Brilla C G, Zhou G, Matsubara L, Weber K T
Division of Cardiology, University of Missouri Health Sciences Center, Columbia.
J Mol Cell Cardiol. 1994 Jul;26(7):809-20. doi: 10.1006/jmcc.1994.1098.
Myocardial fibrosis is associated with an activated renin-angiotensin-aldosterone system (RAAS). In renovascular hypertension, this presents as a reactive perivascular and interstitial fibrosis in not only the pressure overloaded, hypertrophied left ventricle but also the normotensive, nonhypertrophied right ventricle. It therefore would appear that circulating hormonal and not hemodynamic factors are responsible for this adverse fibrous tissue response. To ascertain whether the RAAS effector hormones angiotensin II (AII) or aldosterone (ALDO) directly stimulate collagen synthesis or inhibit collagenase production we used cell culture. Adult rat cardiac fibroblasts (Fb) were cultured since these cells express mRNA for types I and III collagens, the major fibrillar collagens in the heart, and collagenase or matrix metalloproteinase 1 (MMP 1), the key enzyme for interstitial collagen degradation. Collagen synthesis, determined by 3H-proline incorporation, and collagenase activity were measured in confluent, quiescent Fb after 24 h incubation with various concentrations of AII or ALDO (10(-11)-10(-6)M) in the presence or absence of either 10(-5)M type 1 (DuP 753) and type 2 (PD 123177) AII or 10(-9)-3 x 10(-6)M ALDO (spironolactone) receptor antagonists, respectively. Collagen synthesis, normalized per total protein synthesis, increased significantly (P < 0.005) after incubation with either 10(-9)M ALDO (5.9 +/- 1.0%) or 10(-7)M AII (5.3 +/- 1.2%) compared with untreated control cells (2.9 +/- 0.5%) of the same passage (p6-p10). This increase in collagen synthesis could be completely abolished by either types 1 or 2 AII receptor antagonists in AII stimulated Fb or the competitive ALDO receptor antagonist, spironolactone, at equimolar concentration in ALDO stimulated Fb. AII significantly decreased collagenase activity which could be completely abolished by PD 123177, but not DuP 753, while ALDO had no effect on collagenase activity. The mineralocorticoid, ALDO, stimulates collagen synthesis in cultured adult rat cardiac Fb in concentrations similar to those found in plasma in renovascular hypertension and this response appears to occur via type I corticoid receptors. AII appears to stimulate collagen synthesis by both type 1 and 2 AII receptors, but only in high concentrations that could be generated locally within the myocardium. In addition, AII unlike ALDO inhibits collagenase activity that could be attenuated only by type 2 receptor blockade. These findings suggest a direct interaction between ALDO, AII and cardiac Fb in mediating myocardial fibrosis in hypertensive heart disease.
心肌纤维化与激活的肾素-血管紧张素-醛固酮系统(RAAS)有关。在肾血管性高血压中,这表现为不仅在压力负荷过重、肥厚的左心室,而且在血压正常、未肥厚的右心室中出现反应性血管周围和间质纤维化。因此,似乎循环激素而非血流动力学因素是这种不良纤维组织反应的原因。为了确定RAAS效应激素血管紧张素II(AII)或醛固酮(ALDO)是否直接刺激胶原蛋白合成或抑制胶原酶产生,我们采用了细胞培养。使用成年大鼠心脏成纤维细胞(Fb)进行培养,因为这些细胞表达I型和III型胶原蛋白(心脏中主要的纤维状胶原蛋白)以及胶原酶或基质金属蛋白酶1(MMP 1,间质胶原降解的关键酶)的mRNA。在用不同浓度的AII或ALDO(10⁻¹¹ - 10⁻⁶M)孵育24小时后,在汇合、静止的Fb中测量通过³H-脯氨酸掺入法测定的胶原蛋白合成以及胶原酶活性,同时分别存在或不存在10⁻⁵M的1型(杜普753)和2型(PD 123177)AII受体拮抗剂或10⁻⁹ - 3×10⁻⁶M的ALDO(螺内酯)受体拮抗剂。与同一传代(p6 - p10)的未处理对照细胞(2.9±0.5%)相比,在用10⁻⁹M ALDO(5.9±1.0%)或10⁻⁷M AII(5.3±1.2%)孵育后,以总蛋白合成标准化的胶原蛋白合成显著增加(P < 0.005)。在AII刺激的Fb中,1型或2型AII受体拮抗剂或在ALDO刺激的Fb中以等摩尔浓度的竞争性ALDO受体拮抗剂螺内酯可完全消除这种胶原蛋白合成的增加。AII显著降低胶原酶活性,PD 123177可完全消除该作用,但杜普753不能,而ALDO对胶原酶活性无影响。盐皮质激素ALDO在与肾血管性高血压血浆中发现的浓度相似的情况下刺激培养的成年大鼠心脏Fb中的胶原蛋白合成,并且这种反应似乎通过I型皮质激素受体发生。AII似乎通过1型和2型AII受体刺激胶原蛋白合成,但仅在心肌内可局部产生的高浓度下。此外,与ALDO不同,AII抑制胶原酶活性,且只有通过2型受体阻断才能减弱该作用。这些发现表明ALDO、AII与心脏Fb之间在介导高血压性心脏病中的心肌纤维化方面存在直接相互作用。