静息肾传入神经放电与肾炎症:阐明肾传入和传出神经在醋酸脱氧皮质酮盐高血压中的作用

Resting Afferent Renal Nerve Discharge and Renal Inflammation: Elucidating the Role of Afferent and Efferent Renal Nerves in Deoxycorticosterone Acetate Salt Hypertension.

作者信息

Banek Christopher T, Knuepfer Mark M, Foss Jason D, Fiege Jessica K, Asirvatham-Jeyaraj Ninitha, Van Helden Dusty, Shimizu Yoji, Osborn John W

机构信息

From the Department of Integrative Biology and Physiology (C.T.B., J.D.F., N.A.-J., D.V.H., J.W.O.) and Department of Laboratory Medicine and Pathology (J.K.F., Y.S), University of Minnesota Medical School, Minneapolis; and Department of Pharmacology and Physiology, Saint Louis University School of Medicine, MO (M.M.K.).

出版信息

Hypertension. 2016 Dec;68(6):1415-1423. doi: 10.1161/HYPERTENSIONAHA.116.07850. Epub 2016 Oct 3.

Abstract

Renal sympathetic denervation (RDNx) has emerged as a novel therapy for hypertension; however, the therapeutic mechanisms remain unclear. Efferent renal sympathetic nerve activity has recently been implicated in trafficking renal inflammatory immune cells and inflammatory chemokine and cytokine release. Several of these inflammatory mediators are known to activate or sensitize afferent nerves. This study aimed to elucidate the roles of efferent and afferent renal nerves in renal inflammation and hypertension in the deoxycorticosterone acetate (DOCA) salt rat model. Uninephrectomized male Sprague-Dawley rats (275-300 g) underwent afferent-selective RDNx (n=10), total RDNx (n=10), or Sham (n=10) and were instrumented for the measurement of mean arterial pressure and heart rate by radiotelemetry. Rats received 100-mg DOCA (SC) and 0.9% saline for 21 days. Resting afferent renal nerve activity in DOCA and vehicle animals was measured after the treatment protocol. Renal tissue inflammation was assessed by renal cytokine content and T-cell infiltration and activation. Resting afferent renal nerve activity, expressed as a percent of peak afferent nerve activity, was substantially increased in DOCA than in vehicle (35.8±4.4 versus 15.3±2.8 %Amax). The DOCA-Sham hypertension (132±12 mm Hg) was attenuated by ≈50% in both total RDNx (111±8 mm Hg) and afferent-selective RDNx (117±5 mm Hg) groups. Renal inflammation induced by DOCA salt was attenuated by total RDNx and unaffected by afferent-selective RDNx. These data suggest that afferent renal nerve activity may mediate the hypertensive response to DOCA salt, but inflammation may be mediated primarily by efferent renal sympathetic nerve activity. Also, resting afferent renal nerve activity is elevated in DOCA salt rats, which may highlight a crucial neural mechanism in the development and maintenance of hypertension.

摘要

肾交感神经去支配术(RDNx)已成为一种治疗高血压的新方法;然而,其治疗机制仍不清楚。最近有研究表明,传出性肾交感神经活动与肾内炎性免疫细胞的转运以及炎性趋化因子和细胞因子的释放有关。已知其中几种炎性介质可激活传入神经或使其致敏。本研究旨在阐明在醋酸脱氧皮质酮(DOCA)盐大鼠模型中,传出性和传入性肾神经在肾炎症和高血压中的作用。对单侧肾切除的雄性Sprague-Dawley大鼠(275 - 300 g)进行传入神经选择性RDNx(n = 10)、完全RDNx(n = 10)或假手术(n = 10),并通过无线电遥测技术测量平均动脉压和心率。大鼠接受100 mg DOCA(皮下注射)和0.9%生理盐水,持续21天。在治疗方案结束后,测量DOCA组和对照组动物的静息传入性肾神经活动。通过肾细胞因子含量以及T细胞浸润和激活情况评估肾组织炎症。以传入神经活动峰值的百分比表示的静息传入性肾神经活动,DOCA组显著高于对照组(35.8±4.4对15.3±2.8 %Amax)。DOCA-假手术组的高血压(132±12 mmHg)在完全RDNx组(111±8 mmHg)和传入神经选择性RDNx组(117±5 mmHg)中均降低了约50%。DOCA盐诱导的肾炎症在完全RDNx组中减轻,而在传入神经选择性RDNx组中未受影响。这些数据表明,传入性肾神经活动可能介导了对DOCA盐的高血压反应,但炎症可能主要由传出性肾交感神经活动介导。此外,DOCA盐大鼠的静息传入性肾神经活动升高,这可能突出了高血压发生和维持过程中的一个关键神经机制。

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