(Hypertension. 2001;37:1369.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
From the Department of Physiology, The Medical School, Birmingham, UK.
Correspondence to Dr Edward J. Johns, Department of Physiology, The Medical School, Birmingham B15 2TT, UK. E-mail e.j.johns{at}bham.ac.uk
| Abstract |
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Key Words: angiotensin II sympathetic nervous system, renal sodium brain
| Introduction |
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In further investigations, it became evident that stimulation of the somatosensory system in a genetic model of hypertension, the stroke-prone spontaneously hypertensive rat (SHRSP), elicited increases in renal sympathetic nerve activity but that renal nervedependent antidiuresis and antinatriuresis were markedly blunted compared with the response in normotensive Wistar control rats.9 12 The reasons underlying these attenuated excretory responses to the somatosensory stimulation were unclear, but it was apparent that the pattern of activity held within the renal nerve signal was different and changed in a less dynamic way compared with the that in Wistar control rats. This suggested that there was some change or defect in the central nervous system that might have been responsible. One possibility was that there might be a derangement in the levels of Ang II at specific loci within the neural pathway mediating the somatosensory-induced neural control of sodium and water excretion. This was investigated in the present study, in which the activity of the brain renin-angiotensin system in the SHRSP was either suppressed, by administering losartan to block Ang II type 1 (AT1) receptors, or was enhanced by infusing exogenous Ang II into the lateral cerebral ventricles.
| Methods |
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Intracerebroventricular administration of drugs was performed by injection into the right lateral cerebral ventricle with use of a guide cannula placed at a site 1.0 mm posterior to the bregma, 2.5 mm lateral to the midline, and 2.55 mm ventral to the surface of the dura. Another stainless-steel tube, connected to a Hamilton syringe on a microinfusion pump, was inserted into the guide cannula so that it extended 0.2 mm beyond the tip of the guide cannula. Evans blue was injected at the end of experiment to confirm the injection site as the cerebral ventricle.
The main experimental protocol involved a series of six 15-minute clearance periods. Two clearances were taken to establish control levels. The cutaneous nociceptors were then activated with capsaicin, which was given subcutaneously as five 0.1-mg injections every 3 minutes. The first injection was given, and the third clearance period was begun 3 minutes later so that the urine remaining in the ureteral cannula could be washed out. The remaining doses of capsaicin were given into several different sites. RPP was regulated at the level present before the capsaicin injection to prevent any change in systemic blood pressure from influencing kidney function. Immediately, the fourth clearance was taken. Animals were then allowed 30 minutes to recover from the capsaicin injection before 2 further clearances were taken.
Groups of Rats
Six groups of rats (2 groups of Wistar rats and 4
groups of SHRSP) were studied: In group I (n=7), a series of six
15-minute clearance periods, as described above, were undertaken in
Wistar rats. In group II (n=6), a series of eight 15-minute clearance
periods was performed in Wistar rats. Two hours after the surgery, 2
clearances were taken before the nonpeptide
AT1-specific receptor antagonist,
losartan, was given
intracerebroventricularly as a 15 µg
initial bolus (in 2 µL saline), followed by an infusion of 7.5 µg
· h-1 (in 1
µL saline). Twenty minutes later, 6 further clearances were collected
in a pattern that was identical to that in group I. Group III (n=6) and
group IV (n=6) were SHRSP in which the experimental protocols were
identical to those performed in group I and group II, respectively. In
group V (n=6), SHRSP were subjected to the same procedure as group II,
except that Ang II, instead of losartan, was given
intracerebroventricularly as an initial
bolus of 100 ng (in 2 µL saline), followed by an infusion of 50 µg
· h-1 (in 1
µL saline). In group VI (n=8), SHRSP were subjected to the same
protocol as group V, except that the capsaicin challenge was not given.
This represented an Ang II
intracerebroventricular time
control.
