Navar L G, Inscho E W, Imig J D, Mitchell K D
Department of Physiology, Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Kidney Int Suppl. 1998 Sep;67:S17-21. doi: 10.1046/j.1523-1755.1998.06704.x.
Vascular smooth muscle cells in different renal microvascular segments utilize different activation mechanisms to respond to mechanical and vasoactive stimuli. L-type Ca2+ channel blockers vasodilate primarily the preglomerular vascular resistance component responsible for autoregulation. Local interstitial infiltration of Ca2+ channel blockers increases glomerular pressure and markedly reduces vascular responsiveness of the tubuloglomerular feedback mechanism. Ca2+ channel blockers selectively attenuate the afferent vasoconstrictor responses to increases in perfusion pressure. Although both afferent and efferent arterioles constrict in response to angiotensin II (Ang II), afferent but not efferent constriction requires Ca2+ influx through L-type Ca2+ channels. Sensitivity of the preglomerular arterioles to Ang II is also heterogeneous with the greatest sensitivity in glomerulus-near, terminal segments. Adenosine triphosphate (ATP) is a vasoconstrictor agonist that selectively activates Ca2+ entry pathways in afferent arterioles but has no effect on efferent arterioles. In isolated preglomerular smooth muscle cells, increasing extracellular [KCl] increases intracellular Ca2+ by stimulating voltage-dependent Ca2+ influx. Ang II, norepinephrine, and ATP also elicit similar increases in intracellular Ca2+. Mechanical and agonist-induced voltage-dependent Ca2+ influx is thus a primary pathway in the control of cytosolic Ca2+ in afferent arterioles. Efferent arterioles, however, rely primarily on intracellular Ca2+ mobilization and other Ca2+ influx pathways.
不同肾微血管段的血管平滑肌细胞利用不同的激活机制来响应机械和血管活性刺激。L型钙通道阻滞剂主要使负责自身调节的肾小球前血管阻力成分舒张。钙通道阻滞剂的局部间质浸润会增加肾小球压力,并显著降低肾小管-肾小球反馈机制的血管反应性。钙通道阻滞剂选择性减弱传入血管对灌注压升高的收缩反应。虽然入球小动脉和出球小动脉都会因血管紧张素II(Ang II)而收缩,但入球小动脉而非出球小动脉的收缩需要通过L型钙通道的钙内流。肾小球前小动脉对Ang II的敏感性也存在异质性,在靠近肾小球的终末段敏感性最高。三磷酸腺苷(ATP)是一种血管收缩激动剂,它选择性激活入球小动脉中的钙进入途径,但对出球小动脉没有影响。在分离的肾小球前平滑肌细胞中,增加细胞外[KCl]通过刺激电压依赖性钙内流来增加细胞内钙。Ang II、去甲肾上腺素和ATP也会引起细胞内钙的类似增加。因此,机械和激动剂诱导的电压依赖性钙内流是控制入球小动脉胞质钙的主要途径。然而,出球小动脉主要依赖细胞内钙动员和其他钙内流途径。