Harrison-Bernard Lisa M, de Garavilla Lawrence, Bivona Benjamin J
Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA.
Ochsner J. 2013 Spring;13(1):49-55.
Diabetic nephropathy (DN) is associated with enhanced renal, plasma, and urinary endothelin (ET)-1 levels. Chymase cleaves Big ET-1 (1-38) to ET-1 (1-31), which is further cleaved by neutral endopeptidase to ET-1 (1-21). The current study tested the hypothesis that afferent arterioles (AA) of diabetic kidneys exhibit enhanced vasoconstrictor responses to chymase-dependent intrarenal ET formation compared to control kidneys.
In situ juxtamedullary AA vasoconstrictor responses to the intrarenal conversion of Big ET-1 (1-38) to ET-1 (1-21) were performed in the absence and presence of chymase inhibition in type 2 diabetic db/db and control db/m mice studied under in vitro experimental conditions.
AA vasoconstrictor responses to Big ET-1 (1-38) were significantly enhanced in diabetic compared to control kidneys. In the presence of chymase inhibition (JNJ-18054478), AA vasoconstrictor responses of diabetic kidneys to Big ET-1 (1-38) were significantly less than the responses of control kidneys. AA diameters decreased similarly to ET-1 (1-21) in diabetic and control kidneys.
AA responses to the intrarenal conversion of Big ET-1 (1-38) to ET-1 in the absence of chymase enzymatic activity were significantly reduced in kidneys of diabetic compared to control mice, while the magnitude of the vasoconstriction to ET-1 (1-21) was not different. These data suggest that AA vasoconstriction produced by the chymase-dependent pathway is significantly greater in diabetic compared to control kidneys. We propose that intrarenal chymase-dependent ET-1 production contributes to the decline in function and progression to end-stage renal disease in patients with type 2 diabetes.
糖尿病肾病(DN)与肾脏、血浆及尿液中内皮素(ET)-1水平升高有关。糜酶可将大内皮素-1(1-38)裂解为内皮素-1(1-31),后者再被中性内肽酶进一步裂解为内皮素-1(1-21)。本研究检验了以下假设:与对照肾脏相比,糖尿病肾脏的入球小动脉(AA)对糜酶依赖性肾内ET生成表现出更强的血管收缩反应。
在体外实验条件下,对2型糖尿病db/db小鼠和对照db/m小鼠,在有无糜酶抑制的情况下,进行原位近髓AA对大内皮素-1(1-38)向内皮素-1(1-21)肾内转化的血管收缩反应实验。
与对照肾脏相比,糖尿病肾脏中AA对大内皮素-1(1-38)的血管收缩反应显著增强。在存在糜酶抑制(JNJ-18054478)的情况下,糖尿病肾脏对大内皮素-1(1-38)的AA血管收缩反应明显小于对照肾脏。糖尿病和对照肾脏中AA直径的降低与内皮素-1(1-21)相似。
与对照小鼠相比,糖尿病小鼠肾脏在无糜酶酶活性时对大内皮素-1(1-38)向内皮素-1肾内转化的AA反应显著降低,而对内皮素-1(1-21)的血管收缩幅度并无差异。这些数据表明,与对照肾脏相比,糖尿病肾脏中糜酶依赖性途径产生的AA血管收缩作用明显更强。我们认为,肾内糜酶依赖性内皮素-1生成促成了2型糖尿病患者的肾功能下降及向终末期肾病的进展。