Yang Ting, Zollbrecht Christa, Winerdal Malin E, Zhuge Zhengbing, Zhang Xing-Mei, Terrando Niccolo, Checa Antonio, Sällström Johan, Wheelock Craig E, Winqvist Ola, Harris Robert A, Larsson Erik, Persson A Erik G, Fredholm Bertil B, Carlström Mattias
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
J Am Heart Assoc. 2016 Jul 18;5(7):e003868. doi: 10.1161/JAHA.116.003868.
Early-life reduction in nephron number (uninephrectomy [UNX]) and chronic high salt (HS) intake increase the risk of hypertension and chronic kidney disease. Adenosine signaling via its different receptors has been implicated in modulating renal, cardiovascular, and metabolic functions as well as inflammatory processes; however, the specific role of the A3 receptor in cardiovascular diseases is not clear. In this study, gene-modified mice were used to investigate the hypothesis that lack of A3 signaling prevents the development of hypertension and attenuates renal and cardiovascular injuries following UNX in combination with HS (UNX-HS) in mice.
Wild-type (A3 (+/+)) mice subjected to UNX-HS developed hypertension compared with controls (mean arterial pressure 106±3 versus 82±3 mm Hg; P<0.05) and displayed an impaired metabolic phenotype (eg, increased adiposity, reduced glucose tolerance, hyperinsulinemia). These changes were associated with both cardiac hypertrophy and fibrosis together with renal injuries and proteinuria. All of these pathological hallmarks were significantly attenuated in the A3 (-/-) mice. Mechanistically, absence of A3 receptors protected from UNX-HS-associated increase in renal NADPH oxidase activity and Nox2 expression. In addition, circulating cytokines including interleukins 1β, 6, 12, and 10 were increased in A3 (+/+) following UNX-HS, but these cytokines were already elevated in naïve A3 (-/-) mice and did not change following UNX-HS.
Reduction in nephron number combined with chronic HS intake is associated with oxidative stress, chronic inflammation, and development of hypertension in mice. Absence of adenosine A3 receptor signaling was strongly protective in this novel mouse model of renal and cardiovascular disease.
早年肾单位数量减少(单侧肾切除术[UNX])和慢性高盐(HS)摄入会增加患高血压和慢性肾病的风险。腺苷通过其不同受体发出的信号参与调节肾脏、心血管和代谢功能以及炎症过程;然而,A3受体在心血管疾病中的具体作用尚不清楚。在本研究中,使用基因修饰小鼠来研究以下假设:缺乏A3信号可预防高血压的发生,并减轻小鼠UNX联合HS(UNX-HS)后的肾脏和心血管损伤。
与对照组相比,接受UNX-HS的野生型(A3(+/+))小鼠出现高血压(平均动脉压106±3对82±3 mmHg;P<0.05),并表现出代谢表型受损(如肥胖增加、糖耐量降低、高胰岛素血症)。这些变化与心脏肥大、纤维化以及肾损伤和蛋白尿有关。所有这些病理特征在A3(-/-)小鼠中均显著减轻。从机制上讲,缺乏A3受体会保护小鼠免受UNX-HS相关的肾NADPH氧化酶活性和Nox2表达增加的影响。此外,在UNX-HS后的A3(+/+)小鼠中,包括白细胞介素1β、6、12和10在内的循环细胞因子增加,但这些细胞因子在未处理的A3(-/-)小鼠中已经升高,并且在UNX-HS后没有变化。
肾单位数量减少与慢性HS摄入相结合与小鼠的氧化应激、慢性炎症和高血压发展有关。在这种新的肾和心血管疾病小鼠模型中,腺苷A3受体信号缺失具有很强的保护作用。