(Hypertension. 1996;27:653-657.)
© 1996 American Heart Association, Inc.
Articles |
From the Department of Medicine, New York University Medical Center (S.S., W.M.), the College of Physicians and Surgeons, Columbia University (S.S., S.C.), and the Division of Nephrology, St Luke's/Roosevelt Hospital (S.S., G.B., J.B., S.C.), New York, NY.
Correspondence to Dr Shlomoh Simchon, Division of Nephrology, Minturn 205, St Luke's/Roosevelt Hospital, 1111 Amsterdam Ave, New York, NY 10025.
| Abstract |
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Key Words: cyclic GMP microspheres nitric oxide nitroprusside vascular resistance, renal
| Introduction |
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We have previously demonstrated an inability of the renal vasculature of DS rats to dilate in response to increased salt intake.4 5 Renal vascular reactivity was found to be enhanced by vasoconstrictors (norepinephrine and angiotensin II),6 but vasodilators (ANP and NP) failed to decrease RVR in DS rats.4 6 Circulating ANP, which appears to generate cGMP by stimulating receptors on vascular smooth muscle membrane, is increased in hypertensive DS rats.4 6 Paul et al7 recently demonstrated that cultured renal mesangial cells from DS rats generate less cGMP than cells from DR rats in response to ANP. NP is a potent vasodilator whose action does not depend on membrane receptors or an intact endothelium, since it increases cGMP production by directly generating NO, which stimulates soluble guanylate cyclase.8 To define the role of cGMP in renal vasodilation in DR and DS rats, we compared cGMP excretion with RVR in response to various levels of salt intake and to NP infusion in both strains of rats.
This study demonstrates that a reciprocal relationship exists between RVR and cGMP excretion during high salt intake and NP infusion and that the response of RVR in DS rats may reflect a deficit in cGMP production.
| Methods |
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GFR, RVR, and urinary cGMP excretion rate were measured before and during infusion of sodium nitroprusside (Nitropress, Abbott Laboratories). NP was dissolved in 5% dextrose in water (and protected from light by aluminum foil wrapping) and infused intravenously at a dose that did not change blood pressure (0.35±0.02 ng/min per gram body wt) for 15 minutes. Six groups of rats were studied. Group A: 7 DR and 7 DS rats 6 weeks of age were fed a 0.23% NaCl diet. Group B: 6 DR and 6 DS rats 10 weeks of age were fed a 0.23% NaCl diet. Group C: 7 DR and 7 DS rats 6 weeks of age were fed a 1% NaCl diet. Group D: 7 DR and 7 DS rats 10 weeks of age were fed a 1% NaCl diet. Group E: 5 DR and 5 DS rats were fed a 1% NaCl diet for 6 weeks and then fed an 8% NaCl diet for 4 days (all rats remained normotensive). Group F: 5 DR and 5 DS rats were fed a 1% NaCl diet for 6 weeks and then fed an 8% NaCl diet for 4 weeks (DS rats became hypertensive, and at 10 weeks of age results were compared with rats of similar age on 0.23% and 1% NaCl diets).
Surgical Procedure
Following anesthesia with sodium
pentobarbital (35
mg/kg IP), a polyethylene catheter (PE 290, Intramedic, Becton
Dickinson) was inserted through an incision into the trachea to ensure
stable ventilation. A second catheter (PE 50) was inserted into the
abdominal aorta via a femoral artery for blood withdrawal and
recording of arterial pressure (volume removed
during blood sampling was simultaneously replaced by
intravenous infusion of an equal volume of donor blood). A
third catheter (PE 50) was inserted into the jugular vein for
intravenous infusion of NP. A fourth catheter (PE 50) was
inserted into the femoral vein for intravenous infusion of
3H-inulin. For hemodynamic studies, a fifth
catheter was advanced via the carotid artery into the left ventricle
for injection of microspheres; the position of the catheter tip
was confirmed by pressure tracing. For GFR and cGMP studies, a sixth
catheter (PE 160) was placed transabdominally into the urinary bladder.
Thirty minutes after inulin infusion was begun, a urine sample was
collected for another 30 minutes for measurement of cGMP and
3H-inulin; at the end of that time an arterial
blood sample was taken for 3H-inulin measurement. Then NP
was infused for 35 minutes; 5 minutes after the infusion was begun, a
urine sample was collected for 30 minutes for measurement of cGMP and
inulin, and arterial blood was sampled for inulin
measurement. To determine whether the systemic vasculature responded
normally, NP was infused at a depressor dose of 30 pg/min after the
collection of urine at the end of the experiment. All rats responded to
this depressor dose of NP infusion with similar decreases in blood
pressure.
