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内皮素受体亚型激活介导的单侧输尿管梗阻时肾血流动力学改变

Alterations of renal hemodynamics in unilateral ureteral obstruction mediated by activation of endothelin receptor subtypes.

作者信息

Bhangdia Darshan K, Gulmi Frederick A, Chou Shyan-Yih, Mooppan Unni M, Kim Hong

机构信息

Department of Urology, Brookdale University Hospital and Medical Center, Brooklyn, NY, USA.

出版信息

J Urol. 2003 Nov;170(5):2057-62. doi: 10.1097/01.ju.0000081956.16457.67.

Abstract

PURPOSE

Unilateral ureteral obstruction (UUO) for 21 hours causes severe renal vasoconstriction. We examined the role of endothelin (ET)-A receptor in renal hemodynamic alterations induced by UUO.

MATERIALS AND METHODS

Hemodynamic and clearance experiments were performed in 3 groups of anesthetized dogs. In group 1, 6 sham operated dogs received intrarenal infusion of the specific ET-A receptor antagonist BQ-610 (Peninsula Laboratories, Inc., Belmont, California), followed by infusion of the nitric oxide synthase substrate L-arginine. In the 7 group 2 dogs release of 21-hour UUO was followed by intrarenal infusion of BQ-610 and L-arginine. In the 5 group 3 dogs release of 21-hour UUO was followed by L-arginine infusion.

RESULTS

UUO caused marked decreases in renal blood flow (RBF) and glomerular filtration rate (GFR) in groups 2 and 3 compared with group 1. In group 1 BQ-610 and L-arginine infusion did not alter RBF or GFR. In contrast, BQ-610 infusion in group 2 after UUO release led to a significant increase in RBF and GFR as well as additional increases after L-arginine infusion. After UUO release in group 3 L-arginine infusion alone did not change RBF or GFR.

CONCLUSIONS

After UUO release blockade of the ET-A receptor ameliorates renal vasoconstriction. The addition of L-arginine, which is a substrate for nitric oxide synthase, superimposed on ET-A receptor blockade confers a further decrease in renal vascular resistance, suggesting that the ET and L-arginine-nitric oxide systems are involved in renal hemodynamic alterations caused by UUO.

摘要

目的

单侧输尿管梗阻(UUO)21小时会导致严重的肾血管收缩。我们研究了内皮素(ET)-A受体在UUO诱导的肾血流动力学改变中的作用。

材料与方法

对3组麻醉犬进行血流动力学和清除率实验。第1组,6只假手术犬肾内输注特异性ET-A受体拮抗剂BQ-610(半岛实验室公司,加利福尼亚州贝尔蒙特),随后输注一氧化氮合酶底物L-精氨酸。第2组的7只犬在21小时UUO解除后肾内输注BQ-610和L-精氨酸。第3组的5只犬在21小时UUO解除后输注L-精氨酸。

结果

与第1组相比,第2组和第3组中UUO导致肾血流量(RBF)和肾小球滤过率(GFR)显著降低。在第1组中,输注BQ-610和L-精氨酸未改变RBF或GFR。相反,第2组在UUO解除后输注BQ-610导致RBF和GFR显著增加,在输注L-精氨酸后进一步增加。第3组在UUO解除后单独输注L-精氨酸未改变RBF或GFR。

结论

UUO解除后,ET-A受体阻断可改善肾血管收缩。在ET-A受体阻断基础上添加一氧化氮合酶底物L-精氨酸可使肾血管阻力进一步降低,提示ET和L-精氨酸-一氧化氮系统参与了UUO引起的肾血流动力学改变。

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