Statistical Analysis
All data represent the average values
calculated from individual rats and are expressed as mean±SEM. The
effect of capsaicin was taken as the difference between the values
obtained during the capsaicin injection and the average value of the 2
control (or control-drug) clearances. The influence of the drug
intracerebroventricularly was taken as
the difference between the average values of the 2 clearances obtained
immediately before and 20 minutes after the administration. Comparisons
were undertaken by using a Students paired
t test or a 2-way ANOVA (Super
ANOVA software for Macintosh) as appropriate. Significance was assumed
at
P<0.05.
| Results |
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9%) in blood pressure, which had returned to control levels in the
period after capsaicin and was still at this level during the recovery
period. During the entirety of the study, RPP was regulated at a value
close to that obtained in the control period
(Table 1). The capsaicin challenge had no effect on either
renal blood flow or the glomerular filtration rate, but
urinary flow and absolute and fractional sodium excretions were
significantly (P<0.01,
P<0.05, and
P<0.01, respectively) reduced
by 27%, 39%, and 38%, respectively, during the period of capsaicin
administration. In the subsequent period, all 3 variables
rose toward control levels, which were completely attained during the
recovery period
(Table 1).
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The administration of
intracerebroventricular
losartan in group II Wistar rats had no meaningful effect on
the basal values of blood pressure or any renal
hemodynamic or excretory variable
(Table 1). The capsaicin challenge elicited an
10
mm Hg increase in mean blood pressure
(P<0.01), whereas RPP was
maintained at the control value. However, neither renal blood flow,
glomerular filtration rate, urinary flow, nor absolute or
fractional sodium excretion was altered during or after the capsaicin
administration and remained at these levels during the recovery period
(Table 1). Comparisons of the excretory responses caused by
capsaicin are given in the
Figure.
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The group III SHRSP
(Table 2) had control blood pressures and renal blood flows
that were higher than those in the Wistar rats
(Table 1) and urinary flows and absolute and fractional
sodium excretions
(Table 2) that were lower than those in the Wistar rats
(Table 1). When capsaicin was given, systemic blood pressure
was increased significantly (by
13%,
P<0.001), but thereafter, it
fell slightly below control levels in the period after capsaicin and
fell even further during the recovery period (by
8%,
P<0.05). RPP was held at an
unchanged level during and after the capsaicin injections, but in the
recovery period, RPP had fallen to a level significantly
(P<0.05) below the control
level
(Table 2). Capsaicin administration was associated with an
increase in renal blood flow, but neither glomerular
filtration rate, urinary flow, nor sodium excretion changed during the
course of the experiment. These excretory responses to the subcutaneous
capsaicin are compared with those obtained in Wistar rats in the
Figure.
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In group IV SHRSP
(Table 2), after control measurements were taken, the
administration of
intracerebroventricular
losartan had no effect on the basal levels of any of the
measured variables. Capsaicin administration
(Table 2) significantly
(P<0.001) increased blood
pressure by
10%, but in the period after capsaicin and in the
recovery period, it was significantly lower
(P<0.01 and
P<0.05, respectively) than
control levels. Consequently, although RPP was held constant during the
period of capsaicin administration, it was significantly less after
capsaicin and in the recovery period
(P<0.01 and
P<0.05, respectively). The
capsaicin injection had no measurable effect on either renal blood
flow, glomerular filtration rate, urinary flow, or absolute
or fractional sodium excretion during, after, or in the recovery phase
(Table 2), and responses are compared with those of the
other groups in the
Figure.