Cardiovascular pressures were monitored using Statham transducers and a polygraph recorder (model 7, Grass Instrument Co). Blood samples (approximately 1 mL) were centrifuged, and plasma was removed, frozen, and stored until inulin measurement. Urine was frozen and stored until cGMP and inulin levels had been measured. Rats were handled in accordance with National Institutes of Health and New York University Medical Center's guidelines for animal care.
Hemodynamic Measurements
CO (in mL/min) and RBF (in mL/min
per 100 grams of kidney) were
determined by a microsphere method (previously validated in our
laboratory by comparison with electromagnetic flowmeter and
133Xe washout
technique9 10 11 12 ), with
15.0±1.0
µm diameter microspheres (New England Nuclear Corp) injected
into the left ventricle. Two measurements were made using latex
microspheres labeled with radionuclides 57Co and
46Sc. An injection of microspheres labeled with
57Co was given before infusion of NP for control blood flow
measurements. A second injection of microspheres labeled with
46Sc was given after NP infusion. The use of
microspheres labeled with two different radionuclides permits
determination of blood flow at two different time periods in the same
animal. Reference blood samples were withdrawn from the abdominal aorta
at a rate of 0.8 mL/min for 2 minutes (total of 1.6 mL blood;
withdrawal of the blood was started 10 to 15 seconds before injection
of microspheres and blood was simultaneously
replaced by infusing donor blood). After the experiment, rats were
euthanatized by injecting a saturated KCl solution into the left
ventricle. Kidneys were immediately removed and tissue activities of
57Co and 46Sc were determined with a gamma
counter (model 5130, Auto-Gamma System, Packard Instrument Co)
connected to a multichannel analyzer (Tracor Northern Co).
Resistance to flow was calculated as the ratio of mean
arterial blood pressure to regional blood flow. RVR was
calculated as the ratio of mean arterial blood pressure (in
mm Hg) to RBF (in mL/s per 100 gram kidney wt), whereas nonrenal
vascular resistance was calculated as the ratio of mean
arterial pressure to CO minus total RBF (in mL/s). TPR was
calculated as the ratio of mean arterial blood pressure (in
mm Hg) to CO (in mL/s).
Glomerular Filtration Rate
GFR was determined from
3H-inulin
clearance.13 A solution containing 2.0 mCi/mL per kilogram
of 3H-inulin (New England Nuclear Corp) was infused (0.072
mL/min IV) for 90 minutes. After plasma samples were thawed,
radioactivity was counted in a beta counting system (Beckman LS-230,
Liquid Scintillation System, Beckman Instruments, Inc) to determine
3H activity, with PCS scintillation liquid (Amersham/Searle
Corp) as a counting medium. Urine samples were thawed and counted after
appropriate dilution. GFR was calculated as the ratio of urinary
excretion rate of 3H-inulin to its plasma
concentration.
Urinary cGMP Determination
cGMP concentrations in aliquots of
urine (0.2 µL) were
determined by radioimmunoassay after acetylation with a
commercially available assay kit (125I-cGMP kit, New
England Nuclear Corp). Acetylation agent was 0.05 mL acetic
anhydride plus 0.1 mL triethylamine.14 The cGMP standard
was diluted to yield 2000 pmol/mL to 100 pmol/mL of cGMP. In a
preliminary study we found that cGMP excretion remained constant during
a 3-hour vehicle (dextrose) infusion in either DS or DR rats.
Furthermore, during our experimental studies, no increase occurred in
arterial or renal venous plasma cGMP concentration. cGMP
excretion rate (in picomoles per minute per 100 gram) is calculated as
UcGMPxV (per 100 gram of kidney), where UcGMP is urinary concentration
of cGMP (in picomoles per milliliter) and V is urinary flow (in
milliliters per minute).
Statistical Analysis
Results are presented as mean±SD;
significance of
changes was evaluated by ANOVA, followed by a Student-Newman-Keuls test
for multiple comparisons (significance is considered to be
P<.05).
