Hsueh W A, Goldstone R, Carlson E J, Horton R
J Clin Endocrinol Metab. 1985 Sep;61(3):399-403. doi: 10.1210/jcem-61-3-399.
In normal man, converting enzyme inhibition (CEI) acutely increases plasma active renin and decreases plasma inactive renin. This reciprocal relationship suggests that conversion of inactive to active renin may be important in the acute response to stimulation of renin secretion. To determine whether the beta-adrenergic system or prostaglandins (PGs) participate in the acute effect of CEI on renin, we administered captopril (50 mg) alone and with either propranolol (P; 80 mg) or a PG cyclooxygenase inhibitor [PI; indomethacin (50 mg) or ibuprofen (800 mg)] to normal subjects ingesting a 25 meq/day Na diet. Supine blood pressure fell by 12 +/- 2 (+/- SE) mm Hg with CEI alone, 10 +/- 1 mm Hg with CEI plus P, and 7 +/- 1 mm Hg with CEI plus PI. Active renin rose 8-fold (P less than 0.01), with a peak at 1-2 h, after CEI and 3-fold (P less than 0.02) in response to CEI plus P or CEI plus PI. P did not block the fall in acid-activated inactive renin compared to CEI alone. The nadir of the inactive renin response to both CEI or CEI plus P occurred at 1-2 h. PI, however, prevented the fall in inactive renin. To extend this observation, we compared the effects of infusion of a vasodilator PG (PGA1; 0.6 micrograms/kg X min) and a pure beta-agonist (isoproterenol; 0.3 micrograms/kg X min). PGA1 increased active renin 2.5-fold and decreased inactive renin by 80% (both P less than 0.02), while isoproterenol increased active renin 4.1-fold, but did not significantly change inactive renin. These data suggest that the beta-adrenergic system and PGs at least acutely stimulate renin production at different steps of its biosynthesis or secretion.
在正常人体内,转换酶抑制(CEI)可使血浆活性肾素急性升高,并使血浆无活性肾素降低。这种相反的关系表明,无活性肾素向活性肾素的转化可能在肾素分泌刺激的急性反应中起重要作用。为了确定β-肾上腺素能系统或前列腺素(PGs)是否参与CEI对肾素的急性作用,我们对摄入25毫当量/天钠饮食的正常受试者单独给予卡托普利(50毫克),并与普萘洛尔(P;80毫克)或PG环氧化酶抑制剂[PI;吲哚美辛(50毫克)或布洛芬(800毫克)]联合给药。单独使用CEI时仰卧位血压下降12±2(±标准误)毫米汞柱,CEI加P时下降10±1毫米汞柱,CEI加PI时下降7±1毫米汞柱。活性肾素在CEI后升高8倍(P<0.01),在1 - 2小时达到峰值,而在CEI加P或CEI加PI时升高3倍(P<0.02)。与单独使用CEI相比,P并未阻断酸激活的无活性肾素的下降。无活性肾素对CEI或CEI加P的反应最低点出现在1 - 2小时。然而,PI可防止无活性肾素的下降。为了扩展这一观察结果,我们比较了血管舒张性PG(前列环素A1;0.6微克/千克·分钟)和纯β-激动剂(异丙肾上腺素;0.3微克/千克·分钟)输注的效果。前列环素A1使活性肾素增加2.5倍,使无活性肾素降低80%(两者P<0.02),而异丙肾上腺素使活性肾素增加4.1倍,但未显著改变无活性肾素。这些数据表明,β-肾上腺素能系统和PGs至少在肾素生物合成或分泌的不同步骤急性刺激肾素生成。