Tang Minna, Hu Jialu, Li Wenshu, Zhang Ningzhi, Ning Sisi, Yan Yan, Cui Zhaoqiang
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
School of Public Health, Fudan University, Shanghai, 200032, China.
Int J Hypertens. 2024 Jun 24;2024:4763189. doi: 10.1155/2024/4763189. eCollection 2024.
Ouabain, a Na, K-ATPase inhibitor, is elevated in hypertensive patients. Evidence suggests ouabain contributes to hypertension mainly through activation of the sympathetic nervous system (SNS). Renal nerves play a vital role in the regulation of SNS activity, so we hypothesize that renal denervation may attenuate the development of ouabain-induced hypertension.
Forty Sprague-Dawley rats were divided into following groups ( = 10 each): control group (sham surgery plus intraperitoneal saline injection), RDN group (renal denervation (RDN) plus intraperitoneal saline injection), ouabain group (sham surgery plus intraperitoneal ouabain injection), and ouabain + RDN group (RDN plus intraperitoneal ouabain injection). After eight weeks, compared with the control group, rats in the ouabain group exhibited elevated blood pressure ( < 0.05), increased plasma epinephrine, norepinephrine, angiotensin II, and aldosterone levels ( < 0.05). These indexes could be significantly ameliorated by RDN. RDN also reduced the thickening of aortic tunica media and downregulated the expression of proliferating cell nuclear antigen (PCNA) in the thoracic aorta induced by ouabain. Masson staining and echocardiography showed that myocardial fibrosis and increased left ventricular mass in the ouabain group could be attenuated by RDN.
The present study reveals that renal nerves play an important role in the development of ouabain-induced hypertension. RDN could inhibit the pressor effect and the myocardial remodeling induced by ouabain potentially via inhibiting catecholamine release and vascular smooth muscle cell proliferation. Clinical studies are needed to explore whether RDN may exhibit better antihypertensive effects on hypertensive patients with high plasma ouabain levels as compared to those with normal plasma ouabain levels.
哇巴因是一种钠钾ATP酶抑制剂,在高血压患者中水平升高。有证据表明,哇巴因主要通过激活交感神经系统(SNS)导致高血压。肾神经在SNS活动调节中起关键作用,因此我们推测肾去神经支配可能减弱哇巴因诱导的高血压的发展。
40只Sprague-Dawley大鼠分为以下几组(每组n = 10):对照组(假手术加腹腔注射生理盐水)、肾去神经支配组(RDN,肾去神经支配加腹腔注射生理盐水)、哇巴因组(假手术加腹腔注射哇巴因)和哇巴因+RDN组(RDN加腹腔注射哇巴因)。8周后,与对照组相比,哇巴因组大鼠血压升高(P < 0.05),血浆肾上腺素、去甲肾上腺素、血管紧张素II和醛固酮水平升高(P < 0.05)。RDN可显著改善这些指标。RDN还减轻了哇巴因诱导的主动脉中膜增厚,并下调了胸主动脉中增殖细胞核抗原(PCNA)的表达。Masson染色和超声心动图显示,RDN可减轻哇巴因组的心肌纤维化和左心室质量增加。
本研究表明,肾神经在哇巴因诱导的高血压发展中起重要作用。RDN可能通过抑制儿茶酚胺释放和血管平滑肌细胞增殖,抑制哇巴因诱导的升压作用和心肌重塑。需要进行临床研究,以探讨与血浆哇巴因水平正常的高血压患者相比,RDN对血浆哇巴因水平高的高血压患者是否可能表现出更好的降压效果。