Raasch Walter, Wittmershaus Christian, Dendorfer Andreas, Voges Inga, Pahlke Friedrich, Dodt Christoph, Dominiak Peter, Jöhren Olaf
Institute of Experimental and Clinical Pharmacology, University Clinic of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
Endocrinology. 2006 Jul;147(7):3539-46. doi: 10.1210/en.2006-0198. Epub 2006 Mar 30.
Angiotensin II type 1 (AT(1)) receptors are expressed within organs of the hypothalamo-pituitary-adrenal (HPA) axis and seem to be important for its stress responsiveness. Secretion of CRH, ACTH, and corticosterone (CORT) is increased by stimulation of AT(1) receptors. In the present study, we tested whether a blockade of the angiotensin II system attenuates the HPA axis reactivity in spontaneously hypertensive rats. Spontaneously hypertensive rats were treated with candesartan (2 mg/kg), ramipril (1 mg/kg), or mibefradil (12 mg/kg) for 5 wk. In addition to baseline levels, CORT and ACTH responses to injection of CRH (100 microg/kg) were monitored over 4 h. mRNA of CRH, proopiomelanocortin, AT(1A), AT(1B), and AT(2) receptors was quantified by real-time PCR. All treatments induced equivalent reductions of blood pressure and had no effect on baseline levels of CORT and ACTH. However, both candesartan and ramipril significantly reduced CRH-stimulated plasma levels of ACTH (-26 and -15%) and CORT (-36 and -18%) and lowered hypothalamic CRH mRNA (-25 and -29%). Mibefradil did not affect any of these parameters. Gene expression of AT(1A), AT(1B), and AT(2) receptors within the HPA axis was not altered by any drug. We show for the first time that antihypertensive treatment by inhibition of AT(1) receptors or angiotensin-converting enzyme attenuates HPA axis reactivity independently of blood pressure reduction. This action is solely evident after CRH stimulation but not under baseline conditions. Both a reduced pituitary sensitivity to CRH and a down-regulation of hypothalamic CRH expression have the potential to reduce HPA axis activity during chronic AT(1) blockade or angiotensin-converting enzyme inhibition.
血管紧张素II 1型(AT(1))受体在下丘脑-垂体-肾上腺(HPA)轴的器官中表达,并且似乎对其应激反应性很重要。刺激AT(1)受体会增加促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)和皮质酮(CORT)的分泌。在本研究中,我们测试了血管紧张素II系统的阻断是否会减弱自发性高血压大鼠的HPA轴反应性。自发性高血压大鼠用坎地沙坦(2毫克/千克)、雷米普利(1毫克/千克)或米贝拉地尔(12毫克/千克)治疗5周。除了基线水平外,在4小时内监测CORT和ACTH对注射CRH(100微克/千克)的反应。通过实时聚合酶链反应对CRH、阿黑皮素原、AT(1A)、AT(1B)和AT(2)受体的信使核糖核酸进行定量。所有治疗均导致血压等效降低,并且对CORT和ACTH的基线水平没有影响。然而,坎地沙坦和雷米普利均显著降低了CRH刺激的ACTH血浆水平(分别降低26%和15%)和CORT血浆水平(分别降低36%和18%),并降低了下丘脑CRH信使核糖核酸水平(分别降低25%和29%)。米贝拉地尔对这些参数均无影响。任何药物均未改变HPA轴内AT(1A)、AT(1B)和AT(2)受体的基因表达。我们首次表明,通过抑制AT(1)受体或血管紧张素转换酶进行的抗高血压治疗可独立于血压降低而减弱HPA轴反应性。这种作用仅在CRH刺激后明显,而在基线条件下不明显。垂体对CRH敏感性降低和下丘脑CRH表达下调均有可能在慢性AT(1)阻断或血管紧张素转换酶抑制期间降低HPA轴活性。