Laboratory of Renal Physiopathology. INC Ignacio Chávez. Mexico City. Mexico.
Dept. of Nephrology. INC Ignacio Chávez. Mexico City. Mexico.
Int J Biol Sci. 2017 Jul 18;13(8):961-975. doi: 10.7150/ijbs.20074. eCollection 2017.
Recurrent dehydration and heat stress cause chronic kidney damage in experimental animals. The injury is exacerbated by rehydration with fructose-containing beverages. Fructose may amplify dehydration-induced injury by directly stimulating vasopressin release and also by acting as a substrate for the aldose reductase-fructokinase pathway, as both of these systems are active during dehydration. The role of vasopressin in heat stress associated injury has not to date been explored. Here we show that the amplification of renal damage mediated by fructose in thermal dehydration is mediated by vasopressin. Fructose rehydration markedly enhanced vasopressin (copeptin) levels and activation of the aldose reductase-fructokinase pathway in the kidney. Moreover, the amplification of the renal functional changes (decreased creatinine clearance and tubular injury with systemic inflammation, renal oxidative stress, and mitochondrial dysfunction) were prevented by the blockade of V1a and V2 vasopressin receptors with conivaptan. On the other hand, there are also other operative mechanisms when water is used as rehydration fluid that produce milder renal damage that is not fully corrected by vasopressin blockade. Therefore, we clearly showed evidence of the cross-talk between fructose, even at small doses, and vasopressin that interact to amplify the renal damage induced by dehydration. These data may be relevant for heat stress nephropathy as well as for other renal pathologies due to the current generalized consumption of fructose and deficient hydration habits.
反复脱水和热应激会导致实验动物的慢性肾脏损伤。用含果糖的饮料进行补液会加重这种损伤。果糖可能通过直接刺激抗利尿激素的释放,以及作为醛糖还原酶-果糖激酶途径的底物来放大脱水引起的损伤,因为这两个系统在脱水时都很活跃。抗利尿激素在与热应激相关的损伤中的作用尚未得到探索。在这里,我们表明,果糖在热脱水介导的肾脏损伤中的放大作用是通过抗利尿激素介导的。果糖补液显著增加了肾脏中的抗利尿激素(copeptin)水平和醛糖还原酶-果糖激酶途径的激活。此外,通过用 conivaptan 阻断 V1a 和 V2 血管加压素受体,可预防肾脏功能变化(全身炎症时肌酐清除率和肾小管损伤、肾氧化应激和线粒体功能障碍)的放大。另一方面,当使用水作为补液液时,也有其他作用机制会产生较轻的肾脏损伤,而这种损伤不能通过抗利尿激素阻断完全纠正。因此,我们清楚地证明了果糖(即使是小剂量)与血管加压素之间的相互作用,这种相互作用会放大脱水引起的肾脏损伤。这些数据可能与热应激性肾病以及由于果糖的普遍消耗和水分不足的习惯导致的其他肾脏病理有关。