(Hypertension. 2001;37:703.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
From the Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil, and the Department of Physiology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil (R.A.S.S.).
Correspondence to Maria Helena Catelli de Carvalho, PhD, Avenue Prof Lineu Prestes, 1524, sala 217, Cidade Universitaria CEP 05508-900 Sao Paulo, SP, Brazil. E-mail mahecaca{at}icb.usp.br
| Abstract |
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-nitro-L-arginine
methyl ester) did not modify the Ang-(1-7)potentiating activity.
Long-term angiotensin-converting enzyme (ACE)
inhibition increased BK and Ang-(1-7)induced vasodilation. The BK
potentiation by Ang-(1-7) was preserved after ACE inhibition, Ang II
type 1 receptor blockade, or the combination of both treatments.
The most striking finding of this study was the unexpected observation
that the potentiation of BK vasodilation in spontaneously hypertensive
rats treated short- or long-term with ACE inhibitors was
reverted by the Ang-(1-7) antagonist A-779. Our results
unmasked a key role for an Ang-(1-7)related mechanism in mediating BK
potentiation by ACE inhibitors.
Key Words: bradykinin angiotensin microcirculation hypertension angiotensin-converting enzyme renin-angiotensin system
| Introduction |
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Ang-(1-7) potentiates the vasodilatory effect of bradykinin (BK) in isolated dog coronary arteries,4 the vasoconstrictor action in rabbit jugular veins,5 and the hypotensive effect of BK in normotensive6 and hypertensive7 rats. In a previous study, we demonstrated, using in vivo/in situ microvessel preparations of normotensive rats, that Ang-(1-7) increases the BK-induced vasodilation through the release of products of nitric oxide (NO) and cyclooxygenase (COX).8
Taken together, these observations may be particularly important because long-term ACE inhibition further increases plasma Ang-(1-7) levels.9 10 Interestingly, it was demonstrated that systemic administration of an Ang-(1-7) monoclonal antibody11 or short-term inhibition of the endogenous synthesis of Ang-(1-7) by 2 neprilysin inhibitors12 partially reversed the antihypertensive response in spontaneously hypertensive rats (SHR) that were treated with lisinopril/losartan long-term, suggesting that Ang-(1-7) may play a role in the mechanism of action of these drugs. One important question that arises from these observations is whether the direct vasodilation and/or BK potentiation of Ang-(1-7) occurs at the level of resistance vessels, the most functionally important site for determining peripheral vascular resistance.13 In this study, we addressed this issue by investigating the Ang-(1-7) activity on the BK-induced effect and the possible mechanisms involved within SHR resistance arterioles by using in vivo/in situ mesenteric microvessel preparations. Furthermore, the interaction of Ang-(1-7) and BK was also evaluated after long-term ACE inhibition, Ang II type 1 receptor (AT1) blockade, and the combination of both treatments.
| Methods |
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Drugs and Reagents
Acetylcholine chloride, histamine dihydrochloride,
sodium nitroprusside (SNP),
tetraethylammonium chloride (TEA),
indomethacin, and
N
-nitro-L-arginine
methyl ester (L-NAME) were obtained from Sigma Chemical Co; BK,
Ang-(1-7), and D-Ala7-Ang-(1-7) (A-779) were
from Bachem-CA; diclofenac potassium salt
(Cataflan) was from Geigy; and enalapril
(Renitec), losartan
(Cozaar), and chloral hydrate were from Merck,
Sharp, & Döhme. Enalaprilat and HOE 140 were kindly supplied by
Merck, Sharp, & Döhme (Whitehouse Station, NJ) and Hoechst Marion
Roussel (Frankfurt, Germany),
respectively.
Intravital Microscopy
The rats were anesthetized with chloral
hydrate (450 mg/kg SC), and the mesentery was arranged for microscopic
observation in
situ.14 15
Briefly, the animals were kept on a special board that was heated at
37°C; the board included a transparent plate on which the tissue to
be transilluminated was placed. The mesentery was kept moist and warm
by irrigating the tissue with warmed (37°C) Ringer Lockes solution
(pH 7.4) containing 1% gelatin. A 500-line television camera was
combined with a triocular microscope to facilitate observation of the
enlarged image (3400x) on the video screen. An image-splitting
micrometer was adjusted to the phototube of the microscope.