Infusion of
intracerebroventricular Ang II in group
V
(Table 3) significantly increased both blood pressure and
RPP (both P<0.01) by
24 to
28 mm Hg, and although neither renal blood flow nor
glomerular filtration rate was altered, there were marked
2- to 3-fold increases in urinary flow and absolute and fractional
sodium excretions (all
P<0.001). Under these
conditions, capsaicin significantly
(P<0.01) increased blood
pressure while it was being given. It fell to control levels in the
period after capsaicin but decreased significantly
(P<0.05) below control values
during the recovery phase
(Table 3). RPP
(Table 3) was held at a value not different from control
levels both during and after the capsaicin injection but fell below
control levels in the recovery period
(P<0.05). Renal blood flow did
not change either during or after capsaicin administration but was
significantly (P<0.05) lower
during the recovery phase, by
8%
(Table 3). The administration of capsaicin caused the
glomerular filtration rate to decrease significantly
(P<0.05 to
P<0.01) while it was given and
also in the clearance period immediately after the challenge, by
10% to 15%, but it returned to control levels during the recovery
phase
(Table 3). Urinary flow and absolute and fractional sodium
excretions were all significantly
(P<0.01 to
P<0.001) reduced during the
capsaicin administration, by
35%,
40%, and
42%,
respectively (all P<0.01),
decreased further in the period immediately after the capsaicin
administration, and continued to decline in the recovery period
(Table 3). Comparisons of the immediate renal excretory
responses to the capsaicin in this group of rats with the other groups
are given in the
Figure.
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The group VI SHRSP were a control group, in that Ang II was infused but capsaicin was not administered (Table 3). Administration of the Ang II intracerebroventricularly increased both systemic blood pressure and renal perfusion, had no effect on either renal blood flow or glomerular filtration rate, but caused significant (P<0.01 to P<0.001) increases in urinary flow and absolute and fractional sodium excretions of 2- to 3-fold (Table 3). Thereafter, all variables remained at a constant level for the remainder of the experimental protocol.
| Discussion |
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The first set of studies in the normotensive Wistar rats with saline infused intracerebroventricularly showed that subcutaneous administration of capsaicin elicited a transient increase in blood pressure, and although RPP and renal hemodynamics were unchanged, there was a short-lived fall in urinary flow and sodium excretion. We have previously reported6 that in this situation the capsaicin acts to depolarize the subcutaneous nociceptors,16 giving rise to a somatosensory input, thus causing a reflex increase in renal sympathetic nerve activity and a renal nervemediated antidiuresis and antinatriuresis.10 The present study supports this view in that the somatorenal reflex was intact in the Wistar rats. It was also clear that this somatosensory-mediated reflex neural control of urinary flow and sodium excretion was dependent on Ang II in the brain, as following blockade of its receptors with intracerebroventricular losartan, the excretory responses were prevented.10 Indeed, these observations support our previous study, which reported that if endogenous production of brain Ang II was blocked by captopril, exogenous Ang II administration into the brain could restore the excretory responses to subcutaneous capsaicin administration.11
The situation in the SHRSP given saline intracerebroventricularly was very different, in that although the subcutaneous capsaicin produced a prompt and short-lived increase in blood pressure, there were small insignificant changes in urinary flow and sodium excretion. Again, these findings support our earlier observations that somatosensory activation, by electrically stimulating the brachial nerves12 by upper airway tract stimulation or subcutaneous capsaicin,9 resulted in a blunted excretory response compared with that in the normotensive Wistar rats. This occurred even though basal rates of renal hemodynamics were slightly higher and urinary flow and sodium excretion were lower in the SHRSP compared with the Wistar rats. However, the issue to be explored was whether these blunted excretory responses were a consequence of overactivity or underactivity of Ang II within the brain of the SHRSP.
Blockade of AT1 receptors in the brain of the SHRSP was without effect on the basal blood pressure in this group of rats and had no consistent action on either renal hemodynamics or the rate of urinary flow or sodium excretion. During the period of capsaicin administration, there was a significant vasopressor action but no meaningful changes in renal hemodynamics, urinary flow, or sodium excretion, which was a pattern of responses very similar to that obtained in the SHRSP in which saline was given intracerebroventricularly. This would suggest that the blunted antidiuretic and antinatriuretic responses were not due to an overactivity of Ang II in the brain, exerting a tonic inhibitory action, but rather due to a deficit in its action or ability to exert a normal effect at important points along the pathway that integrated the somatosensory input with an appropriate response in renal sympathetic outflow.
