Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
Kidney Int. 2017 Nov;92(5):1100-1118. doi: 10.1016/j.kint.2017.04.044. Epub 2017 Jul 26.
Elastin deficiency causes vascular stiffening, a leading risk for hypertension and chronic kidney disease (CKD). The mechanisms mediating hypertension and/or CKD pathogenesis due to elastin deficiency are poorly understood. Using the elastin heterozygous (Eln+/-) mouse model, we tested whether renal dysfunction due to elastin deficiency occurs independently of and precedes the development of hypertension. We assessed blood pressure and renal hemodynamics in 30-day and 12-week-old male and female mice. At P30, blood pressure of Eln+/- mice was similar to wild-type controls; however, renal blood flow was lower, whereas renal vascular resistance was augmented at baseline in Eln+/- mice. At 12 weeks, renal vascular resistance remained elevated while filtration fraction was higher in male Eln+/- relative to wild-type mice. Heterozygous mice showed isolated systolic hypertension that was evident only at nighttime. Acute salt loading with 6% dietary sodium increased daytime systolic blood pressure only in male Eln+/- mice, causing a rightward shift and blunted slope of the pressure-natriuresis curve. Renal interlobar artery basal tone and myogenic response to increasing intraluminal pressure at day 10 were similar, whereas they were augmented at day 30 and at 12 weeks old in Eln+/- mice, and normalized by the AT1R blocker, candesartan. Heterozygous mice also exhibited podocyte foot process damage that persisted even when blood pressure was normalized to wild-type levels with hydralazine. Thus, elastin insufficiency triggers structural defects and abnormal remodeling of renal vascular signaling involving AT1R-mediated vascular mechanotransduction and renal hyperfiltration with increased blood pressure sensitivity to dietary sodium contributing to systolic hypertension.
弹性蛋白缺乏会导致血管僵硬,这是高血压和慢性肾病 (CKD) 的主要风险因素。由于弹性蛋白缺乏导致高血压和/或 CKD 发病机制的机制尚未得到很好的理解。我们使用弹性蛋白杂合子 (Eln+/-) 小鼠模型,测试了由于弹性蛋白缺乏导致的肾功能障碍是否独立于高血压的发展而发生。我们评估了 30 天和 12 周龄雄性和雌性小鼠的血压和肾脏血液动力学。在 P30 时,Eln+/- 小鼠的血压与野生型对照相似;然而,基础状态下 Eln+/- 小鼠的肾血流量较低,而肾血管阻力增加。在 12 周时,Eln+/- 雄性小鼠的肾血管阻力仍然升高,而滤过分数升高。杂合子小鼠表现出孤立性收缩期高血压,仅在夜间明显。急性盐负荷(6%饮食钠)仅增加雄性 Eln+/- 小鼠的日间收缩压,导致压力-排钠曲线向右移位和斜率变平。在第 10 天,肾叶间动脉基础张力和对腔内压力增加的肌源性反应相似,而在第 30 天和 12 周时,Eln+/- 小鼠的这些反应增强,并且通过 AT1R 阻滞剂坎地沙坦使其正常化。杂合子小鼠还表现出足细胞足突损伤,即使在用肼屈嗪将血压正常化至野生型水平时,这种损伤也持续存在。因此,弹性蛋白不足会引发结构缺陷和肾脏血管信号的异常重塑,涉及 AT1R 介导的血管机械转导和高血压对膳食钠的敏感性增加导致的肾高滤过。