Kusano E, Braun-Werness J L, Vick D J, Keller M J, Dousa T P
J Clin Invest. 1983 Oct;72(4):1298-313. doi: 10.1172/JCI111086.
To determine vasopressin (VP)-potentiating effect of chlorpropamide (CPMD), we studied the effect of CPMD in vivo and in vitro in kidneys and in specific tubule segments of rats with hypothalamic diabetes insipidus, homozygotes of the Brattleboro strain (DI rats). Rats on ad lib. water intake were treated with CPMD (20 mg/100 g body wt s.c. daily) for 7 d. While on ad lib. water intake, the urine flow, urine osmolality, urinary excretion of Na +, K +, creatinine, or total solute excretion did not change. However, corticopapillary gradient of solutes was significantly increased in CPMD-treated rats. Higher tissue osmolality was due to significantly increased concentration of Na +, and to a lesser degree urea, in the medulla and papilla of CPMD-treated rats. Consequently, the osmotic gradient between urine and papillary tissue of CPMD-treated rats (delta = 385 +/- 47 mosM) was significantly (P less than 0.001) higher compared with controls (delta = 150 +/- 26 mosM). Minimum urine osmolality after water loading was higher in CPMD-treated DI rats than in controls. Oxidation of [14C]lactate to 14CO2 coupled to NaCl cotransport was measured in thick medullary ascending limb of Henle's loop (MAL) microdissected from control and CPMD-treated rats. The rate of 14CO2 production was higher (delta + 113% +/- 20; P less than 0.01) in CPMD-treated MAL compared with controls, but 14CO2 production in the presence of 10(-3) M furosemide did not differ between MAL from control and from CPMD-treated rats. These observations suggest that CPMD treatment enhances NaCl transport in MAL. Cyclic AMP metabolism was analyzed in microdissected MAL and in medullary collecting tubule (MCT). MCT from control and from CPMD-treated rats did not differ in the basal or VP-stimulated accumulated of cAMP. The increase in cAMP content elicited by 10(-6) M VP in MAL from CPMD-treated rats (delta + 12.0 +/- 1.8 fmol cAMP/mm) was significantly (P less than 0.02) higher compared with MAL from control rats (delta + 5.1 +/- 1.0 fmol cAMP/mm). Preincubation of MAL dissected from Sprague-Dawley rats with 10(-4) M CPMD in vitro increased cAMP accumulation in the presence of VP, but no such enhancement was found in preincubated MCT. Adenylate cyclase activity, basal or stimulated by VP, 5'guanylimidodiphosphate, or by NaF, assayed in isotonic medium did not differ between MAL or MCT from control rats and MAL or MCT from CPMD-treated rats. When assayed in hypertonic medium (800 mosM), the adenylate cyclase activity in the presence of 10(-6) M VP was significantly higher in MAL of CPMD-treated rats. MAL and MCT from control and CPMD-treated rats did not differ in the activities of cAMP phosphodiesterase. The rate of [(14)C]prostaglandin E2 by medullary and papillary microsomes was not different between the control and CPMD-treated rats; likewise, there was no difference in accumulation of immunoreactive prostaglandin E2 in the medium of in vitro incubated medullary or papillary slices prepared from control and CPMD-treated rats. Based on the findings recounted above, we propose a hypothesis that CPMD administration enhances the antidiuretic effect of VP, primarily by increasing medullary and papillary tonicity dye to increased NaCl reabsorption in MAL. There is no evidence that CPMD sensitizes collecting tubules to the action of VP, at least at the camp-generation step. Therefore, increased antidiuretic response to VP in the kidneys of CPMD-treated DI rats is due to enhanced osmotic driving force for water reabsorption (lumen-to-interstitium osmotic gradient) in collecting tubules, rather than due to increased VP-dependent water permeability of tubular epithelium.
为了确定氯磺丙脲(CPMD)对血管加压素(VP)的增强作用,我们在体内和体外研究了CPMD对下丘脑性尿崩症大鼠(Brattleboro品系纯合子,即DI大鼠)肾脏及特定肾小管节段的影响。自由饮水的大鼠每天皮下注射CPMD(20mg/100g体重),持续7天。在自由饮水期间,尿流量、尿渗透压、尿中Na⁺、K⁺、肌酐的排泄或总溶质排泄均未改变。然而,CPMD处理的大鼠皮质-乳头溶质梯度显著增加。较高的组织渗透压是由于CPMD处理的大鼠髓质和乳头中Na⁺浓度显著增加,尿素浓度也有一定程度增加。因此,CPMD处理的大鼠尿与乳头组织之间的渗透梯度(δ = 385±47 mosM)与对照组(δ = 150±26 mosM)相比显著更高(P<0.001)。水负荷后CPMD处理的DI大鼠的最低尿渗透压高于对照组。在从对照和CPMD处理的大鼠中显微分离的亨氏袢厚髓升支(MAL)中测量了[¹⁴C]乳酸氧化为¹⁴CO₂与NaCl共转运的情况。与对照组相比,CPMD处理的MAL中¹⁴CO₂产生率更高(δ + 113%±20;P<0.01),但在10⁻³M呋塞米存在下,对照和CPMD处理的大鼠的MAL中¹⁴CO₂产生无差异。这些观察结果表明CPMD处理增强了MAL中的NaCl转运。在显微分离的MAL和髓质集合管(MCT)中分析了环磷酸腺苷(cAMP)代谢。对照和CPMD处理的大鼠的MCT在基础或VP刺激的cAMP积累方面没有差异。与对照大鼠的MAL(δ + 5.1±1.0 fmol cAMP/mm)相比,10⁻⁶M VP引起的CPMD处理的大鼠的MAL中cAMP含量增加(δ + 12.0±1.8 fmol cAMP/mm)显著更高(P<0.02)。用10⁻⁴M CPMD体外预孵育从Sprague-Dawley大鼠分离的MAL,在VP存在下增加了cAMP积累,但在预孵育的MCT中未发现这种增强。在等渗培养基中测定的基础或由VP、5'-鸟苷亚胺二磷酸或NaF刺激的腺苷酸环化酶活性,对照大鼠的MAL或MCT与CPMD处理的大鼠的MAL或MCT之间没有差异。在高渗培养基(800 mosM)中测定时,10⁻⁶M VP存在下CPMD处理的大鼠的MAL中腺苷酸环化酶活性显著更高。对照和CPMD处理的大鼠的MAL和MCT在cAMP磷酸二酯酶活性方面没有差异。对照和CPMD处理的大鼠的髓质和乳头微粒体产生[(¹⁴C)]前列腺素E₂的速率没有差异;同样,在从对照和CPMD处理的大鼠制备的体外孵育的髓质或乳头切片的培养基中,免疫反应性前列腺素E₂的积累也没有差异。基于上述发现,我们提出一个假设,即给予CPMD主要通过增加MAL中NaCl重吸收来增强VP的抗利尿作用,从而增加髓质和乳头张力。没有证据表明CPMD使集合管对VP的作用敏感,至少在cAMP生成步骤是这样。因此,CPMD处理的DI大鼠肾脏中对VP的抗利尿反应增加是由于集合管中水重吸收的渗透驱动力增强(管腔到间质渗透梯度),而不是由于肾小管上皮细胞VP依赖性水通透性增加。