The image splitter sheared the optical image into 2 separate images and
displaced one with respect to the other. The displacement of one image
from the other allowed for the measurement of the vessel
diameter.16
A2 arterioles (15 to 25 µm) were selected for
study, and any changes in vessel diameter were estimated after the
topical application of vasoactive agents. The drugs were added to the
preparation in a standard volume of 0.01 mL and were removed by washing
with warmed Ringer-Lockes solution.
Experimental Protocols
Effect of Ang-(1-7) on the BK-Induced
Vasodilation in Mesenteric Arterioles
In the first set of experiments, different doses of
BK (1, 10, and 30 pmol) and Ang-(1-7) (10, 100, and 1000 pmol; n=8 for
each dose) were applied alone. For potentiation experiments, the dose
of 1 pmol of BK was initially applied. After an interval of 3 minutes,
each dose (n=8 to 12) of Ang-(1-7) was added to the preparation 30
seconds before BK application. On the basis of these preliminary
studies, the doses of 1 pmol of BK and 100 pmol of Ang-(1-7) were
chosen for the additional experiments. To verify whether 1 pmol of BK
would potentiate the vasodilation induced by 100 pmol of Ang-(1-7), the
nonapeptide was applied 30 seconds before Ang-(1-7)
(n=8).
Specificity of the Ang-(1-7) Potentiating
Activity
BK-equipotent doses of acetylcholine (ACh; 1.6 nmol),
SNP (38 pmol), and histamine (5.4 nmol; n=8 to 10 for each drug) were
tested in the absence and presence of 100 pmol of
Ang-(1-7).
Effect of B2 and
Ang-(1-7) Receptors Antagonists on the Ang-(1-7)BK
Interaction
HOE 140, a specific B2
receptor
antagonist,17
and A-779, a specific Ang-(1-7) receptor
antagonist,18
were used. The dose and the time delay necessary for the specific
effects of these agents were chosen in preliminary experiments. HOE 140
(100 pmol) or A-779 (100 pmol) were added to the preparations 15
seconds and 1 minute, respectively, before test BK (n=8) and Ang-(1-7)
(n=7), alone or in combination (n=8).
Participation of Prostanoids,
Endothelium-Derived Hyperpolarizing Factor, and NO on
the Ang-(1-7)-BK Interaction
To inhibit the COX pathway, animals were treated with
indomethacin (5 mg/kg IM) or diclofenac (2,5 mg/kg IM)
30 minutes before the following experiments (n=8 for each
group). Control animals received vehicle (Tris buffer for
indomethacin or saline for diclofenac). The
participation of an endothelium-derived hyperpolarizing
Factor (EDHF) on the potentiation of BK by Ang-(1-7) was evaluated
using TEA. Due to the rapid onset of action of this
agent,19 100 pmol of
Ang-(1-7) was applied combined with 90 pmol of TEA (n=8). To
investigate whether NO could be involved in the interaction of BK and
Ang-(1-7), L-NAME (10 nmol), a NO synthase (NOS) inhibitor,
was added to the preparations 3 minutes before BK, Ang-(1-7), or both
(n=9). The dose and the time delay necessary for the effect of this
agent were chosen in preliminary experiments. In all groups, BK (1
pmol) and Ang-(1-7) (100 pmol) were tested alone and in
combination.
Effect of ACE Inhibition and
AT1 Blockade on Ang-(1-7)-BK Interaction
Animals were treated with the ACE
inhibitor enalapril (10 mg ·
kg1 · d1)
or with the AT1 antagonist
losartan (15 mg · kg1 ·
d1) by gavage over 21 days (n=8 to 10).
Animals in a third group (n=10) received both drugs in combination (10
mg/kg enalapril plus 15 mg/kg losartan) during the same period.
Control animals received vehicle (saline). At the end of the treatment
period, animals were anesthetized, and the interaction of
Ang-(1-7) and BK was analyzed as described
above.
Effect of Ang-(1-7) Receptor Blockade
on BK Vasodilation After ACE Inhibition
BK (1 pmol) was tested in the presence of A-779 (100
pmol, topically applied 15 seconds before BK administration) in animals
treated short-term with enalaprilat (10 mg/kg IV for 30 minutes before
administration; n=8) or long-term with enalapril (10 mg/kg each day for
21 days by gavage, n=9). Control animals received vehicle
(saline).
