Benter Ibrahim F, Yousif Mariam H M, Anim J T, Cojocel C, Diz D I
Dept. of Pharmacology and Toxicology, Faculty of Medicine, Kuwait Univ., PO Box 24923, Safat 13110, Kuwait.
Am J Physiol Heart Circ Physiol. 2006 Feb;290(2):H684-91. doi: 10.1152/ajpheart.00632.2005.
We examined the influence of chronic treatment with ANG-(1-7) on development of hypertension and end-organ damage in spontaneously hypertensive rats (SHR) chronically treated with the nitric oxide synthesis inhibitor L-NAME (SHR-L-NAME). L-NAME administered orally (80 mg/l) for 4 wk significantly elevated mean arterial pressure (MAP) compared with SHR controls drinking regular water (269 +/- 10 vs. 196 +/- 6 mmHg). ANG-(1-7) (24 microg x kg(-1) x h(-1)) or captopril (300 mg/l) significantly attenuated the elevation in MAP due to L-NAME (213 +/- 7 and 228 +/- 8 mmHg, respectively), and ANG-(1-7) + captopril completely reversed the L-NAME-dependent increase in MAP (193 +/- 5 mmHg). L-NAME-induced increases in urinary protein were significantly lower in ANG-(1-7)-treated animals (226 +/- 6 vs. 145 +/- 12 mg/day). Captopril was more effective (96 +/- 12 mg/day), and there was no additional effect of captopril + ANG-(1-7) (87 +/- 5 mg/day). The abnormal vascular responsiveness to endothelin-1, carbachol, and sodium nitroprusside in perfused mesenteric vascular bed of SHR-L-NAME was improved by ANG-(1-7) or captopril, with no additive effect of ANG-(1-7) + captopril. In isolated perfused hearts, recovery of left ventricular function from 40 min of global ischemia was significantly better in ANG-(1-7)- or captopril-treated SHR-L-NAME, with additive effects of combined treatment. The beneficial effects of ANG-(1-7) on MAP and cardiac function were inhibited when indomethacin was administered with ANG-(1-7), but indomethacin did not reverse the protective effects on proteinuria or vascular reactivity. The protective effects of the ANG-(1-7) analog AVE-0991 were qualitatively comparable to those of ANG-(1-7) but were not improved over those of captopril alone. Thus, during reduced nitric oxide availability, ANG-(1-7) attenuates development of severe hypertension and end-organ damage; prostaglandins participate in the MAP-lowering and cardioprotective effects of ANG-(1-7); and additive effects of captopril + ANG-(1-7) on MAP, but not proteinuria or endothelial function, suggest common, as well as different, mechanisms of action for the two treatments. Together, the results provide further evidence of a role for ANG-(1-7) in protective effects of angiotensin-converting enzyme inhibition and suggest dissociation of factors influencing MAP and those influencing end-organ damage.
我们研究了用血管紧张素-(1-7)(ANG-(1-7))长期治疗对一氧化氮合成抑制剂L-NAME长期治疗的自发性高血压大鼠(SHR)高血压发展和靶器官损害的影响。与饮用普通水的SHR对照组相比,口服L-NAME(80mg/l)4周可显著升高平均动脉压(MAP)(269±10 vs. 196±6mmHg)。ANG-(1-7)(24μg·kg⁻¹·h⁻¹)或卡托普利(300mg/l)可显著减轻L-NAME所致的MAP升高(分别为213±7和228±8mmHg),且ANG-(1-7)+卡托普利可完全逆转L-NAME依赖性的MAP升高(193±5mmHg)。L-NAME诱导的尿蛋白增加在接受ANG-(1-7)治疗的动物中显著降低(226±6 vs. 145±12mg/天)。卡托普利更有效(96±12mg/天),卡托普利+ANG-(1-7)无额外作用(87±5mg/天)。ANG-(1-7)或卡托普利可改善SHR-L-NAME灌注肠系膜血管床对内皮素-1、卡巴胆碱和硝普钠的异常血管反应性,ANG-(1-7)+卡托普利无相加作用。在离体灌注心脏中,ANG-(1-7)或卡托普利治疗的SHR-L-NAME在40分钟全心缺血后左心室功能的恢复明显更好,联合治疗有相加作用。当吲哚美辛与ANG-(1-7)一起给药时,ANG-(1-7)对MAP和心脏功能的有益作用受到抑制,但吲哚美辛并未逆转对蛋白尿或血管反应性的保护作用。ANG-(1-7)类似物AVE-0991的保护作用在性质上与ANG-(1-7)相当,但并不优于单独使用卡托普利。因此,在一氧化氮可用性降低期间,ANG-(1-7)可减轻严重高血压的发展和靶器官损害;前列腺素参与ANG-(1-7)的降压和心脏保护作用;卡托普利+ANG-(1-7)对MAP有相加作用,但对蛋白尿或内皮功能无相加作用,提示两种治疗有共同及不同的作用机制。总之,结果进一步证明了ANG-(1-7)在血管紧张素转换酶抑制的保护作用中的作用,并提示影响MAP的因素与影响靶器官损害的因素相互分离。