Quigley Raymond, Chakravarty Sumana, Baum Michel
Department of Pediatrics, Univeristy of Texas Southwestern Medical Center, Dallas, TX 75235-9063, USA.
Am J Physiol Renal Physiol. 2004 Feb;286(2):F317-22. doi: 10.1152/ajprenal.00122.2003. Epub 2003 Nov 25.
Neonates cannot concentrate their urine to the same degree as adults. One of the key factors in concentrating the urine is the renal collecting duct osmotic water permeability (Pf) response to antidiuretic hormone (ADH). Neonatal cortical collecting ducts have a blunted Pf response to ADH compared with adult tubules (Pf: 119.0 +/- 12.5 vs. 260.1 +/- 29.5 microm/s, P < 0.05). We found that the phosphodiesterase activity in the neonatal collecting ducts was higher than that in the adult collecting ducts (3,970 +/- 510 vs. 2,440 +/- 220 cpm.microg tubular protein-1.20 min-1, P < 0.05). After pretreatment of in vitro microperfused tubules with the nonspecific phosphodiesterase inhibitor IBMX (10-6 M in the bath), the Pf response to ADH in neonatal collecting ducts was 271.4 +/- 51.7 microm/s, which was identical to that of the adult collecting duct [315.3 +/- 31.3 microm/s, P = not significant (NS)]. Rolipram, a specific type IV phosphodiesterase inhibitor, lowered the elevated phosphodiesterase activity in the neonatal tubules to that in the adult tubules (2,460 +/- 210 vs. 2,160 +/- 230 cpm.microg tubular protein-1.20 min-1, P = NS). Neonatal tubules pretreated with rolipram (10-5 M) in the bath also had a Pf response to ADH that was comparable to that of the adult tubules (258.2 +/- 17.0 vs. 271.4 +/- 32.6 microm/s, P = NS). Thus the elevated phosphodiesterase activity in the neonatal tubules appears to be due to an increase in type IV phosphodiesterase activity. Hence, one of the key factors in the decreased ability of neonates to concentrate their urine is overactivity of phosphodiesterase in the cortical collecting duct that blunts the neonatal collecting duct Pf response to ADH.
新生儿无法像成年人那样高度浓缩尿液。尿液浓缩的关键因素之一是肾集合管对抗利尿激素(ADH)的渗透水通透性(Pf)反应。与成年肾小管相比,新生儿皮质集合管对ADH的Pf反应迟钝(Pf:119.0±12.5对260.1±29.5μm/s,P<0.05)。我们发现新生儿集合管中的磷酸二酯酶活性高于成年集合管(3970±510对2440±220 cpm·μg肾小管蛋白-1·2.0分钟-1,P<0.05)。在用非特异性磷酸二酯酶抑制剂异丁基甲基黄嘌呤(IBMX,浴槽中浓度为10-6 M)对体外微灌流肾小管进行预处理后,新生儿集合管对ADH的Pf反应为271.4±51.7μm/s,与成年集合管的反应相同[315.3±31.3μm/s,P=无显著性差异(NS)]。罗匹尼罗,一种特异性IV型磷酸二酯酶抑制剂,将新生儿肾小管中升高的磷酸二酯酶活性降低至成年肾小管的水平(2460±210对2160±230 cpm·μg肾小管蛋白-1·2.0分钟-1,P=NS)。在浴槽中用罗匹尼罗(10-5 M)预处理的新生儿肾小管对ADH的Pf反应也与成年肾小管相当(258.2±17.0对271.4±32.6μm/s,P=NS)。因此,新生儿肾小管中升高的磷酸二酯酶活性似乎是由于IV型磷酸二酯酶活性增加所致。因此,新生儿尿液浓缩能力下降的关键因素之一是皮质集合管中的磷酸二酯酶过度活跃,从而使新生儿集合管对ADH的Pf反应迟钝。