aDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands bDivision of Women's Health, Women's Health Academic Centre KHP, King's College London, London, UK.
J Hypertens. 2017 Dec;35(12):2537-2547. doi: 10.1097/HJH.0000000000001472.
Material obesity in rodents is associated with neonatal hyperleptinemia and hypertension of sympathetic origin in adult offspring. Previously, we reported that experimentally induced hyperleptinemia in rat pups results in adulthood hypertension. Here, we addressed the hypothesis that experimental neonatal hyperleptinemia, through renal nerve activation, adversely affects adult renal function.
Sprague-Dawley male and female pups were treated with neonatal leptin (3 mg/kg, intraperitoneal) or neonatal saline, twice daily from postnatal day 9-14. Juvenile (1 month) neonatal leptin and neonatal saline rats were subjected to either bilateral renal denervation, unilateral renal denervation or Sham surgery. Arterial pressure was telemetrically monitored.
Juvenile neonatal leptin rats with intact renal nerves demonstrated increased mean arterial pressure (MAP) accompanied by local renin-angiotensin system overactivity and reduced glomerular filtration rate. Bilateral renal denervation in rats protected against neonatal leptin-induced MAP, renal renin-angiotensin system and impaired glomerular filtration rate. A two-fold increase in sympathetically mediated tubulointerstitial damage in young adult (2 months) neonatal leptin females, was suppressed by unilateral renal denervation, independent of MAP. Neonatal leptin rats also demonstrated increases in urinary protein, neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1. Raised blood pressure was associated with increased salt sensitivity and with sustained renal dysfunction in adulthood.
We propose that neonatal hyperleptinemia programmes long-term renal structural and functional damage, through renal sympathetic nerve activation.
啮齿动物的物质肥胖与新生儿高瘦素血症和交感神经源性高血压有关。此前,我们报道过,实验诱导的新生大鼠高瘦素血症会导致成年后高血压。在这里,我们假设实验性新生儿高瘦素血症通过肾神经激活,对成年肾功能产生不利影响。
雄性和雌性斯普拉格-道利大鼠幼崽从出生后第 9-14 天起,每天两次接受腹腔内注射 3mg/kg 的新生瘦素或新生盐水。将幼崽(1 个月)的新生瘦素和新生盐水大鼠进行双侧肾去神经支配、单侧肾去神经支配或假手术。通过遥测监测动脉压。
具有完整肾神经的幼崽新生瘦素大鼠表现出平均动脉压(MAP)升高,伴有局部肾素-血管紧张素系统过度活跃和肾小球滤过率降低。在大鼠中进行双侧肾去神经支配可预防新生瘦素诱导的 MAP、肾肾素-血管紧张素系统和肾小球滤过率受损。在年轻成年(2 个月)的新生瘦素雌性大鼠中,交感神经介导的肾小管间质损伤增加了两倍,通过单侧肾去神经支配得到抑制,与 MAP 无关。新生瘦素大鼠还表现出尿蛋白、中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子-1 的增加。血压升高与盐敏感性增加和成年后持续肾功能障碍有关。
我们提出,新生儿高瘦素血症通过肾交感神经激活,对长期的肾脏结构和功能损伤进行编程。