Department of Pharmacology, University of Virginia, School of Medicine, Charlottesville, VA 22908, USA.
Hypertension. 2012 May;59(5):999-1005. doi: 10.1161/HYPERTENSIONAHA.111.189662. Epub 2012 Apr 9.
Idiopathic primary hyperaldosteronism (IHA) and low-renin essential hypertension (LREH) are common forms of hypertension, characterized by an elevated aldosterone-renin ratio and hypersensitivity to angiotensin II. They are suggested to be 2 states within a disease spectrum that progresses from LREH to IHA as the control of aldosterone production by the renin-angiotensin system is weakened. The mechanism(s) that drives this progression remains unknown. Deletion of Twik-related acid-sensitive K(+) channels (TASK) subunits, TASK-1 and TASK-3, in mice (T1T3KO) produces a model of human IHA. Here, we determine the effect of deleting only TASK-3 (T3KO) on the control of aldosterone production and blood pressure. We find that T3KO mice recapitulate key characteristics of human LREH, salt-sensitive hypertension, mild overproduction of aldosterone, decreased plasma-renin concentration with elevated aldosterone:renin ratio, hypersensitivity to endogenous and exogenous angiotensin II, and failure to suppress aldosterone production with dietary sodium loading. The relative differences in levels of aldosterone output and aldosterone:renin ratio and in autonomy of aldosterone production between T1T3KO and T3KO mice are reminiscent of differences in human hypertensive patients with LREH and IHA. Our studies establish a model of LREH and suggest that loss of TASK channel activity may be one mechanism that advances the syndrome of low renin hypertension.
特发性醛固酮增多症(IHA)和低肾素原发性高血压(LREH)是常见的高血压形式,其特征是醛固酮-肾素比值升高和对血管紧张素 II 敏感。它们被认为是一种疾病谱中的两种状态,随着肾素-血管紧张素系统对醛固酮产生的控制减弱,从 LREH 进展为 IHA。导致这种进展的机制尚不清楚。在小鼠中敲除 TWIK 相关酸敏感钾(TASK)通道亚基 TASK-1 和 TASK-3(T1T3KO)可产生人类 IHA 的模型。在这里,我们确定仅敲除 TASK-3(T3KO)对醛固酮产生和血压控制的影响。我们发现,T3KO 小鼠重现了人类 LREH 的关键特征,即盐敏感性高血压、醛固酮轻度过度产生、血浆肾素浓度降低伴醛固酮/肾素比值升高、对内源性和外源性血管紧张素 II 敏感以及饮食钠负荷不能抑制醛固酮产生。T1T3KO 和 T3KO 小鼠之间醛固酮输出和醛固酮/肾素比值以及醛固酮产生自主性的相对差异,类似于 LREH 和 IHA 人类高血压患者之间的差异。我们的研究建立了 LREH 的模型,并表明 TASK 通道活性的丧失可能是低肾素高血压综合征进展的一种机制。