过多的状态下,抗利尿作用减弱,导致出现一定程度的水利尿。这种状态被称为“AVP逃逸”现象。本研究旨在确定在存在和不存在容量扩张的情况下,慢性AVP分泌过多时肾浓缩能力减弱的潜在机制。
建立两组实验大鼠。一组给予固体饲料并随意饮水。第二组给予作为液体饲料的食物。两组在整个为期一周的观察期内均以5 ng/h的剂量皮下注射1-去氨基-8-D-精氨酸加压素(dDAVP)。在观察期内,测量水通道蛋白-2(AQP-2)mRNA和蛋白质的组织水平。通过测量mRNA水平和使用[3H]AVP的配体结合研究来监测AVP V2受体的水平。还测定了组织中的cAMP水平。
在为期7天的观察期内,患有抗利尿激素分泌不当综合征(SIADH)的实验大鼠出现严重低钠血症,血钠低于120 mmol/L,尿浓缩能力受损。相比之下,给予固体饲料的dDAVP分泌过多的大鼠维持最大浓缩尿和正常血清钠水平。两组中AVP V2受体功能的下调程度相当。最大结合容量(Bmax)在第2天降至最低点,此后在实验期间维持在对照大鼠的约60%。发现AQP-2 mRNA表达上调,但与dDAVP分泌过多的大鼠相比,SIADH大鼠中的这种上调明显较少(第7天分别为153.5±29.8%和323.7±23.8%,P<0.05)。通过组织和尿排泄中AQP-2蛋白水平的测量差异证实了这两组之间的这种差异反应。
这些结果表明,与接受AVP的血钠正常大鼠相比,患有高血容量状态的实验性SIADH大鼠中AQP-2基因调节减弱导致尿浓缩能力下降。在SIADH中发现的慢性AVP分泌过多状态下,高血容量或低渗状态可能会减弱AVP在肾集合管细胞中的受体后信号传导。