Statistical Analysis
Comparisons were made by ANOVA followed by the
Tukey-Kramer test, Kruskal-Wallis test, Students paired or unpaired
t test, and linear regression
when appropriate. All values are reported as mean±SEM. Statistical
significance was set as
P<0.05.
| Results |
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Specificity of the BK Potentiation by
Ang-(1-7)
The vascular effects of ACh and SNP were not
potentiated in the presence of 100 pmol of Ang-(1-7) (ACh:
2.12±1.0% to 2.99±0.9%; SNP: 5.19±0.3% to 4.21±0.4%). The
responses to histamine were reduced with Ang-(1-7) [3.49±0.4% to
1.34±0.3%; P<0.01 versus
value in the absence of Ang-(1-7)].
Effect of B2 and
Ang-(1-7) Receptor Blockade on the Ang-(1-7)-BK Interaction
Application of HOE 140 (100 pmol) nearly abolished the
vasodilation induced by BK, without any statistically significant
effect on Ang-(1-7) dilation. Treatment with A-779 (100 pmol) did not
interfere with BK dilation but blocked the effect of Ang-(1-7)
(Table).
The potentiation of BK by Ang-(1-7) was not observed after
B2 or Ang-(1-7) receptor
blockade.
|
Contribution of Prostanoids, EDHF, and NO to
the Potentiation of BK by Ang-(1-7)
After treatments with the COX inhibitors
indomethacin (5 mg/kg) or diclofenac (2.5 mg/kg), the
vasodilation induced by BK or Ang-(1-7) alone was unaltered
(Table),
but the potentiating effect of Ang-(1-7) was completely abolished
(Figure 2). In the same way, the
K+ channel blockade (TEA- 90 pmol) did not
alter the effects of BK and Ang-(1-7) alone
(Table),
but it abolished the BK potentiation by Ang-(1-7)
(Figure 2). NOS inhibition (10 nmol of L-NAME) reduced the
effects of BK and Ang-(1-7)
(Table),
without preventing the Ang-(1-7) potentiating activity on BK
vasodilation. The ratio between BK and Ang-(1-7) plus BK was the same
before and after NOS inhibition, as seen in
Figure 2.
|
Effects of ACE Inhibition,
AT1 Blockade, or Combination of Both Treatments
on the Ang-(1-7)-BK Interaction
Enalapril (ACE inhibitor), losartan
(AT1 antagonist), and enalapril plus
losartan treatments decreased blood pressure in SHR from
171.7±5.6 to 143.4±5.3 mm Hg, 167.8±2.8 to 147.1±6.9
mm Hg, and 179.8±3.2 to 129.2±6.6 mm Hg, respectively
(P<0.05 versus values before
treatment for all). ACE inhibition induced an increase in BK and
Ang-(1-7) dilation, whereas AT1 blockade did not
modify the effects of each of these agents alone
(Table).
ACE inhibition (enalapril or enalapril plus losartan) promoted
a slight but significant potentiation of BK by Ang-(1-7)
(Figure 3A). AT1 blockade did not
modify the Ang-(1-7)-activity on BK (Figure 3A). There was no relation between the decrease in
blood pressure caused by these treatments and the vasodilation elicited
by Ang-(1-7) plus BK. The correlation coefficient (r) was -0.29 for
enalapril, 0.59 for losartan, and 0.18 for enalapril plus
losartan.
|
Effect of Ang-(1-7) Receptor Blockade on
the BK Vasodilation
BK (1 pmol) was tested in the presence of A-779 (100
pmol, topically applied 15 seconds before BK) in rats treated
short-term with enalaprilat (10 mg/kg) or long-term with enalapril (10
mg · kg1 ·
d1). The increased BK vasodilation
observed after short- or long-term ACE inhibition was reverted by A-779
in the microvessels of SHR
(Figure 3B). It is important to mention that the dose used of
A-779 did not modify the vascular effects of 1 pmol of BK in untreated
rats(Table).
| Discussion |
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Several studies have described the vascular effects of the heptapeptide Ang-(17). Its vasodilatory effect was demonstrated in cat hindlimbs,20 dog coronary arteries,4 21 and the microcirculation of normotensive rats.8 Interestingly, our experiments showed that Ang-(1-7) produces vasodilation in SHR arterioles, even when applied at low doses (10 pmol).
