Missale C, Lombardi C, De Cotiis R, Memo M, Carruba M O, Spano P F
Institute of Pharmacology and Experimental Therapeutics, School of Medicine, University of Brescia, Italy.
J Cardiovasc Pharmacol. 1989;14 Suppl 8:S29-39.
Several studies suggested that dopamine may be one of the inhibitory modulators of aldosterone secretion. Metoclopramide, a selective antagonist for dopamine D-2 receptors, increases both basal plasma aldosterone levels and the aldosterone response to angiotensin II (Ang II) in rats and humans kept on a high sodium intake, these effects being blocked by dopamine infusion. Dopamine, which has no significant effects on Ang II-induced aldosterone secretion in sodium-replete subjects, inhibits the hormonal response to Ang II infusion in sodium-depleted normal subjects, suggesting that the sodium balance state may be an important factor in the dopaminergic mechanisms controlling aldosterone secretion. The effect of dopamine on the hormone production is mediated by D-2 receptors in the adrenal cortex as shown by in vitro studies with isolated adrenal glomerulosa cells. Clinical studies have shown that dihydroergotoxine, a selective D-2 agonist, suppresses the aldosterone secretion induced by sodium depletion in hypertensive patients, an effect blocked by sulpiride. This mechanism could be of relevant therapeutic interest in its contribution to the natriuretic effects of dopaminergic agonists, which have clinical applications in the treatment of hypertension and congestive heart failure.
多项研究表明，多巴胺可能是醛固酮分泌的抑制性调节因子之一。甲氧氯普胺是一种多巴胺D - 2受体的选择性拮抗剂，在高钠摄入的大鼠和人类中，它会增加基础血浆醛固酮水平以及醛固酮对血管紧张素II（Ang II）的反应，多巴胺输注可阻断这些作用。多巴胺在钠充足的受试者中对Ang II诱导的醛固酮分泌无显著影响，但在钠缺乏的正常受试者中会抑制对Ang II输注的激素反应，这表明钠平衡状态可能是多巴胺能机制控制醛固酮分泌的一个重要因素。体外对分离的肾上腺球状带细胞的研究表明，多巴胺对激素产生的作用是由肾上腺皮质中的D - 2受体介导的。临床研究表明，选择性D - 2激动剂双氢麦角毒碱可抑制高血压患者因钠缺乏诱导的醛固酮分泌，舒必利可阻断这一作用。这种机制可能与其对多巴胺能激动剂利钠作用的贡献具有相关治疗意义，多巴胺能激动剂在高血压和充血性心力衰竭的治疗中具有临床应用价值。
