Institute for Translational Medicine and Therapeutics, University of Pennsylvania, 153 Johnson Pavilion, Philadelphia, PA 19104, USA.
Circ Res. 2010 Feb 5;106(2):337-45. doi: 10.1161/CIRCRESAHA.109.204529. Epub 2009 Nov 25.
Cyclooxygenase (COX)-derived prostanoids (PGs) are involved in blood pressure homeostasis. Both traditional nonsteroidal antiinflammatory drugs (NSAIDs) that inhibit COX-1 and COX-2 and NSAIDs designed to be selective for inhibition of COX-2 cause sodium retention and elevate blood pressure.
To elucidate the role of COX-2 in blood pressure homeostasis using COX-1>COX-2 mice, in which the COX-1 expression is controlled by COX-2 regulatory elements.
COX-1>COX-2 mice developed systolic hypertension relative to wild types (WTs) on a high-salt diet (HSD); this was attenuated by a PGI(2) receptor agonist. HSD increased expression of COX-2 in WT mice and of COX-1 in COX-1>COX-2 mice in the inner renal medulla. The HSD augmented in all strains urinary prostanoid metabolite excretion, with the exception of the major PGI(2) metabolite that was suppressed on regular chow and unaltered by the HSD in both mutants. Furthermore, inner renal medullary expression of the receptor for PGI(2), but not for other prostanoids, was depressed by HSD in WT and even more so in both mutant strains. Increasing osmolarity augmented expression of COX-2 in WT renal medullary interstitial cells and again the increase in formation of PGI(2) observed in WTs was suppressed in cells derived from both mutants. Intramedullary infusion of the PGI(2) receptor agonist increased urine volume and sodium excretion in mice.
These studies suggest that dysregulated expression of the COX-2 dependent, PGI(2) biosynthesis/response pathway in the renal inner renal medulla undermines the homeostatic response to a HSD. Inhibition of this pathway may contribute directly to the hypertensive response to NSAIDs.
环氧化酶(COX)衍生的前列腺素(PGs)参与血压稳态。传统的非甾体抗炎药(NSAIDs)抑制 COX-1 和 COX-2,以及专门设计用于抑制 COX-2 的 NSAIDs 都会导致钠潴留和血压升高。
使用 COX-1>COX-2 小鼠阐明 COX-2 在血压稳态中的作用,其中 COX-1 的表达受 COX-2 调节元件控制。
COX-1>COX-2 小鼠在高盐饮食(HSD)下比野生型(WT)发展为收缩压高血压;这被 PGI(2)受体激动剂减弱。HSD 增加了 WT 小鼠肾髓质内 COX-2 的表达和 COX-1>COX-2 小鼠的 COX-1 表达。在所有品系中,HSD 增加了尿前列腺素代谢产物的排泄,但主要的 PGI(2)代谢产物除外,在普通饲料中被抑制,在两种突变体中均不受 HSD 影响。此外,PGI(2)受体而不是其他前列腺素受体在 WT 和两种突变体中的肾髓质内的表达均被 HSD 下调。增加渗透压会增加 WT 肾髓质间质细胞中 COX-2 的表达,并且在 WT 中观察到的 PGI(2)形成增加再次被两种突变体衍生的细胞所抑制。内髓内输注 PGI(2)受体激动剂可增加小鼠的尿量和尿钠排泄。
这些研究表明,肾髓质内 COX-2 依赖性、PGI(2)生物合成/反应途径的失调表达破坏了对 HSD 的稳态反应。该途径的抑制可能直接导致 NSAIDs 引起的高血压反应。