Tofovic S P, Branch K R, Oliver R D, Magee W D, Jackson E K
Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee.
J Pharmacol Exp Ther. 1991 Mar;256(3):850-60.
Previous studies strongly suggest that adenosine receptors on juxtaglomerular cells function to restrain the secretion of renin induced by a variety of stimuli. The clinical significance of this is that caffeine, a widely consumed adenosine receptor antagonist, could augment renin release responses to diseases such as renovascular hypertension, liver cirrhosis and heart failure and to therapeutic maneuvers such as salt restriction, diuretics and vasodilators. Caffeine may be particularly troublesome in this regard because this methylxanthine has central nervous system effects and intracellular actions that also might contribute to the overall ability of caffeine to potentiate renin secretion. The purpose of this study was to document the effects of caffeine on renin release responses to a vasodilator and to investigate what mechanisms were responsible for any augmentation of vasodilator-induced renin secretion. Accordingly, we compared the effects of caffeine vs. 1,3-dipropyl-8-p-sulfophenylxanthine (DPSPX; a xanthine that we documented in this study not to significantly enter the brain or penetrate cell membranes) on base-line and hydralazine-induced renin release in both normal and beta adrenoceptor-blocked (propranolol, 15 mg/kg) rats. Both xanthines (at a dose of 10 mg/kg plus 150 micrograms/min) attenuated adenosine-mediated hypotension and bradycardia, and DPSPX was at least as effective as caffeine in antagonizing peripheral adenosine receptors. Caffeine and DPSPX increased base-line plasma renin activity to a similar extent regardless of whether the animals were pretreated with propranolol. In rats with an intact beta adrenergic system, caffeine, but not DPSPX, increased the renin release response to low-dose hydralazine (1 mg/kg). Although both xanthines augmented the renin release response to high-dose hydralazine (10 mg/kg), caffeine was more efficacious in this regard. In beta adrenoceptor-blocked rats, neither caffeine nor DPSPX augmented the renin release response to low-dose hydralazine, whereas both xanthines equally potentiated the renin release response to high-dose hydralazine. These data demonstrate that caffeine increases base-line renin release primarily by blocking peripheral (most likely renal), cell-surface adenosine receptors; however, caffeine potentiates vasodilator-induced renin secretion in part by blocking peripheral (most likely renal), cell-surface adenosine receptors and in part by additional central nervous system and/or intracellular mechanism(s) that involve the beta adrenergic system.
以往的研究有力地表明,球旁细胞上的腺苷受体起到抑制多种刺激诱导的肾素分泌的作用。其临床意义在于,咖啡因作为一种广泛使用的腺苷受体拮抗剂,可能会增强对诸如肾血管性高血压、肝硬化和心力衰竭等疾病以及对诸如限盐、利尿剂和血管扩张剂等治疗手段的肾素释放反应。在这方面,咖啡因可能特别麻烦,因为这种甲基黄嘌呤具有中枢神经系统效应和细胞内作用,这也可能有助于咖啡因增强肾素分泌的总体能力。本研究的目的是记录咖啡因对血管扩张剂诱导的肾素释放反应的影响,并研究是什么机制导致血管扩张剂诱导的肾素分泌增加。因此,我们比较了咖啡因与1,3 - 二丙基 - 8 - 对 - 磺基苯基黄嘌呤(DPSPX;我们在本研究中记录到这种黄嘌呤不会显著进入大脑或穿透细胞膜)对正常和β肾上腺素能受体阻断(普萘洛尔,15mg/kg)大鼠的基线和肼屈嗪诱导的肾素释放的影响。两种黄嘌呤(剂量为10mg/kg加150μg/min)均减弱了腺苷介导的低血压和心动过缓,并且DPSPX在拮抗外周腺苷受体方面至少与咖啡因一样有效。无论动物是否用普萘洛尔预处理,咖啡因和DPSPX都以相似的程度增加基线血浆肾素活性。在具有完整β肾上腺素能系统的大鼠中,咖啡因而非DPSPX增加了对低剂量肼屈嗪(1mg/kg)的肾素释放反应。虽然两种黄嘌呤都增强了对高剂量肼屈嗪(10mg/kg)的肾素释放反应,但在这方面咖啡因更有效。在β肾上腺素能受体阻断的大鼠中,咖啡因和DPSPX均未增强对低剂量肼屈嗪的肾素释放反应,而两种黄嘌呤均同等程度地增强了对高剂量肼屈嗪的肾素释放反应。这些数据表明,咖啡因主要通过阻断外周(很可能是肾脏)细胞表面的腺苷受体来增加基线肾素释放;然而,咖啡因部分通过阻断外周(很可能是肾脏)细胞表面的腺苷受体,部分通过涉及β肾上腺素能系统的额外中枢神经系统和/或细胞内机制来增强血管扩张剂诱导的肾素分泌。