Thomson Scott C, Deng Aihua, Komine Norikuni, Hammes John S, Blantz Roland C, Gabbai Francis B
Department of Medicine, Division of Nephrology-Hypertension, University of California and Veterans Affairs San Diego Health Care System, San Diego, CA 92161, USA.
Am J Physiol Renal Physiol. 2004 Oct;287(4):F732-8. doi: 10.1152/ajprenal.00340.2003. Epub 2004 Jun 22.
Dysregulation of kidney nitric oxide synthase (NOS) I may alter renal hemodynamics in diabetes. Four types of studies were performed in anesthetized 1- to 2-wk-streptozotocin diabetic rats. 1) Glomerular filtration rate (GFR) was measured before and during NOS I blockade. Subsequent addition of nonspecific NOS blocker tested for residual NO from other isoforms. Acute systemic NOS I blockade reduced GFR only in diabetics. Nonspecific NOS blockade had no additional effect on NOS I-blocked diabetics. 2) Renal blood flow (RBF) was monitored for evidence that tubuloglomerular feedback (TGF) resets during 1 h of continuous activation with benzolamide. NOS I blockade was added to test for the role of NOS I in TGF resetting. During 1 h of TGF activation in controls, RBF initially declined and then returned to baseline. In diabetic and NOS I-blocked rats, RBF declined and remained low. 3) The ability of NOS I blockade to increase the homeostatic efficiency of TGF in diabetes was tested by micropuncture in free-flowing nephrons. The addition of NOS I blocker to the tubular fluid increased TGF efficiency in control and diabetic rats. 4) The influence of distal salt delivery on local NOS I activity was tested by micropuncture. Henle's loop was perfused at varying rates with NOS I blocker while single-nephron GFR (SNGFR) from the late proximal tubule was measured. In controls, NOS I blockade mainly reduced SNGFR when flow through Henle's loop was high. In diabetics, NOS I blockade reduced SNGFR independently of flow through Henle's loop. In conclusion, normally, salt delivered to the macula densa (MD) exerts immediate control over MD NOS I activity. In diabetes, there is ongoing overactivity of NOS I that is not regulated by MD salt.
肾脏一氧化氮合酶(NOS)I 的失调可能会改变糖尿病患者的肾脏血流动力学。对麻醉后的 1 至 2 周龄链脲佐菌素诱导的糖尿病大鼠进行了四类研究。1)在阻断 NOS I 之前和期间测量肾小球滤过率(GFR)。随后添加非特异性 NOS 阻滞剂以检测来自其他同工型的残余 NO。急性全身性 NOS I 阻断仅在糖尿病患者中降低了 GFR。非特异性 NOS 阻断对 NOS I 阻断的糖尿病患者没有额外影响。2)监测肾血流量(RBF),以寻找在苯甲酰胺持续激活 1 小时期间肾小管-肾小球反馈(TGF)重置的证据。添加 NOS I 阻断剂以测试 NOS I 在 TGF 重置中的作用。在对照组中 TGF 激活 1 小时期间,RBF 最初下降然后恢复到基线。在糖尿病和 NOS I 阻断的大鼠中,RBF 下降并保持在低水平。3)通过对自由流动肾单位进行微穿刺,测试了 NOS I 阻断增加糖尿病患者中 TGF 稳态效率的能力。向肾小管液中添加 NOS I 阻滞剂可提高对照和糖尿病大鼠的 TGF 效率。4)通过微穿刺测试远端盐输送对局部 NOS I 活性的影响。用 NOS I 阻滞剂以不同速率灌注亨氏袢,同时测量来自近端小管晚期的单肾单位 GFR(SNGFR)。在对照组中,当通过亨氏袢的流量较高时,NOS I 阻断主要降低 SNGFR。在糖尿病患者中,NOS I 阻断独立于通过亨氏袢的流量降低 SNGFR。总之,正常情况下,输送到致密斑(MD)的盐会立即控制 MD NOS I 的活性。在糖尿病中,存在 NOS I 的持续过度活性,且不受 MD 盐的调节。