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(Hypertension. 2006;48:1151.)
© 2006 American Heart Association, Inc.
Original Articles |
From the Departments of Pathology and Laboratory Medicine (N.M., H.-S.K., O.S.) and Pediatrics (M.L.S.S.-L., R.A.G.), University of Virginia, Charlottesville.
Correspondence to Oliver Smithies, Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, 701 Brinkhous-Bullitt Building, Chapel Hill, NC 27599-7525. E-mail jenny_langenbach{at}med.unc.edu
| Abstract |
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Key Words: aldosterone synthase blood pressure electrolytes renin COX-2
| Introduction |
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Aldosterone synthase (AS) catalyzes the last step of aldosterone synthesis, and data from some studies suggest610 that polymorphic variations in the AS gene (CYP11B2) are associated with differences in BP, although other studies do not.1113 Some mutations in the human AS gene cause AS deficiency, a rare autosomal recessively inherited disorder, which is usually diagnosed because of hyperkalemia, hypotension, metabolic acidosis, and elevated plasma renin activity.14 To study the effects of genetically decreased amounts or absence of aldosterone, we disrupted the coding region of the mouse AS gene by gene targeting15 and have shown16 that AS/ mice completely lacking aldosterone survive on a normal salt (NS) diet but have low BP, abnormal electrolyte, and water homeostasis despite markedly enhanced renin synthesis in the kidney and adrenal glands. When fed a high-salt diet, the plasma electrolyte concentrations and kidney renin levels in the AS-null became similar to those of wild-type mice, but their lower BP was not corrected. The heterozygous AS+/ mice on the NS diet have normal BP and show no abnormalities in electrolytes or kidney gene expression.16 The objective of our present study was to determine whether differences in expression of AS affect how mice respond to low salt (LS) in their diet. We show that aldosterone is critical for urine concentration and maintenance of BP. We also show that the mild reduction of AS expression, which occurs in AS+/ mice, makes their BP sensitive to LS, suggesting that modest genetic differences of AS levels in humans may also influence how decreasing dietary salt affects BP.
| Methods |
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3 to 5 months old and were approved by the Institutional Animal Care and Use Committee of the University of North Carolina, Chapel Hill.
BP Measurement
BPs were measured in conscious mice with a computerized tail-cuff system (Visitech Systems).17
Blood Analysis
Blood from the retro-orbital sinus was collected under anesthesia with 2.5% avertin, and plasma electrolyte concentrations were measured using a VT250 Chemical Analyzer (Orthodiagnostic Clinical). Hematologic analyses were performed with an Animal Blood Counter (Heska). Plasma aldosterone was measured by radioimmunoassay (RIA) using the Coat-A-Count RIA procedure (Diagnostic Products). Plasma corticosterone was determined with an RIA kit (ICN Biomedicals). The concentration of Ang II was measured with an RIA kit (Peninsula Laboratories). Plasma samples were assayed for vasopressin with an RIA kit (Peninsula Laboratories).
Histological Analysis
Mice were euthanized with 2.5% avertin for harvesting organs. The organs were fixed in 4% buffered paraformaldehyde overnight, embedded in paraffin, and sectioned and stained with hematoxylin and eosin, periodic acid-Schiff, or Masson-Trichrome for light microscopy. The immunohistochemical detection of renin and cyclooxygenase (COX)-2 was performed as described previously.16
Real-Time RT-PCR
Expression in the kidney of genes responsible for salt and water transport was determined by quantitative real-time PCR with an Applied Biosystems 7700 Sequence Detection System (Perkin-Elmer), as described.18
Analyses of Urine and Kidney Function
To determine 24-hour water and food intakes, urine volumes, and excretion of electrolytes, mice were housed in metabolic cages for 3 days. Urine osmolality was measured by freezing point depression. After 5 days of drinking 5% dextrose, the effect of vasopressin on urinary concentrating mechanisms was investigated by measuring urine osmolality before and 4 hours after subcutaneous injection of 1-ng/g body weight of desmopressin (dDAVP, Sigma) as described previously.19 To eliminate the effects of increased water intake during assays of urinary concentrating ability, we restricted the water intake in the AS/ mice to be the same for 4 days as that consumed by wild-type mice with similar body weights and then measured their body weights and urine osmolality.
Statistical Analysis
All of the statistical analyses were performed using JMP Statistical Software (SAS Institute) and are presented as mean±SEM. Statistical significances were assessed with ANOVA, and posthoc analyses were performed using the unpaired t test.
| Results |
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AS/ Mice Show Decreases in BP on LS Diet
The BP in AS-null mice on NS diet was 11 mm Hg lower (96±2 mm Hg) compared with either wild-type (107±2 mm Hg; P<0.001) or heterozygous (108±2 mm Hg; P<0.0001) mice, in which BP did not differ significantly (Figure 1A). The LS diet had no effect on BP in wild-type mice (Figure 1A). In contrast, the LS diet in AS/ mice resulted in a further decrease in BP to 85±3 mm Hg compared with their already reduced BP on NS diet (96±2 mm Hg; P<0.01).
