Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
J Am Heart Assoc. 2018 Jun 21;7(13):e008259. doi: 10.1161/JAHA.117.008259.
Mineralocorticoid receptor (MR) has pathological roles in various cell types, including renal tubule cells, myocytes, and smooth muscle cells; however, the role of MR in intestinal epithelial cells (IECs) has not been sufficiently evaluated. The intestine is the sensing organ of ingested sodium; accordingly, intestinal MR is expected to have essential roles in blood pressure (BP) regulation.
We generated IEC-specific MR knockout (IEC-MR-KO) mice. With a standard diet, fecal sodium excretion was 1.5-fold higher in IEC-MR-KO mice, with markedly decreased colonic expression of β- and γ-epithelial sodium channel, than in control mice. Urinary sodium excretion in IEC-MR-KO mice decreased by 30%, maintaining sodium balance; however, a low-salt diet caused significant reductions in body weight and BP in IEC-MR-KO mice, and plasma aldosterone exhibited a compensatory increase. With a high-salt diet, intestinal sodium absorption markedly increased to similar levels in both genotypes, without an elevation in BP. Deoxycorticosterone/salt treatment elevated BP and increased intestinal sodium absorption in both genotypes. Notably, the increase in BP was significantly smaller in IEC-MR-KO mice than in control mice. The addition of the MR antagonist spironolactone to deoxycorticosterone/salt treatment eliminated the differences in BP and intestinal sodium absorption between genotypes.
Intestinal MR regulates intestinal sodium absorption in the colon and contributes to BP regulation. These regulatory effects are associated with variation in epithelial sodium channel expression. These findings suggest that intestinal MR is a new target for studying the molecular mechanism of hypertension and cardiovascular diseases.
醛固酮受体(MR)在多种细胞类型中具有病理性作用,包括肾小管细胞、心肌细胞和平滑肌细胞;然而,MR 在肠上皮细胞(IECs)中的作用尚未得到充分评估。肠道是摄入钠的感应器官;因此,肠道 MR 有望在血压(BP)调节中发挥重要作用。
我们生成了 IEC 特异性 MR 敲除(IEC-MR-KO)小鼠。在标准饮食下,IEC-MR-KO 小鼠的粪便钠排泄量是对照组的 1.5 倍,结肠中β和γ上皮钠通道的表达明显减少。IEC-MR-KO 小鼠的尿钠排泄量减少了 30%,维持了钠平衡;然而,低钠饮食导致 IEC-MR-KO 小鼠体重和 BP 显著下降,血浆醛固酮呈代偿性增加。在高盐饮食下,肠道钠吸收明显增加到两种基因型相似的水平,BP 没有升高。地塞米松/盐处理使两种基因型的 BP 升高,肠道钠吸收增加。值得注意的是,BP 的升高在 IEC-MR-KO 小鼠中明显小于对照组。在地塞米松/盐处理中加入 MR 拮抗剂螺内酯消除了基因型间 BP 和肠道钠吸收的差异。
肠道 MR 调节结肠中的肠道钠吸收,有助于 BP 调节。这些调节作用与上皮钠通道表达的变化有关。这些发现表明,肠道 MR 是研究高血压和心血管疾病分子机制的新靶点。