Hayamizu S, Kanda K, Ohmori S, Murata Y, Seo H
Department of Endocrinology and Metabolism, Nagoya University, Japan.
Endocrinology. 1994 Dec;135(6):2459-64. doi: 10.1210/endo.135.6.7988432.
Adrenal insufficiency in human and rat is associated with an impairment of the diuretic response to water load, and only glucorticoids (GCs) restore this deficit. Our observation that GCs potentiate atrial natriuretic polypeptide (ANP)-stimulated cGMP production in cultured renal cells prompted us to examine the possibility that GCs may restore the diuretic response through the potentiation of ANP action. Initially, changes in urine volume and ANP levels were studied in adrenalectomized (Adx) and sham-operated intact rats after an oral water load of 5 ml/100 g BW. Urine volume after water load was 4.5 +/- 0.5 ml/30 min in the intact rats, whereas it was 0.8 +/- 0.2 ml/30 min in the Adx rats. In the intact rats, a significant increase in plasma ANP level was observed 30 min after the water load, whereas no increase was observed in Adx rats. This defective ANP response may be involved in the impairment of the diuretic response in Adx rats. Indeed, pretreatment of Adx rats with dexamethasone (Dex, 20 micrograms/100 g BW) increased plasma ANP levels even before water load and improved diuretic response. Subsequently, effect of iv administration of human or rat ANP at a pharmacological dose (2.5 micrograms/100 g BW) on urine volume, osmolarity, and urinary excretion of cGMP, and sodium was studied in Adx rats that received an oral water load 30 min before ANP. Dex treatment was achieved by per os administration 3 h before the ANP injection. In Adx rats, the urine volume after ANP administration was 1.2 +/- 0.1 ml/30 min, and pretreatment with Dex markedly increased the urine volume to 6.3 +/- 0.4 ml/30 min. Dex also increased ANP-induced osmolar and sodium excretion by 2.6- and 2.9-fold, respectively. Although urinary excretion of cGMP was increased in Adx rats by ANP administration, a further significant increase was observed by the pretreatment with Dex. Injection of (Bu)2cGMP to Adx rats pretreated with Dex resulted in a significant increase in urine volume and osmolar and sodium excretion. However, no significant increase in urine volume was observed in Adx rats not pretreated with Dex. The present study suggests that GCs restore the diuretic response to acute water load not only by increasing the secretion of ANP but also by potentiating ANP-stimulated cGMP production. Furthermore, GCs may augment ANP action at one or more steps other than cGMP formation because administration of (Bu)2cGMP to Adx rats did not correct the diuretic response to water load.
人类和大鼠的肾上腺功能不全与水负荷利尿反应受损有关,只有糖皮质激素(GCs)能恢复这一缺陷。我们观察到GCs可增强培养的肾细胞中心房利钠多肽(ANP)刺激的环磷酸鸟苷(cGMP)生成,这促使我们研究GCs是否可能通过增强ANP作用来恢复利尿反应。首先,研究了切除肾上腺(Adx)和假手术的完整大鼠在口服5 ml/100 g体重水负荷后的尿量和ANP水平变化。完整大鼠水负荷后的尿量为4.5±0.5 ml/30分钟,而Adx大鼠为0.8±0.2 ml/30分钟。在完整大鼠中,水负荷后30分钟观察到血浆ANP水平显著升高,而Adx大鼠中未观察到升高。这种有缺陷的ANP反应可能与Adx大鼠利尿反应受损有关。事实上,用地塞米松(Dex,20微克/100 g体重)预处理Adx大鼠,即使在水负荷前也能提高血浆ANP水平并改善利尿反应。随后,研究了以药理剂量(2.5微克/100 g体重)静脉注射人或大鼠ANP对在ANP注射前30分钟接受口服水负荷的Adx大鼠的尿量、渗透压以及cGMP和钠的尿排泄的影响。在ANP注射前3小时通过口服给予Dex进行处理。在Adx大鼠中,ANP给药后的尿量为1.2±0.1 ml/30分钟,而用Dex预处理可使尿量显著增加至6.3±0.4 ml/30分钟。Dex还分别使ANP诱导的渗透压和钠排泄增加了2.6倍和2.9倍。虽然ANP给药使Adx大鼠的cGMP尿排泄增加,但用Dex预处理可使其进一步显著增加。向用Dex预处理的Adx大鼠注射(Bu)2cGMP可导致尿量、渗透压和钠排泄显著增加。然而,未用Dex预处理的Adx大鼠中未观察到尿量显著增加。本研究表明,GCs不仅通过增加ANP分泌,还通过增强ANP刺激的cGMP生成来恢复对急性水负荷的利尿反应。此外,GCs可能在cGMP形成以外的一个或多个步骤增强ANP作用,因为向Adx大鼠注射(Bu)2cGMP并未纠正对水负荷的利尿反应。