A further study was performed with the use of SHRSP in which exogenous Ang II was infused intracerebroventricularly with a view to replacing the peptide at functionally important areas. It was evident that the Ang II increased blood pressure even further in these hypertensive animals and was accompanied by a diuretic and natriuretic response. Once the new basal levels had been achieved, the administration of capsaicin caused a further small transient pressor response, and although renal blood flow remained constant with a small fall in glomerular filtration rate, there were marked reductions in urinary flow and absolute and fractional sodium excretions. Thus, it was apparent that during this initial period of stimulation of the somatosensory system, there was an antidiuresis/antinatriuresis, the magnitude of which was significantly larger than that obtained in the SHRSP simply given a saline vehicle intracerebroventricularly but very comparable to that obtained in the normotensive Wistar rats given saline intracerebroventricularly. These observations were consistent with the suggestion that in some way Ang II was unable to exert its normal facilitatory action on the somatorenal reflex in the SHRSP. Whether this was due to a reduced generation of Ang II at important loci or to a fall in AT1 receptor density in specific regions is not clear and could not be determined by the experimental approaches used in these studies.
Over the course of the studies using SHRSP, a further important finding became apparent: when capsaicin was being given subcutaneously, there was a prompt pressure response, but in the subsequent clearance period, blood pressure fell to or more often below the various control values in the animals receiving saline, losartan, or Ang II intracerebroventricularly. Thereafter, in the recovery periods, blood pressure fell even further to a relatively low level. This progressive fall in pressure was not evident in the Wistar rats and appeared to be a feature of the SHRSP. One further consequence of the gradual reduction in blood pressure was that although renal hemodynamics were generally well maintained, urinary flow and sodium excretion progressively decreased. It is most likely that the reduced fluid output could be attributed in part to the pressure fall, because it is generally accepted that the level of blood pressure, via renal interstitial hydrostatic pressure, directly determines the level of tubular fluid reabsorption.17 However, an alternative possibility might be that there was a generalized decrease in sympathetic outflow, leading to dilation in a range of vascular beds. Although this may have resulted in a raised fluid excretion from the kidney as a result of withdrawal of sympathetic tone, this may have been confounded by the pressure-dependent mechanisms determining fluid output.
The cause of this fall in pressure after capsaicin administration was not immediately apparent. One possibility could be that the depressor response was a consequence of a long-lasting stimulation of the sensory receptors within the skin. Indeed, there have been reports that somatosensory stimulation can cause a long-lasting reduction in blood pressure,18 and it may be that by using this experimental approach in the SHRSP, this feature was more evident. The alternative possibility was that the fall in pressure in the later part of the experiments could have been due to Ang II within the central nervous system or could even be time-related. To explore this possibility, a final group of SHRSP were used. In that group, after the control measurements, Ang II was infused intracerebroventricularly throughout the study, but capsaicin was not given. The findings were clear-cut; ie, after the initial vasopressor, diuretic, and natriuretic effects of the Ang II infusion, blood pressure and fluid excretion remained unchanged for the duration of the experiment. These observations indicated that Ang II was not involved and provided further support for the view that it was subcutaneous capsaicin that was responsible for the long-term vasodepressor, antidiuretic, and antinatriuretic events.
These studies have shown that somatosensory stimulation using subcutaneous capsaicin increased blood pressure and caused an antinatriuresis and antidiuresis in normotensive Wistar rats that was dependent on Ang II in the brain. By contrast, in the SHRSP, although the capsaicin-induced vasopressor response was intact, antidiuresis and antinatriuresis were not evident. In the SHRSP, blockade of AT1 receptors had no effect on the somatosensory-induced pressure or excretory responses, but when Ang II was given intracerebroventricularly, the capsaicin-induced antidiuretic and antinatriuretic responses were comparable to those obtained in Wistar rats. These findings suggest that in the SHRSP, there is a defect in the ability of Ang II in the brain to facilitate the signals from the somatosensory system to elicit response in the renal sympathetic nerves, leading to a fluid retention. It was evident that in the SHRSP, capsaicin elicited not only a short-term pressure response but also a longer-term depression of blood pressure and fluid output. The mechanisms underlying these responses require further investigation.
| Acknowledgments |
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Received August 9, 2000; first decision September 12, 2000; accepted November 16, 2000.
| References |
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