Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University.
Institute of Nephrology, Zhengzhou University.
J Hypertens. 2023 Jun 1;41(6):958-970. doi: 10.1097/HJH.0000000000003419. Epub 2023 Apr 4.
Functional impairment of renal sodium handling and blood pressure (BP) homeostasis is an early characteristic manifestation of type 1 diabetes. However, the underlying mechanisms remain unclear.
Metabolic cages, radio-telemetry, immunoblotting, and electrophysiology were utilized to examine effects of high salt (8% NaCl, HS) intake on Na + /K + balance, BP, Na + -Cl - cotransporter (NCC) function, and basolateral K + channel activity in the distal convoluted tubule (DCT) under diabetic conditions.
Improper Na + balance, hypernatremia, and a mild but significant increase in BP were found in streptozotocin (STZ)-induced diabetic mice in response to HS intake for 7 days. Compared to the vehicle, STZ mice showed increased Kir4.1 expression and activity in the DCT, a more negative membrane potential, higher NCC abundance, and enhanced hydrochlorothiazide-induced natriuretic effect. However, HS had no significant effect on basolateral Kir4.1 expression/activity and DCT membrane potential, or NCC activity under diabetic conditions, despite a downregulation in phosphorylated NCC abundance. In contrast, HS significantly downregulated the expression of Na + -H + exchanger 3 (NHE3) and cleaved epithelial sodium channel-γ in STZ mice, despite an increase in NHE3 abundance after STZ treatment. Kir4.1 deletion largely abolished STZ-induced upregulation of NCC expression and prevented BP elevation during HS intake. Interestingly, HS causes severe hypokalemia in STZ-treated kidney-specific Kir4.1 knockout (Ks-Kir4.1 KO) mice and lead to death within a few days, which could be attributed to a higher circulating aldosterone level.
We concluded that Kir4.1 is required for upregulating NCC activity and may be essential for developing salt-sensitive hypertension in early STZ-induced diabetes.
肾脏钠处理和血压(BP)稳态的功能障碍是 1 型糖尿病的早期特征性表现。然而,其潜在机制尚不清楚。
利用代谢笼、无线电遥测、免疫印迹和电生理学方法,研究高盐(8%NaCl,HS)摄入对糖尿病条件下近端曲管(DCT)钠离子/钾离子平衡、BP、钠离子-氯离子共转运蛋白(NCC)功能和基底外侧钾通道活性的影响。
在链脲佐菌素(STZ)诱导的糖尿病小鼠中,7 天 HS 摄入后发现钠平衡失调、高钠血症和 BP 轻度但显著升高。与载体相比,STZ 小鼠的 DCT 中 Kir4.1 表达和活性增加,膜电位更负,NCC 丰度更高,氢氯噻嗪诱导的排钠作用增强。然而,HS 对糖尿病条件下 DCT 基底外侧 Kir4.1 表达/活性和 DCT 膜电位或 NCC 活性没有显著影响,尽管磷酸化 NCC 丰度下调。相反,HS 显著下调了 STZ 小鼠的钠氢交换体 3(NHE3)和上皮钠通道-γ的表达,尽管 STZ 处理后 NHE3 丰度增加。Kir4.1 缺失在很大程度上消除了 STZ 诱导的 NCC 表达上调,并防止了 HS 摄入期间 BP 升高。有趣的是,HS 会导致 STZ 处理的肾脏特异性 Kir4.1 敲除(Ks-Kir4.1 KO)小鼠严重低钾血症,并在数天内死亡,这可能归因于循环醛固酮水平升高。
我们得出结论,Kir4.1 上调 NCC 活性所必需的,可能对早期 STZ 诱导的糖尿病中盐敏感性高血压的发展至关重要。