Navar L G, Von Thun A M, Zou L, el-Dahr S S, Mitchell K D
Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Blood Press Suppl. 1995;2:88-92.
Previous studies have indicated that the hypertension that develops after unilateral arterial constriction (2 kidney, 1 clip) involves an active participation by the non-clipped contralateral kidney. Even though the non-clipped kidney is not the initial causative factors, and despite the progressive renin depletion during the early weeks following clipping, the non-clipped kidney is highly responsive to angiotensin blockers. Furthermore, the non-clipped kidney has augmented tissue ANG II levels and ACE activity suggesting that some renin-independent mechanism may be stimulating intrarenal ANG II formation. This model has been simulated by infusing ANG II at low subpressor doses (40 ng/min) to uninephrectomized rats for 14 days. With this model, plasma and renal renin levels are markedly suppressed; however, the renal ANG II levels are increased to levels above those that can be explained on the basis of circulating ANG II. In agreement with the responses observed in the non-clipped kidney of 2K1C rats, there is also an increased renal ACE activity. In contrast to the marked suppression of renin gene expression and renin activity, angiotensinogen gene expression is not suppressed. These results support the hypothesis that small elevations in circulating ANG II stimulate intrarenal ANG II production through a renin-independent mechanism.
先前的研究表明,单侧动脉狭窄(两肾一夹)后发生的高血压涉及未夹闭的对侧肾脏的积极参与。尽管未夹闭的肾脏不是初始致病因素,并且尽管在夹闭后的最初几周内肾素逐渐耗竭,但未夹闭的肾脏对血管紧张素阻滞剂高度敏感。此外,未夹闭的肾脏组织中血管紧张素II水平升高且ACE活性增强,这表明某些不依赖肾素的机制可能刺激肾内血管紧张素II的形成。通过以低降压剂量(40 ng/分钟)向单侧肾切除的大鼠输注血管紧张素II 14天来模拟该模型。在这个模型中,血浆和肾脏肾素水平明显受到抑制;然而,肾脏血管紧张素II水平升高至高于基于循环血管紧张素II所能解释的水平。与在两肾一夹大鼠未夹闭的肾脏中观察到的反应一致,肾脏ACE活性也增加。与肾素基因表达和肾素活性的明显抑制相反,血管紧张素原基因表达未受抑制。这些结果支持这样的假设,即循环血管紧张素II的小幅升高通过不依赖肾素的机制刺激肾内血管紧张素II的产生。