Blakely P, Vaughn D A, Fanestil D D
Department of Medicine, School of Medicine, University of California, San Diego, La Jolla 92093-0623, USA.
J Am Soc Nephrol. 1996 Jul;7(7):1052-7. doi: 10.1681/ASN.V771052.
Thiazide diuretic drugs act in the distal convoluted tubule (DCT) to inhibit a Na+Cl- cotransporter and enhance reabsorption of luminal calcium. The density of receptors for thiazides in the rat DCT is known to be increased by adrenocortical steroids, furosemide, and bendroflumethiazide, but decreased by ischemia. Because the DCT is a physiologic site of action by calcitonin and parathyroid hormone, this study examined the effects of these calcitropic hormones in thyroparathyroidectomized Sprague-Dawley rats on (1) the density of the rat thiazide receptor (TZR), as quantitated by binding of (3H)metolazone to renal membranes, and (2) urinary electrolyte excretion rate. Salmon calcitonin (sCT) (20 to 100 ng/h) (1) increased the density of the renal TZR twofold, an effect that is maximal by 6 h after sCT administration, and (2) decreased urinary calcium excretion rate. Adequate dietary calcium must be provided for the effects of sCT to be observed. Regression analysis demonstrated that renal TZR density correlated negatively with total urinary calcium excretion rate but not with plasma calcium ion concentration. In addition, neither rat calcitonin (rCT), at doses that cause hypocalcemia, nor parathyroid hormone, at doses that cause hypercalcemia, produce direct effects on TZR density in the DCT of the thyroparathyroidectomized rat. Our findings indicate that upregulation of TZR by sCT, which occurs independently of plasma calcium-ion concentration, is likely via a calcitonin-like receptor other than that for rat calcitonin itself.
噻嗪类利尿药作用于远曲小管(DCT),抑制Na⁺Cl⁻协同转运蛋白,增强管腔钙的重吸收。已知大鼠DCT中噻嗪类药物受体的密度会因肾上腺皮质类固醇、呋塞米和苄氟噻嗪而增加,但因缺血而降低。由于DCT是降钙素和甲状旁腺激素的生理作用部位,本研究检测了这些钙调节激素对甲状腺甲状旁腺切除的Sprague-Dawley大鼠的影响,包括(1)通过(³H)美托拉宗与肾膜结合定量的大鼠噻嗪类受体(TZR)密度,以及(2)尿电解质排泄率。鲑鱼降钙素(sCT)(20至100 ng/h)(1)使肾TZR密度增加两倍,给药后6小时达到最大效果,(2)降低尿钙排泄率。必须提供充足的膳食钙才能观察到sCT的作用。回归分析表明,肾TZR密度与尿总钙排泄率呈负相关,但与血浆钙离子浓度无关。此外,导致血钙过低剂量的大鼠降钙素(rCT)和导致血钙过高剂量的甲状旁腺激素,均对甲状腺甲状旁腺切除大鼠DCT中的TZR密度无直接影响。我们的研究结果表明,sCT对TZR的上调作用独立于血浆钙离子浓度,可能是通过大鼠降钙素本身以外的降钙素样受体实现的。