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血管紧张素、口渴与钠食欲。

Angiotensin, thirst, and sodium appetite.

作者信息

Fitzsimons J T

机构信息

The Physiological Laboratory, Cambridge, United Kingdom.

出版信息

Physiol Rev. 1998 Jul;78(3):583-686. doi: 10.1152/physrev.1998.78.3.583.

Abstract

Angiotensin (ANG) II is a powerful and phylogenetically widespread stimulus to thirst and sodium appetite. When it is injected directly into sensitive areas of the brain, it causes an immediate increase in water intake followed by a slower increase in NaCl intake. Drinking is vigorous, highly motivated, and rapidly completed. The amounts of water taken within 15 min or so of injection can exceed what the animal would spontaneously drink in the course of its normal activities over 24 h. The increase in NaCl intake is slower in onset, more persistent, and affected by experience. Increases in circulating ANG II have similar effects on drinking, although these may be partly obscured by accompanying rises in blood pressure. The circumventricular organs, median preoptic nucleus, and tissue surrounding the anteroventral third ventricle in the lamina terminalis (AV3V region) provide the neuroanatomic focus for thirst, sodium appetite, and cardiovascular control, making extensive connections with the hypothalamus, limbic system, and brain stem. The AV3V region is well provided with angiotensinergic nerve endings and angiotensin AT1 receptors, the receptor type responsible for acute responses to ANG II, and it responds vigorously to the dipsogenic action of ANG II. The nucleus tractus solitarius and other structures in the brain stem form part of a negative-feedback system for blood volume control, responding to baroreceptor and volume receptor information from the circulation and sending ascending noradrenergic and other projections to the AV3V region. The subfornical organ, organum vasculosum of the lamina terminalis and area postrema contain ANG II-sensitive receptors that allow circulating ANG II to interact with central nervous structures involved in hypovolemic thirst and sodium appetite and blood pressure control. Angiotensin peptides generated inside the blood-brain barrier may act as conventional neurotransmitters or, in view of the many instances of anatomic separation between sites of production and receptors, they may act as paracrine agents at a distance from their point of release. An attractive speculation is that some are responsible for long-term changes in neuronal organization, especially of sodium appetite. Anatomic mismatches between sites of production and receptors are less evident in limbic and brain stem structures responsible for body fluid homeostasis and blood pressure control. Limbic structures are rich in other neuroactive peptides, some of which have powerful effects on drinking, and they and many of the classical nonpeptide neurotransmitters may interact with ANG II to augment or inhibit drinking behavior. Because ANG II immunoreactivity and binding are so widely distributed in the central nervous system, brain ANG II is unlikely to have a role as circumscribed as that of circulating ANG II. Angiotensin peptides generated from brain precursors may also be involved in functions that have little immediate effect on body fluid homeostasis and blood pressure control, such as cell differentiation, regeneration and remodeling, or learning and memory. Analysis of the mechanisms of increased drinking caused by drugs and experimental procedures that activate the renal renin-angiotensin system, and clinical conditions in which renal renin secretion is increased, have provided evidence that endogenously released renal renin can generate enough circulating ANG II to stimulate drinking. But it is also certain that other mechanisms of thirst and sodium appetite still operate when the effects of circulating ANG II are blocked or absent, although it is not known whether this is also true for angiotensin peptides formed in the brain. Whether ANG II should be regarded primarily as a hormone released in hypovolemia helping to defend the blood volume, a neurotransmitter or paracrine agent with a privileged role in the neural pathways for thirst and sodium appetite of all kinds, a neural organizer especially in sodium appetit

摘要

血管紧张素(ANG)II是一种强大且在系统发育上广泛存在的引发口渴和钠食欲的刺激物。当它直接注入大脑的敏感区域时,会导致饮水立即增加,随后氯化钠摄入量缓慢增加。饮水行为强烈、动机十足且迅速完成。注射后约15分钟内摄入的水量可能超过动物在正常活动24小时内自发饮水的量。氯化钠摄入量的增加起效较慢、持续时间更长且受经验影响。循环中的ANG II增加对饮水有类似影响,尽管这些影响可能部分被伴随的血压升高所掩盖。室周器官、视前正中核以及终板层前腹侧第三脑室周围的组织(AV3V区域)为口渴、钠食欲和心血管控制提供了神经解剖学焦点,与下丘脑、边缘系统和脑干建立了广泛联系。AV3V区域有丰富的血管紧张素能神经末梢和血管紧张素AT1受体,该受体类型负责对ANG II的急性反应,并且它对ANG II的致渴作用反应强烈。脑干中的孤束核和其他结构构成了血容量控制负反馈系统的一部分,对来自循环的压力感受器和容量感受器信息做出反应,并向AV3V区域发送上行去甲肾上腺素能及其他投射。穹窿下器官、终板血管器和最后区含有对ANG II敏感的受体,使循环中的ANG II能够与参与低血容量性口渴、钠食欲和血压控制的中枢神经结构相互作用。在血脑屏障内产生的血管紧张素肽可能作为传统神经递质起作用,或者鉴于产生部位与受体之间存在许多解剖学上的分隔情况,它们可能在远离释放点处作为旁分泌剂起作用。一种引人注目的推测是,其中一些负责神经元组织的长期变化,尤其是钠食欲方面的变化。在负责体液稳态和血压控制的边缘和脑干结构中,产生部位与受体之间的解剖学不匹配不太明显。边缘结构富含其他神经活性肽,其中一些对饮水有强大影响,并且它们以及许多经典的非肽神经递质可能与ANG II相互作用以增强或抑制饮水行为。由于ANG II免疫反应性和结合在中枢神经系统中分布如此广泛,脑内的ANG II不太可能具有与循环中的ANG II那样明确界定的作用。由脑内前体产生的血管紧张素肽也可能参与对体液稳态和血压控制几乎没有直接影响的功能,如细胞分化、再生和重塑,或学习和记忆。对激活肾素 - 血管紧张素系统的药物和实验程序所导致的饮水增加机制的分析,以及肾素分泌增加的临床情况,都提供了证据表明内源性释放的肾素能够产生足够的循环ANG II来刺激饮水。但也确定的是,当循环中的ANG II的作用被阻断或不存在时,其他口渴和钠食欲机制仍然起作用,尽管尚不清楚对于脑内形成的血管紧张素肽是否也是如此。ANG II究竟应主要被视为在低血容量时释放以帮助维持血容量的激素、在各种口渴和钠食欲神经通路中具有特殊作用的神经递质或旁分泌剂、特别是在钠食欲方面的神经组织者

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