Koeners Maarten P, Braam Branko, van der Giezen Dionne M, Goldschmeding Roel, Joles Jaap A
Department of Nephrology and Hypertension F03.223, University Medical Center Utrecht, Utrecht, The Netherlands.
Am J Physiol Regul Integr Comp Physiol. 2008 Jun;294(6):R1847-55. doi: 10.1152/ajpregu.00073.2008. Epub 2008 Apr 16.
Enhancing perinatal nitric oxide (NO) availability persistently reduces blood pressure in spontaneously hypertensive rats. We hypothesize that this approach can be generalized to other models of genetic hypertension, for instance those associated with renal injury. Perinatal exposure to the NO donor molsidomine was studied in fawn-hooded hypertensive (FHH) rats, a model of mild hypertension, impaired preglomerular resistance, and progressive renal injury. Perinatal molsidomine increased urinary NO metabolite excretion at 8 wk of age, i.e., 4 wk after treatment was stopped (P < 0.05). Systolic blood pressure was persistently reduced after molsidomine (42-wk females: 118 +/- 3 vs. 141 +/- 5 and 36-wk males: 139 +/- 4 vs. 158 +/- 4 mmHg; both P < 0.001). Perinatal treatment decreased glomerular filtration rate (P < 0.05) and renal blood flow (P < 0.01) and increased renal vascular resistance (P < 0.05), without affecting filtration fraction, suggesting persistently increased preglomerular resistance. At 4 wk of age natriuresis was transiently increased by molsidomine (P < 0.05). Molsidomine decreased glomerulosclerosis (P < 0.05). Renal blood flow correlated positively with glomerulosclerosis in control (P < 0.001) but not in perinatally treated FHH rats. NO dependency of renal vascular resistance was increased by perinatal molsidomine. Perinatal enhancement of NO availability can ameliorate development of hypertension and renal injury in FHH rats. Paradoxically, glomerular protection by perinatal exposure to the NO donor molsidomine may be due to persistently increased preglomerular resistance. The mechanisms by which increased perinatal NO availability can persistently reprogram kidney function and ameliorate hypertension deserve further study.
持续提高围产期一氧化氮(NO)水平可使自发性高血压大鼠的血压持续降低。我们推测这种方法可推广至其他遗传性高血压模型,比如与肾损伤相关的模型。在淡色带帽高血压(FHH)大鼠(一种轻度高血压、肾小体前阻力受损及进行性肾损伤的模型)中研究了围产期给予NO供体吗多明的情况。围产期给予吗多明可使8周龄(即停药后4周)时尿中NO代谢产物排泄增加(P<0.05)。给予吗多明后收缩压持续降低(42周龄雌性大鼠:118±3 vs. 141±5 mmHg,36周龄雄性大鼠:139±4 vs. 158±4 mmHg;均P<0.001)。围产期治疗使肾小球滤过率降低(P<0.05)、肾血流量降低(P<0.01)并使肾血管阻力增加(P<0.05),而不影响滤过分数,提示肾小体前阻力持续增加。4周龄时吗多明使利钠作用短暂增加(P<0.05)。吗多明使肾小球硬化减轻(P<0.05)。在对照大鼠中肾血流量与肾小球硬化呈正相关(P<0.001),但在围产期接受治疗的FHH大鼠中无此相关性。围产期给予吗多明增加了肾血管阻力对NO的依赖性。围产期提高NO水平可改善FHH大鼠高血压及肾损伤的发展。矛盾的是,围产期给予NO供体吗多明对肾小球的保护作用可能归因于肾小体前阻力的持续增加。围产期NO水平升高可使肾功能持续重编程并改善高血压的机制值得进一步研究。