Valentin J P, Ribstein J, Pussard E, Nussberger J, Neuser D, Mimran A
Service de médecine interne, hôpital Lapeyronie, CHU Montpellier, France.
Arch Mal Coeur Vaiss. 1990 Jul;83(8):1343-6.
Unilateral nephrectomy (UNX) is associated with an immediate and transient increase in arterial pressure and in prompt natriuresis from the remaining kidney. The hypothesis that atrial natriuretic peptide (ANP) is involved in the acute adaptation to unilateral nephrectomy was tested in euvolemic anesthetized Sprague-Dawley rats. In a first series of experiments, an increase in circulating ir-ANP levels (from 23.5 +/- 3.6 to 66.3 +/- 12.8 fmol/ml; p less than 0.01) was found within 2 minutes following renal exclusion. In a second set of experiments, the ANP response was inhibited by performing a right atrial appendectomy, in order to eliminate the major source of ANP, or by intravenous administration of monoclonal antibodies directed against ANP. When UNX was performed in the control groups (sham atrial appendectomy and administration of non specific monoclonal antibodies), mean arterial pressure rose immediately (maximal about 12% within 4 minutes) and transiently (return to pre-UNX values within 20 minutes) after UNX. At the same time, central venous pressure, monitored in the right atrium, tended to decrease slightly. In rats pretreated by right atrial appendectomy or by monoclonal antibodies directed against ANP, arterial pressure increased to the same extent as observed in control groups; this increase however was significantly more prolonged. In control groups, urinary cGMP excretion, the biological marker of ANP, increased twofold in parallel with the natriuretic response. These two responses were blunted in right atrial appendectomized rats and in rats receiving antibodies against-ANP. These results suggest that atrial natriuretic peptide plays a major role in the immediate functional adaptation to unilateral nephrectomy by blunting the increase in blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
单侧肾切除(UNX)与动脉血压立即且短暂升高以及剩余肾脏迅速排钠有关。在血容量正常的麻醉Sprague-Dawley大鼠中,对心房利钠肽(ANP)参与单侧肾切除急性适应过程这一假说进行了验证。在第一组实验中,发现肾脏切除后2分钟内循环中免疫反应性ANP水平升高(从23.5±3.6升高至66.3±12.8 fmol/ml;p<0.01)。在第二组实验中,通过进行右心耳切除术以消除ANP的主要来源,或静脉注射针对ANP的单克隆抗体来抑制ANP反应。在对照组(假右心耳切除术和注射非特异性单克隆抗体)中进行UNX时,平均动脉压在UNX后立即升高(4分钟内最大升高约12%)且为短暂性升高(20分钟内恢复至UNX前值)。同时,在右心房监测的中心静脉压有轻微下降趋势。在接受右心耳切除术或针对ANP的单克隆抗体预处理的大鼠中,动脉压升高幅度与对照组相同;然而,这种升高明显更持久。在对照组中,作为ANP生物学标志物的尿cGMP排泄量与利钠反应平行增加两倍。在右心耳切除的大鼠和接受抗ANP抗体的大鼠中,这两种反应均减弱。这些结果表明,心房利钠肽通过减弱血压升高在单侧肾切除的即刻功能适应中起主要作用。(摘要截选至250词)