From the Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville (B.A.K., N.L.H., S.R.K., R.M.C.).
Department of Pathology, University of Virginia Health System, Charlottesville (J.J.G.).
Circ Res. 2020 Feb 28;126(5):644-659. doi: 10.1161/CIRCRESAHA.119.316193. Epub 2020 Jan 30.
Previous studies identified a defect in Ang III (angiotensin III [des-aspartyl-angiotensin II])-elicited ATR (Ang type-2 receptor)-mediated natriuresis in renal proximal tubule cells of spontaneously hypertensive rats (SHR).
This study aimed to delineate in prehypertensive SHR kidneys the receptor or postreceptor defect causing impaired ATR signaling and renal sodium (Na) retention by utilizing the selective ATR agonist compound-21 (C-21).
Female 4-week-old Wistar Kyoto and SHR rats were studied after 24-hour systemic ATR (Ang II type-1 receptor) blockade. Left kidneys received 30-minute renal interstitial infusions of vehicle followed by C-21 (20, 40, and 60 ng/[kg·min], each dose 30 minutes). Right kidneys received vehicle infusions. In Wistar Kyoto, C-21 dose-dependently increased urine Na excretion from 0.023±0.01 to 0.064±0.02, 0.087±0.01, and 0.089±0.01 µmol/min (=0.008, <0.0001, and <0.0001, respectively) and renal interstitial fluid levels of ATR downstream signaling molecule cGMP (cyclic guanosine 3',5' monophosphate) from 0.91±0.3 to 3.1±1.0, 5.9±1.2 and 5.3±0.5 fmol/mL (=nonsignificant, <0.0001, and <0.0001, respectively). In contrast, C-21 did not increase urine Na excretion or renal interstitial cGMP in SHR. Mean arterial pressure was slightly higher in SHR but within the normotensive range and unaffected by C-21. In Wistar Kyoto, but not SHR, C-21 induced ATR translocation to apical plasma membranes of renal proximal tubule cells, internalization/inactivation of NHE-3 (sodium-hydrogen exchanger-3) and Na/KATPase (sodium-potassium-atpase) and phosphorylation of ATR-cGMP downstream signaling molecules Src (Src family kinase), ERK (extracellular signal-related kinase), and VASP (vasodilator-stimulated phosphoprotein). To test whether cGMP could bypass the natriuretic defect in SHR, we infused 8-bromo-cGMP. This restored natriuresis, Na transporter internalization/inactivation, and Src and VASP phosphorylation, but not apical plasma membrane ATR recruitment. In contrast, 8-bromo-cAMP administration had no effect on natriuresis or ATR recruitment in SHR.
The results demonstrate a primary renal proximal tubule cell ATR natriuretic defect in SHR that may contribute to the development of hypertension. Since the defect is abrogated by exogenous intrarenal cGMP, the renal cGMP pathway may represent a viable target for the treatment of hypertension. Visual Overview: An online visual overview is available for this article.
先前的研究表明,自发性高血压大鼠(SHR)的肾近端小管细胞中存在血管紧张素 III(血管紧张素 III [去天冬氨酸血管紧张素 II])诱导的 ATR(血管紧张素 II 型 2 受体)介导的利钠作用缺陷。
本研究旨在利用选择性 ATR 激动剂化合物 21(C-21),阐明在预高血压 SHR 肾脏中导致 ATR 信号转导受损和肾钠(Na)潴留的受体或受体后缺陷。
4 周龄雌性 Wistar 京都大鼠和 SHR 大鼠在 24 小时全身 ATR(血管紧张素 II 型 1 受体)阻断后进行研究。左肾接受 30 分钟的肾间质输注载体,然后接受 C-21(20、40 和 60ng/[kg·min],每种剂量 30 分钟)。右肾接受载体输注。在 Wistar 京都大鼠中,C-21 剂量依赖性地增加尿 Na 排泄,从 0.023±0.01 增加至 0.064±0.02、0.087±0.01 和 0.089±0.01µmol/min(=0.008,<0.0001 和 <0.0001,分别),肾间质液中 ATR 下游信号分子 cGMP(环鸟苷酸 3',5' 单磷酸)水平从 0.91±0.3 增加至 3.1±1.0、5.9±1.2 和 5.3±0.5 fmol/mL(=无统计学意义,<0.0001 和 <0.0001,分别)。相比之下,C-21 并未增加 SHR 的尿 Na 排泄或肾间质 cGMP。SHR 的平均动脉压略高,但仍处于正常血压范围内,不受 C-21 影响。在 Wistar 京都大鼠中,但不在 SHR 中,C-21 诱导 ATR 向肾近端小管细胞的顶质膜转位,NHE-3(钠-氢交换器-3)和 Na/KATPase(钠-钾-atpase)的内化/失活以及 ATR-cGMP 下游信号分子Src(Src 家族激酶)、ERK(细胞外信号相关激酶)和 VASP(血管扩张刺激磷酸蛋白)的磷酸化。为了测试 cGMP 是否可以绕过 SHR 的利钠缺陷,我们输注了 8-溴-cGMP。这恢复了利钠、Na 转运体内化/失活以及 Src 和 VASP 磷酸化,但没有募集顶端质膜 ATR。相比之下,8-溴-cAMP 给药对 SHR 的利钠作用或 ATR 募集没有影响。
结果表明 SHR 存在原发性肾近端小管细胞 ATR 利钠缺陷,这可能导致高血压的发生。由于缺陷被内源性肾 cGMP 消除,因此肾 cGMP 途径可能成为治疗高血压的可行靶点。
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