Katz A I, Lindheimer M D
J Clin Invest. 1973 Apr;52(4):796-804. doi: 10.1172/JCI107243.
The relationship between net tubular reabsorption of sodium and renal microsomal sodium- and potassium-activated adenosine triphosphatase (Na-K-ATPase) was evaluated in hypothyroid and hyperthyroid rats and in age-matched euthyroid controls. Tubular sodium reabsorption per gram of kidney was lower in thyroidectomized rats than in controls (186+/-14 vs. 246+/-12 mueq/min; P < 0.005) and was accompanied by a quantitatively similar reduction in Na-K-ATPase specific activity (49.4+/-2.4 vs. 65.8+/-2.3 mumol inorganic phosphate (P(t))/mg protein per h; P < 0.001). This decrement was present in both cortex and outer medulla, and was limited to Na-K-ATPase since other representative enzymes not involved in sodium transport (magnesium-dependent adenosine triphosphatase [Mg-ATPase], glucose-6-phosphatase, 5'-nucleotidase) remained unchanged or increased in the hypothyroid animals. Conversely, Na-K-ATPase rose when sodium reabsorption increased in euthyroid rats treated with triiodothyronine. Subsequent experiments were performed to determine to what extent the decrease in Na-K-ATPase is due to lack of thyroid hormone per se or to an adaptive response to decreased reabsorptive sodium load. Triiodothyronine in concentrations of 10(-12) to 10(-5) M had no effect in vitro on microsomal Na-K-ATPase of either thyroidectomized or euthyroid rats. When hypothyroid rats were uninephrectomized or treated with methylprednisolone, sodium reabsorption per gram kidney increased markedly and was similar to that of intact controls. Despite persistence of the hypothyroid state, Na-K-ATPase specific activity also increased to levels not significantly different from euthyroid animals. These data suggest that decreased tubular sodium transport is a major determinant of the reduction in renal Na-K-ATPase in thyroid deficiency since the latter can be reversed by increasing sodium reabsorption during continuing hypothyroidism. Furthermore, the modest sodium leak of hypothyroid animals does not appear to be due to decreased Na-K-ATPase since it was not corrected by uninephrectomy despite restoration of both cortical and medullary Na-K-ATPase activity to normal by this maneuver. The close correlation between net sodium reabsorption and Na-K-ATPase in all the experimental situations described here demonstrates that renal Na-K-ATPase changes adaptively in hyper- or hypothyroidism as it does in numerous situations in the normal animal, in accord with its postulated role in the active transport of sodium across the renal tubule.
在甲状腺功能减退和甲状腺功能亢进的大鼠以及年龄匹配的甲状腺功能正常的对照大鼠中,评估了肾小管钠重吸收与肾微粒体钠钾激活的三磷酸腺苷酶(Na-K-ATPase)之间的关系。每克肾脏的肾小管钠重吸收在甲状腺切除的大鼠中低于对照组(186±14对246±12微当量/分钟;P<0.005),并且伴随着Na-K-ATPase比活性的类似定量降低(49.4±2.4对65.8±2.3微摩尔无机磷酸盐(P(t))/毫克蛋白质每小时;P<0.001)。这种降低在皮质和外髓质中均存在,并且仅限于Na-K-ATPase,因为其他不参与钠转运的代表性酶(镁依赖性三磷酸腺苷酶[Mg-ATPase]、葡萄糖-6-磷酸酶、5'-核苷酸酶)在甲状腺功能减退的动物中保持不变或增加。相反,在用三碘甲状腺原氨酸治疗的甲状腺功能正常的大鼠中,当钠重吸收增加时,Na-K-ATPase升高。随后进行了实验,以确定Na-K-ATPase的降低在多大程度上是由于甲状腺激素本身的缺乏,还是对重吸收钠负荷降低的适应性反应。浓度为10(-12)至10(-5)M的三碘甲状腺原氨酸在体外对甲状腺切除或甲状腺功能正常的大鼠的微粒体Na-K-ATPase均无影响。当甲状腺功能减退的大鼠进行单侧肾切除或用甲基强的松龙治疗时,每克肾脏的钠重吸收显著增加,与完整对照组相似。尽管甲状腺功能减退状态持续存在,但Na-K-ATPase比活性也增加到与甲状腺功能正常的动物无显著差异的水平。这些数据表明,肾小管钠转运减少是甲状腺功能减退时肾Na-K-ATPase降低的主要决定因素,因为在持续甲状腺功能减退期间通过增加钠重吸收可以逆转后者。此外,甲状腺功能减退动物适度的钠泄漏似乎不是由于Na-K-ATPase降低,因为尽管通过这种操作皮质和髓质Na-K-ATPase活性均恢复正常,但单侧肾切除并未纠正钠泄漏。此处描述的所有实验情况下净钠重吸收与Na-K-ATPase之间的密切相关性表明,肾Na-K-ATPase在甲状腺功能亢进或减退时会像正常动物在许多情况下一样发生适应性变化,这与其在肾小管钠主动转运中的假定作用一致。