Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
J Hypertens. 2011 Jul;29(7):1400-10. doi: 10.1097/HJH.0b013e32834786d6.
Hyperaldosteronism, important in hypertension, is associated with electrolyte alterations, including hypomagnesemia, through unknown mechanisms.
To test whether aldosterone influences renal Mg(2+) transporters, (transient receptor potential melastatin (TRPM) 6, TRPM7, paracellin-1) leading to hypomagnesemia, hypertension and target organ damage and whether in a background of magnesium deficiency, this is exaggerated.
Aldosterone effects in mice selectively bred for high-normal (MgH) or low (MgL) intracellular Mg(2+) were studied. Male MgH and MgL mice received aldosterone (350 μg/kg per day, 3 weeks). SBP was elevated in MgL. Aldosterone increased blood pressure and albuminuria and increased urinary Mg(2+) concentration in MgH and MgL, with greater effects in MgL. Activity of renal TRPM6 and TRPM7 was lower in vehicle-treated MgL than MgH. Aldosterone increased activity of TRPM6 in MgH and inhibited activity in MgL. TRPM7 and paracellin-1 were unaffected by aldosterone. Aldosterone-induced albuminuria in MgL was associated with increased renal fibrosis, increased oxidative stress, activation of mitogen-activated protein kinases and nuclear factor-NF-κB and podocyte injury. Mg(2+) supplementation (0.75% Mg(2+)) in aldosterone-treated MgL normalized plasma Mg(2+), increased TRPM6 activity and ameliorated hypertension and renal injury. Hence, in a model of inherited hypomagnesemia, TRPM6 and TRPM7, but not paracellin-1, are downregulated. Aldosterone further decreased TRPM6 activity in hypomagnesemic mice, a phenomenon associated with hypertension and kidney damage. Such effects were prevented by Mg(2+) supplementation.
Amplified target organ damage in aldosterone-induced hypertension in hypomagnesemic conditions is associated with dysfunctional Mg(2+)-sensitive renal TRPM6 channels. Novel mechanisms for renal effects of aldosterone and insights into putative beneficial actions of Mg(2+), particularly in hyperaldosteronism, are identified.
醛固酮在高血压中很重要,它通过未知机制与电解质紊乱(包括低镁血症)有关。
检测醛固酮是否影响肾脏镁转运体(瞬时受体电位 melastatin (TRPM) 6、TRPM7、paracellin-1),导致低镁血症、高血压和靶器官损伤,以及在镁缺乏的情况下,这种影响是否会加剧。
研究了选择性繁殖的高正常(MgH)或低(MgL)细胞内镁(2+)的小鼠中醛固酮的作用。雄性 MgH 和 MgL 小鼠接受醛固酮(350 μg/kg/天,3 周)。MgL 的 SBP 升高。醛固酮增加了 MgH 和 MgL 的血压和白蛋白尿,并增加了尿镁(2+)浓度,在 MgL 中作用更大。与 MgH 相比,未用醛固酮处理的 MgL 中的肾脏 TRPM6 和 TRPM7 活性降低。醛固酮增加了 MgH 中的 TRPM6 活性,而抑制了 MgL 中的 TRPM6 活性。醛固酮对 TRPM7 和 paracellin-1 没有影响。MgL 中的醛固酮诱导的白蛋白尿与肾纤维化增加、氧化应激增加、丝裂原激活蛋白激酶和核因子-NF-κB 激活以及足细胞损伤有关。在醛固酮治疗的 MgL 中补充镁(0.75%Mg(2+))可使血浆镁(2+)正常化,增加 TRPM6 活性,并改善高血压和肾脏损伤。因此,在遗传性低镁血症模型中,TRPM6 和 TRPM7(而非 paracellin-1)下调。醛固酮进一步降低了低镁血症小鼠的 TRPM6 活性,这与高血压和肾脏损伤有关。镁(2+)补充可预防此类作用。
在低镁血症条件下,醛固酮诱导的高血压中的靶器官损伤加剧与功能失调的镁(2+)敏感的肾脏 TRPM6 通道有关。确定了醛固酮对肾脏的作用的新机制以及镁(2+)的潜在有益作用的见解,特别是在醛固酮增多症中。