The BK-potentiation by Ang-(1-7) was described in conscious
normotensive6 and
hypertensive rats,7 isolated
dog coronary
arteries,4 21 and
mesenteric microvessels of normotensive
rats.8 In the present
investigation, we demonstrated that in the mesenteric bed of SHR, the
effect of 1 pmol of BK was potentiated in the presence of 10 and 100
pmol of Ang-(1-7). The fact that the alteration in diameter induced by
Ang-(1-7) had already disappeared when BK was applied led us to
conclude that Ang-(1-7) is, in fact, potentiating BK, excluding a
summation of both vasodilation effects. One of the first important
aspects of this study is the fact that the potentiation of BK by
Ang-(1-7) was observed at low doses but not at high doses of the
heptapeptide (1000 pmol). Similar results were reported in the
mesenteric microvessels of normotensive
rats.8 Curiously, a
bell-shaped dose-response curve was obtained for the release of
arachidonic acid and 6-keto-prostaglandin
F1
by Ang-(1-7) in cultured vascular smooth muscle
cells,22 indicating the
existence of an ideal concentration of this agent to activate
intracellular pathways. Although our data do not allow the evaluation
of this phenomenon, the hypothesis of receptor desensitization cannot
be discarded.
One of the possible mechanisms proposed for the BK potentiation by Ang-(1-7) is based on the fact that the heptapeptide, as a substrate for ACE, could inhibit ACE activity and elevate BK levels.3 21 Our results are in contrast with this hypothesis, because the Ang-(1-7) receptor blockade by topical application of its antagonist A-779 completely abolished the potentiation of BK by Ang-(1-7), indicating that the binding of the heptapeptide to its own receptor is an essential condition for BK potentiation. Similar observations were reported previously,7 8 suggesting that this metabolic effect may not represent the main pathway of BK potentiation by Ang-(1-7).
It has been suggested that the Ang-(1-7) receptor could be linked to a signaling pathway that would stimulate the formation of NO via an intermediate rise in the concentration of vascular kinins.4 Our data with the BK B2 antagonist HOE 140 does not support this hypothesis. The dose of HOE 140 was sufficient to completely block the vasodilation produced by BK and did not significantly change the effect of Ang-(1-7). These data are in agreement with previous findings8 and may indicate that, in the vascular bed tested, Ang-(1-7) binds to a specific receptor and activates an intracellular signal pathway that is independent of BK stimulus.
Similar to the observations in normotensive rats,8 Ang-(1-7) did not potentiate the vasodilation produced by ACh or SNP in SHR mesenteric microvessels; instead, it reduced histamine dilation. These data might indicate that in hypertensive animals the Ang-(1-7) potentiating activity may be specific for BK and may not be evoked by any agent that releases NO, similar to the data from normotensive vascular preparations.6 8 21
In the mesenteric bed of SHR, pretreatment with L-NAME produced a pronounced reduction of the Ang-(1-7) effect (70%). The vasodilation induced by BK was also significantly reduced in SHR, but in a manner different from the observed reductions in the microvessels of normotensive rats.8 BK can induce vasodilation by releasing at least 3 endothelium-derived relaxing factors (NO, prostaglandin I2, and EDHF); however, the contribution of each factor may vary according to the vascular territory and animal model. It was reported that in hypertensive rats, part of the hypotensive effect of BK was mediated through the NO system, whereas in normotensive rats, the hypotensive effect of BK would be mediated mainly by prostaglandins or EDHF.23 We also demonstrated that in microvessels of SHR, the BK-potentiation by Ang-(1-7) was preserved after NOS inhibition, in opposition to the observations in normotensive animals.8 These data can indicate that, although Ang-(1-7) and BK may stimulate NO production/release in mesenteric microvessels of SHR, the Ang-(1-7)-potentiating activity is not dependent on the NO system in this animal model of hypertension.
