Bugge J F
J Oslo City Hosp. 1989 Nov-Dec;39(11-12):123-36.
Similar distributions of prostaglandins in urine and renal venous blood both during prostaglandin infusion and stimulated synthesis indicated a vascular origin for both urinary and renal venous PGE2 and PGI2. Various stimulation procedures demonstrated that the renal vasculature releases PGE2 and PGI2 in a fixed proportion. Renal degradation of circulating prostaglandins was not influenced by ureteral occlusion and seems to be mainly confined to the blood vessels. The vascular capacity for both synthesis and degradation was much greater for PGE2 than for PGI2. Urinary PGE2 was shown to be of renal origin, but constituted a small and variable fraction of renally produced PGE2, making it a poor estimate of renal PGE2 synthesis. Urinary 6-keto-PGF1 alpha may originate from renal PGI2 production or from circulating 6-keto-PGF1 alpha which readily appears in the urine. Equimolar infusions of PGE2 and PGI2 demonstrated that PGI2 was a more potent stimulator of renin release than PGE2, but the difference seemed to be mainly due to differences in degradation and not to differences in intrinsic potency. Prostaglandins stimulated renin release only when the intrarenal mechanisms for renin release were activated and not at control blood pressure and free urine flow. beta-adrenoceptor agonists stimulated renin release independently of activation of the macula densa, but required activation of the hemodynamic mechanism. Ethacrynic acid activated both the hemodynamic and the macula densa mechanism, but had no direct stimulatory effect on renin release. PGE2 and PGI2 were released during autoregulatory vasodilation, but neither PGE2 nor PGI2 participated in the autoregulatory mechanism. Autoregulatory and prostaglandin mediated vasodilation seems to be independent. Descending autoregulatory vasodilation was demonstrated during successive reductions in RAP, but a more simultaneous dilation of all preglomerular vessels was indicated during successive elevations of ureteral pressure. This difference may be due to participation of TGF together with the myogenic mechanism in autoregulation of RBF. Participation of TGF may also explain why prostaglandin and renin release dissociate during successive reductions in RAP, but increase in parallel during successive elevations of ureteral pressure. It also explains why maximal renin release induced both by the hemodynamic and the macula densa mechanism coincides with the breaking point of the RBF autoregulatory curve, and why loop diuretics induce complete autoregulatory vasodilation at control blood pressure.
在前列腺素输注和刺激合成过程中,尿液和肾静脉血中前列腺素的分布相似,这表明尿液和肾静脉中的PGE2和PGI2均起源于血管。各种刺激程序表明,肾血管系统以固定比例释放PGE2和PGI2。循环前列腺素的肾脏降解不受输尿管阻塞的影响,似乎主要局限于血管。PGE2的合成和降解的血管能力比PGI2大得多。尿液中的PGE2显示起源于肾脏,但仅占肾脏产生的PGE2的一小部分且变化不定,因此它不是肾脏PGE2合成的良好估计指标。尿液中的6-酮-PGF1α可能源自肾脏PGI2的产生,也可能源自易出现在尿液中的循环6-酮-PGF1α。等摩尔输注PGE2和PGI2表明,PGI2比PGE2更能有效刺激肾素释放,但这种差异似乎主要是由于降解差异,而非内在活性差异。前列腺素仅在肾素释放的肾内机制被激活时才刺激肾素释放,而在对照血压和自由尿流时则不会。β-肾上腺素能受体激动剂独立于致密斑的激活而刺激肾素释放,但需要血流动力学机制的激活。依他尼酸激活了血流动力学和致密斑机制,但对肾素释放没有直接刺激作用。在自动调节性血管舒张过程中释放PGE2和PGI2,但PGE2和PGI2均不参与自动调节机制。自动调节性和前列腺素介导的血管舒张似乎是独立的。在肾动脉压连续降低期间显示出下行自动调节性血管舒张,但在输尿管压力连续升高期间表明所有肾小球前血管更同时舒张。这种差异可能是由于管球反馈与肌源性机制共同参与肾血流量的自动调节。管球反馈的参与也可以解释为什么在肾动脉压连续降低期间前列腺素和肾素释放会分离,但在输尿管压力连续升高期间会平行增加。这也解释了为什么由血流动力学和致密斑机制诱导的最大肾素释放与肾血流量自动调节曲线的断点一致,以及为什么袢利尿剂在对照血压下诱导完全的自动调节性血管舒张。