Mai Tu H, Garland Emily M, Diedrich André, Robertson David
Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Department of Clinical Pharmacology, Vanderbilt University, Nashville, TN, United States.
Department of Medicine, Vanderbilt University Medical Center, United States; Department of Clinical Pharmacology, Vanderbilt University, Nashville, TN, United States.
Auton Neurosci. 2017 Mar;203:58-66. doi: 10.1016/j.autneu.2017.01.007. Epub 2017 Jan 27.
Increased blood pressure (BP) is observed in patients with impaired baroreflexes after water drinking. The stimulus for this effect is low blood osmolality, and it has been termed the osmopressor response (OPR). The BP increase is associated with activation of the sympathetic nervous system and a requirement for transient receptor potential vanilloid 4 (TRPV4) channels. However, the mechanisms underlying the OPR are poorly understood. We tested the hypothesis that hypotonicity is sensed in the portal area to initiate the OPR. Sino-aortic denervated mice were used and BP was monitored for 30min after fluid infusion while mice were under anesthesia. Infusion of hypotonic fluid (0.45% saline), but not of isotonic 0.9% saline, directly into the portal vein, produced an immediate OPR (increase in BP with saline 0.45%: 15±13 vs. 0.9%: -7±2mmHg, p=0.003; AUC: 0.45%: 150±99, n=7 vs. 0.9%: -74±60mmHg·min, n=5, p=0.003). However, 0.45% saline was not able to trigger a similar response in TRPV4 mice (ΔBP: -2±5mmHg, n=8, p=0.009). Hypotonic saline did not raise BP when infused at the same speed and volume into the jugular vein (jugular: -5±6mmHg, p=0.002, compared to portal). Denervation of the splanchnic nerve by celiac ganglionectomy (CGX) did not abolish the OPR (CGX: 15±11 vs. Sham: 16±6mmHg, p=0.34). Renal denervation diminished the OPR elicited by duodenal water infusion (denervation: 9±4 vs. sham: 31±15mmHg, p=0.016). Therefore, hypotonicity in the portal circulation, probably sensed by TRPV4 channels, triggers the OPR and intact renal nerves are needed for the full response.
在饮水后压力反射受损的患者中观察到血压(BP)升高。这种效应的刺激因素是低血渗透压,它被称为渗透压加压反应(OPR)。血压升高与交感神经系统的激活以及瞬时受体电位香草酸受体4(TRPV4)通道的需求有关。然而,OPR的潜在机制尚不清楚。我们测试了这样一个假设,即在门静脉区域感知到低渗性以启动OPR。使用去窦弓神经小鼠,在麻醉状态下给小鼠输注液体后监测血压30分钟。将低渗液体(0.45%盐水)而非等渗的0.9%盐水直接注入门静脉,会立即产生OPR(0.45%盐水时血压升高:15±13 vs. 0.9%盐水时:-7±2mmHg,p = 0.003;曲线下面积:0.45%盐水时:150±99,n = 7 vs. 0.9%盐水时:-74±60mmHg·min,n = 5,p = 0.003)。然而,0.45%盐水在TRPV4基因敲除小鼠中无法引发类似反应(血压变化:-2±5mmHg,n = 8,p = 0.009)。当以相同速度和体积将低渗盐水注入颈静脉时,血压并未升高(颈静脉:-5±6mmHg,与门静脉相比,p = 0.002)。通过腹腔神经节切除术(CGX)去内脏神经并没有消除OPR(CGX组:15±11 vs.假手术组:16±6mmHg,p = 0.34)。肾去神经减弱了十二指肠注水引发的OPR(去神经组:9±4 vs.假手术组:31±15mmHg,p = 0.016)。因此,门静脉循环中的低渗性可能由TRPV4通道感知,触发了OPR,并且完整的肾神经对于完全反应是必需的。