Our experiments showed that in the microcirculation of SHR, the potentiation of BK by Ang-(1-7) depends on prostanoids release, although the vascular effect of each peptide separately was not altered by pretreatments with COX inhibitors such as indomethacin or diclofenac. Concerning the Ang-(1-7) potentiating activity, similar results were previously observed in normotensive rats,6 8 suggesting that Ang-(1-7) can potentiate BK, at least in part, by facilitating the production of a vasodilator prostaglandin, such as prostaglandin I2, or impairing the release of vasoconstrictor prostanoids in the microvessels of hypertensive animals.
It has been described that, in addition to NO and prostaglandin I2 release, the vasodilation produced by BK could involve EDHF production.24 25 In the present study, we demonstrated that the blockade of K+ channels with TEA abolished the Ang-(1-7)potentiating effect on BK vasodilation in the microvessels of SHR, without interfering with the effect of each agent alone. This is the first demonstration that the BK-potentiation by Ang-(1-7) can involve hyperpolarization of the cell membrane, probably elicited by an EDHF. This finding is particularly relevant when taking in account the fact that EDHF seems to have a prevalent role in the vasorelaxation of rat mesenteric microvessels.26
It was demonstrated that some of the Ang-(1-7) actions in the kidney27 and heart28 can be blocked by the AT1 receptor antagonist losartan and that this blockade can increase plasmatic levels of the heptapeptide.29 Our data, however, showed no interference of losartan on the Ang-(1-7) effects, which is unlike the involvement of AT1 receptors on the actions of this substance in SHR microvessels.
In the present study, Ang-(1-7) vasodilation was
significantly augmented by long-term treatment with the ACE
inhibitor alone or in combination with an
AT1 receptor antagonist, probably
due to the fact that ACE is a major Ang-(1-7) metabolizing
enzyme.2 Similar results were
obtained in microvessels of normotensive
rats,8 in which the
vasodilation induced by Ang-(1-7) increased
2-fold after the
administration of enalaprilat.
It has been suggested that some actions of Ang-(1-7) could be mediated by the potentiation of endogenous BK through the facilitation of a "cross-talk" mechanism between ACE and the B2 receptor.30 In this way, the binding of Ang-(1-7) to ACE would facilitate the "cross-talk" of ACE and the B2 receptors, leading to the potentiation of endogenous BK independent of interference with BK hydrolysis. In our experiments, ACE inhibition did not prevent the Ang-(1-7) potentiating activity. This observation and the finding that the Ang-(1-7) antagonist A-779 completely abolished the Ang-(1-7) effects strongly suggest that, in mesenteric microvessels of SHR, the BK-potentiating activity of Ang-(1-7) is a receptor-mediated event that is not dependent on its interaction with ACE.
The most striking finding of our study was the unexpected observation that the potentiation of BK vasodilation in SHR treated short- or long-term with ACE inhibitors was reverted by the Ang-(1-7) antagonist A-779. This effect cannot be attributed to a nonspecific action because A-779 had no noticeable influence on the vasodilation produced by BK in untreated rats. Our findings strongly suggest that endogenous Ang-(1-7) is an important component of the BK potentiation by ACE inhibition in vivo. A-779 [and Ang-(1-7)] could displace the ACE inhibitor from a catalytic ACE site involved in the BK metabolism. However, this possibility is highly unlike because A-779 does not interfere with the ACE activity measured with Hip-His-Leu,31 which is hydrolyzed by either the N- or C- domain of ACE.32 A permissible effect of Ang-(1-7), after binding to its own receptor, for the cross-talkrelated transduction mechanism evoked by the binding of enalaprilat to ACE should be considered as well.
In summary, we found that the BK potentiation by Ang-(1-7) also occurs in resistance vessels of SHR through a receptor-mediated mechanism involving vasodilator prostaglandin and membrane hyperpolarization but not NO release. We also demonstrated that the Ang-(1-7) potentiating activity is preserved after long-term ACE inhibition in hypertensive animals. Although further studies are needed for clarifying the mechanism(s) conveying this effect, it is important to emphasize that our results unmasked a key role for an Ang-(1-7)related mechanism in mediating BK potentiation by ACE inhibitors.
| Acknowledgments |
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Received October 26, 2000; first decision December 4, 2000; accepted December 18, 2000.
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