(Hypertension. 2000;35:32.)
© 2000 American Heart Association, Inc.
Scientific Contributions |
From the Institute of Experimental and Clinical Pharmacology and Toxicology (A.D., S.W., U.S., P.D.), Medical University of Lübeck, Lübeck, Germany; Biochemistry Department (J.M.S.), University of Colorado Medical School, Denver, Colo; and Global Product Planning and Development (N.I.), Fujisawa Pharmaceutical Co., Yodogawa-Ku, Osaka, Japan.
Correspondence to Dr A. Dendorfer, Medical University of Lübeck, Institute of Experimental and Clinical Pharmacology and Toxicology, Ratzeburger Allee 160, D-23538 Lübeck, Germany. E-mail dendorfe{at}medinf.mu-luebeck.de
AbstractInhibitors of angiotensin Iconverting enzyme (ACE) are very efficacious in the potentiation of the actions of bradykinin (BK) and are able to provoke a B2 receptormediated vasodilation even after desensitization of this receptor. Because this activity cannot be easily explained only by an inhibition of kinin degradation, direct interactions of ACE inhibitors with the B2 receptor or its signal transduction have been hypothesized. To clarify the significance of degradation-independent potentiation, we studied the vasodilatory effects of BK and 2 degradation-resistant B2 receptor agonists in the isolated rat heart, a model in which ACE and aminopeptidase P (APP) contribute equally to the degradation of BK. Coronary vasodilation to BK and to a peptidic (B6014) and a nonpeptidic (FR190997) degradation-resistant B2 agonist was assessed in the presence or absence of the ACE inhibitor ramiprilat, the APP inhibitor mercaptoethanol, or both. Ramiprilat or mercaptoethanol induced leftward shifts in the BK dose-response curve (EC50=3.4 nmol/L) by a factor of 4.6 or 4.9, respectively. Combined inhibition of ACE and APP reduced the EC50 of BK to 0.18 nmol/L (ie, by a factor of 19) but potentiated the activity of B6014 (EC50=1.9 nmol/L) only weakly without altering that of FR190997 (EC50=0.34 nmol/L). Desensitization of B2 receptors was induced by the administration of BK (0.2 µmol/L) or FR190997 (0.1 µmol/L) for 30 minutes; the vascular reactivity to ramiprilat or increasing doses of BK was tested thereafter. After desensitization with BK, but not FR190997, an additional application of ramiprilat provoked a B2 receptormediated vasodilation. High BK concentrations were still effective at the desensitized receptor. The process of desensitization was not altered by ramiprilat. These results show that in this model, all potentiating actions of ACE inhibitors on kinin-induced vasodilation are exclusively related to the reduction in BK breakdown and are equivalently provoked by APP inhibition. The desensitization of B2 receptors is overcome by increasing BK concentrations, either directly or through the inhibition of ACE. These observations do not suggest any direct interactions of ACE inhibitors with the B2 receptor or its signal transduction but point to a very high activity of BK degradation in the vicinity of the B2 receptor in combination with a stimulation-dependent reduction in receptor affinity.
Key Words: bradykinin angiotensin-converting enzyme receptor, bradykinin rats heart
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