| Results |
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Table 2
reveals that 6- or 10-week-old DR rats
responded to NP infusion with approximately a twofold increase in GFR
(P<.01) on 0.23% and 1% NaCl diets. In DS rats fed a
0.23% NaCl diet, NP infusion resulted in only an approximate 1.5-fold
increase (P<.01) in GFR; and, when they were fed a 1% NaCl
diet, NP infusion resulted in no augmentation of GFR. The results in
Table 2
and Fig 1
demonstrate that an increase
in
dietary salt in DR rats was associated with a rise in cGMP excretion
from 15±2 to 255±25 pmol/min per 100 gram and in RBF from
521±12 to
1103±41 mL/min per 100 gram, which was associated with a decrease in
RVR from 11±0.6 to 5±0.08 mm Hg/mL per second per 100 gram
(P<.01). In contrast, salt feeding failed to progressively
increase cGMP excretion or to decrease RVR in DS rats. In addition, NP
infusion in DS rats caused a significant decrease of RVR only in rats
on a 0.23% diet (Table 2
and Fig 2
); in
6-week-old
DS rats on a 1% NaCl diet, there was actually an unexplained increase
in RVR that was associated with a decrease in cGMP. In contrast, NP
infusion in DR rats invariably caused RVR to decrease significantly
(P<.01) from preinfusion levels. NP caused a pronounced
increase in cGMP excretion (P<.01) in all DR rats, whereas
the increase in cGMP in DS rats in response to NP infusion was markedly
impaired (P<.01). When data from DR and DS rats are
combined, there is a significant negative correlation between cGMP
production and RVR
(y=-0.45x+10.8;
r=-.71); however, a relatively small increase in cGMP
resulted in maximal renal vasodilation (Fig 3
).
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| Discussion |
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ANP is thought to cause renal vasodilation by activating a nonheme-containing transmembrane protein with a single subunit, so-called particulate guanylate cyclase. ANP binds to specific receptors on the endothelial cell membranes and causes an increase in cGMP production. In contrast, NP is thought to act, after conversion to a NO radical, by directly activating a soluble heme-containing enzyme consisting of two subunits, so-called soluble guanylate cyclase, thereby increasing cGMP production in the cytoplasm.8 A defect in the ability of DS rats to increase cGMP production was suggested from our observations that ANP and NP were ineffective renal vasodilators in DS rats and from the study of Paul et al,7 which reported that renal mesangial cells from DS rats grown in tissue culture generate less cGMP than DR rats when ANP is added to the medium.
Shultz and Tolins15 postulated that an increase in dietary salt intake causes an increase in NO synthesis, an endothelium-derived relaxing factor. Lüscher et al16 also postulated that an increase in dietary salt intake results in endothelium-dependent relaxation. On the basis of a demonstration that hypertension develops in rats when NOS is inhibited, Tolins et al,17 concluded that this defect in NOS may be a pathogenic factor in the development of salt-sensitive hypertension. Chen and Sanders,18 and more recently Deng and Rapp,19 have postulated that hypertension develops in DS rats because of a decrease in the production of NO. The study of Deng and Rapp19 suggests that there are specific alleles for NOS that are lacking when DS rats are bred with normotensive rats. This study indicates by molecular genetic linkage analysis the locus for the inducible NOS cosegregates with blood pressure in the DS rat. This genetic analysis clearly implicates the enzyme responsible for NOS in the phenotypic expression of the disease in these rats. Chen and Sanders18 showed that hypertension could be prevented in DS rats on an 8% NaCl diet if they were treated with L-arginine, the substrate for NOS associated with an increase in urinary cGMP excretion. Early studies20 21 showed that DS rats can be protected from the development of hypertension if they are treated with a variety of antihypertensive medications whose modes of action occur by a variety of pathways, including calcium channel blocking agents20 and diuretics.21 Since these studies did not focus on the role of cGMP in hypertension and our previous studies showed that NP infusion dilates the renal vessels of DR rats but not of DS rats,6 we investigated the role of renal cGMP production in renal vasodilation by direct stimulation of cGMP with NP infusion. The present study demonstrates that failure of NP to reduce RVR is accompanied by failure to increase cGMP production.
cGMP production plays a central role in the dilation of renal
vasculature, because there is a significant negative correlation
between cGMP production and RVR (r=-.71) in DR
and DS rats; even a small increase in cGMP production is
associated with a major impact on RVR (Fig 3
). The increase in
urinary
cGMP, although primarily derived from glomerular mesanglial
or epithelial cells,22 is closely correlated with RVR and
appears to reflect renal vascular generation of cGMP. As previously
shown, when a nonhypotensive dose of NP was given to DS and DR rats,
the expected decrease in RVR occurred in DR rats but not DS
rats.6 In addition, there was a strikingly smaller
increase in cGMP excretion in DS than DR rats (P<.01) on
excessive salt and in response to NP infusion. Although the DS rats on
a 1% NaCl diet excreted less cGMP than DR rats on the same diet, it is
unclear why DS rats on the 1% NaCl diet excreted more cGMP and had a
greater decrease in RVR than they did on an 8% NaCl diet.
These results suggest that there is a defect in the ability of DS rats to generate cGMP either in response to chronic administration of a high salt diet or in response to the acute administration of NP. It appears that hypertension in DS rats on a high salt diet may be related to their inability to generate cGMP, which impairs renal vasodilation and salt excretion. Whether impaired cGMP excretion results from a deficiency of cGMP production and/or NO production (or conceivably is due to an inhibitor of NO production) remains to be determined.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
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| References |
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