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清醒犬的正常血压钠负荷:β受体阻断期间肾素分泌的调节

Normotensive sodium loading in conscious dogs: regulation of renin secretion during beta-receptor blockade.

作者信息

Bie Peter, Mølstrøm Simon, Wamberg Søren

机构信息

Department of Physiology and Pharmacology, University of Southern Denmark, 21 Winslowparken, Odense, DK-5000, Denmark.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2009 Feb;296(2):R428-35. doi: 10.1152/ajpregu.90753.2008. Epub 2008 Dec 10.

Abstract

Renin secretion is regulated in part by renal nerves operating through beta1-receptors of the renal juxtaglomerular cells. Slow sodium loading may decrease plasma renin concentration (PRC) and cause natriuresis at constant mean arterial blood pressure (MAP) and glomerular filtration rate (GFR). We hypothesized that in this setting, renin secretion and renin-dependent sodium excretion are controlled by via the renal nerves and therefore are eliminated or reduced by blocking the action of norepinephrine on the juxtaglomerular cells with the beta1-receptor antagonist metoprolol. This was tested in conscious dogs by infusion of NaCl (20 micromol.kg(-1).min(-1) for 180 min, NaLoad) during regular or low-sodium diet (0.03 mmol.kg(-1).day(-1), LowNa) with and without metoprolol (2 mg/kg plus 0.9 mg.kg(-1).h(-1)). Vasopressin V2 receptors were blocked by Otsuka compound OPC31260 to facilitate clearance measurements. Body fluid volume was maintained by servocontrolled fluid infusion. Metoprolol per se did not affect MAP, heart rate, or sodium excretion significantly, but reduced PRC and ANG II by 30-40%, increased plasma atrial natriuretic peptide (ANP), and tripled potassium excretion. LowNa per se increased PRC (+53%), ANG II (+93%), and aldosterone (+660%), and shifted the vasopressin function curve to the left. NaLoad elevated plasma [Na+] by 4.5% and vasopressin by threefold, but MAP and plasma ANP remained unchanged. NaLoad decreased PRC by approximately 30%, ANG II by approximately 40%, and aldosterone by approximately 60%, regardless of diet and metoprolol. The natriuretic response to NaLoad was augmented during metoprolol regardless of diet. In conclusion, PRC depended on dietary sodium and beta1-adrenergic control as expected; however, the acute sodium-driven decrease in PRC at constant MAP and GFR was unaffected by beta1-receptor blockade demonstrating that renin may be regulated without changes in MAP, GFR, or beta1-mediated effects of norepinephrine. Low-sodium diet augments vasopressin secretion, whereas ANP secretion is reduced.

摘要

肾素分泌部分受通过肾近球细胞β1受体起作用的肾神经调节。缓慢的钠负荷可能会降低血浆肾素浓度(PRC),并在平均动脉血压(MAP)和肾小球滤过率(GFR)恒定的情况下引起利钠作用。我们假设在这种情况下,肾素分泌和肾素依赖性钠排泄是通过肾神经控制的,因此通过用β1受体拮抗剂美托洛尔阻断去甲肾上腺素对近球细胞的作用可以消除或减少这种情况。通过在正常或低钠饮食(0.03 mmol·kg⁻¹·天⁻¹,低钠)期间输注NaCl(20 μmol·kg⁻¹·分钟⁻¹,持续180分钟,钠负荷),并在有或没有美托洛尔(2 mg/kg加0.9 mg·kg⁻¹·小时⁻¹)的情况下,对清醒犬进行了测试。用大冢化合物OPC31260阻断血管加压素V2受体以促进清除率测量。通过伺服控制的液体输注维持体液量。美托洛尔本身对MAP、心率或钠排泄没有显著影响,但使PRC和血管紧张素II降低30 - 40%,增加血浆心钠素(ANP),并使钾排泄增加两倍。低钠本身使PRC增加(+53%)、血管紧张素II增加(+93%)和醛固酮增加(+660%),并使血管加压素功能曲线向左移动。钠负荷使血浆[Na⁺]升高4.5%,血管加压素升高三倍,但MAP和血浆ANP保持不变。无论饮食和美托洛尔如何,钠负荷使PRC降低约30%,血管紧张素II降低约40%,醛固酮降低约60%。无论饮食如何,在美托洛尔治疗期间,对钠负荷的利钠反应都会增强。总之,正如预期的那样,PRC取决于饮食钠和β1肾上腺素能控制;然而,在MAP和GFR恒定的情况下,急性钠驱动的PRC降低不受β1受体阻断的影响,这表明肾素的调节可能与MAP、GFR或去甲肾上腺素的β1介导作用的变化无关。低钠饮食会增加血管加压素分泌,而心钠素分泌会减少。

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