Institute of Physiology II, University of Münster, Münster, Germany.
Ann Med. 2012 Jun;44 Suppl 1(Suppl 1):S143-8. doi: 10.3109/07853890.2011.653397. Epub 2012 Apr 3.
Vascular endothelium plays a key role in blood pressure regulation. Recently, it has been shown that a 5% increase of plasma sodium concentration (sodium excess) stiffens endothelial cells by about 25%, leading to cellular dysfunction. Surface measurements demonstrated that the endothelial glycocalyx (eGC), an anionic biopolymer, deteriorates when sodium is elevated. In view of these results, a two-barrier model for sodium exiting the circulation across the endothelium is suggested. The first sodium barrier is the eGC which selectively buffers sodium ions with its negatively charged proteoglycans. The second sodium barrier is the endothelial plasma membrane which contains sodium channels. Sodium excess, in the presence of aldosterone, leads to eGC break-down and, in parallel, to an up-regulation of plasma membrane sodium channels. The following hypothesis is postulated: Sodium excess increases vascular sodium permeability. Under such conditions (e.g. high-sodium diet), day-by-day ingested sodium, instead of being readily buffered by the eGC and then rapidly excreted by the kidneys, is distributed in the whole body before being finally excreted. Gradually, the sodium overload damages the organism.
血管内皮在血压调节中起着关键作用。最近的研究表明,血浆钠离子浓度升高 5%(即钠过剩)会使内皮细胞僵硬约 25%,导致细胞功能障碍。表面测量表明,当钠离子升高时,带负电荷的糖胺聚糖等阴离子生物聚合物组成的内皮糖萼(eGC)会恶化。鉴于这些结果,提出了一个钠离子通过内皮细胞从循环系统中排出的双屏障模型。第一道钠离子屏障是 eGC,它通过带负电荷的糖胺聚糖选择性缓冲钠离子。第二道钠离子屏障是内皮细胞膜,其中含有钠离子通道。在醛固酮的存在下,钠过剩会导致 eGC 破裂,同时,内皮细胞膜上的钠离子通道上调。提出以下假说:钠过剩会增加血管对钠的通透性。在这种情况下(例如高钠饮食),每天摄入的钠不再被 eGC 轻易缓冲,然后迅速由肾脏排出,而是在最终排出之前分布在全身。随着时间的推移,钠过载会损害机体。