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AS+/ Mice Show Decreases in BP on LS Diet
Although there were no significant differences in BP between AS+/+ and AS+/ mice on the NS diet, the mean BP of the heterozygous AS+/ mice on the LS diet was decreased to 101±2 mm Hg compared with the unchanged BP of wild-type mice (106±2 mm Hg; P<0.05) on the LS diet (Figure 1A).
Abnormalities in Electrolyte Homeostasis in the AS-Null Become More Severe on LS Diet
To determine the effects of LS diet on electrolyte homeostasis, we measured plasma Na+ and K+ concentrations in AS+/+, AS+/, and AS/ mice. There were no differences in plasma Na+ concentration on the NS diet among the 3 genotypes (Figure 1B). However, on the LS diet, plasma Na+ concentration was significantly lower in the AS/ mice (139±2 mmol/L) compared with wild-type mice (145±2 mmol/L; P<0.05); and plasma K+ concentration in the AS/ mice increased significantly from 6.6±0.1 mmol/L on the NS diet to 7.2±0.2 mmol/L (P<0.01) on the LS diet, which was also significantly higher than in AS+/ and AS+/+ mice on the LS diet (5.6±0.15 mmol/L; P<0.0001; Figure 1C). Dietary salt had no effect on these parameters in the AS+/ mice.
Body and Kidney Weights, Urine Volume, and Osmolality in AS+/ and AS/ Mice on LS Diet
Table 1 shows that on the NS diet, homozygous AS/ mice had significantly lower body weights compared with wild-type and heterozygous mice, and their kidney/body weight ratios were also decreased. The LS diet did not significantly affect the body weight or the kidney/body weight ratio in any of the 3 genotypes. Nor were there any differences in hematocrit on the NS and the LS diets among the 3 genotypes (Table 1). On the NS diet, the AS/ mice showed higher urine outputs and decreased urine osmolalities than wild- type mice. On LS diet, the abnormalities in water handling in the homozygous mice became more severe. Thus, 24-hour urine volume in the AS/ mice increased (P<0.01) and urine osmolality decreased (P<0.01) further on the LS diet compared with the NS diet. Urine volumes in the heterozygous AS+/ mice were also increased on the NS and the LS diets compared with AS+/+ mice; however, in AS+/ or AS+/+ mice, the dietary salt had no effect on any other of the parameters listed in Table 1, except plasma vasopressin.
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Plasma Vasopressin in AS+/ and AS/ Mice
To determine whether changes in plasma vasopressin levels might be responsible for the abnormalities in water homeostasis seen in the AS null mice, the circulating levels of vasopressin of AS+/+, AS+/, and AS/ mice on NS and LS diets were measured by RIA. The plasma vasopressin levels were not different between the 3 genotypes (Table 1) on the NS diet. However, plasma vasopressin levels were markedly increased in all 3 of the genotypes (P<0.0001) when fed the LS diet, but this increase was unaffected by the AS genotype.
Response to Desmopressin
To further investigate the underlying mechanism for the urinary concentrating defect in the AS/ mice, we compared the responses of the AS+/+ and the AS/ mice to the V2 receptorspecific vasopressin analog dDAVP. Figure 2A shows that 4 hours after subcutaneous injection of dDAVP, urinary osmolality was significantly increased in both the AS/ mice (from 1802±64 milliosmols [mosmol] to 2132 mosmol; n=6; P<0.05) and the AS+/+ mice (from 2244±96 mosmol to 2910 mosmol; n=4; P<0.05), although urine osmolality was always lower in the AS-null mice than in wild-type.
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Restriction of Water Intake Does Not Correct the Urinary Concentrating Defect
To eliminate the effects of increased water intake on urinary concentrating capacity in the AS-null mice, we restricted their water consumption for 4 days to the same level as that consumed by wild-type mice with similar body weights. As shown in Figure 2B, there were no changes in the urine osmolality in the AS/ mice during this period of water restriction, however, because body weights decreased markedly in the smaller mice, so that experiment was terminated. The average changes in body weight were from 19.0±1.3 g before water restriction to 15.6±1.6 on day 4 (n=5; P=0.1).
mRNAs in the Adrenal Gland
To characterize the effect of LS diet on gene expression in the adrenal gland of AS+/+, AS+/, and AS/ mice, we analyzed mRNA levels by quantitative RT-PCR. As expected, expression of the AS gene (Cyp11b2) was not detectable in the AS/ mice on NS and LS diets. The AS mRNA in the adrenals of the heterozygous AS+/ mice on the NS diet was 70% of wild-type, although this difference did not reach significance (Figure 3A). The LS diet caused a significant increase in adrenal AS mRNA in both the wild-type and AS+/ mice (P<0.001 by ANOVA), with the heterozygotes AS+/ now showing a significant difference from wild-type mice (P<0.05).
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There were no differences in the expression of Cyp11b1 mRNA, which codes for 11ß-hydroxylase, among the 3 genotypes on the NS diet (Figure 3B). However, on the LS diet, expression of Cyp11b1 in AS/ mice tended to increase (P=0.06) compared with that of wild-type mice.
Absence of aldosterone in the AS/ mice resulted in a >100-fold increase in adrenal renin mRNA level on the NS diet compared with that of wild-type (P<0.0001) or heterozygous mice (P<0.0001), which did not differ from each other (Figure 3C). However, the LS diet has no detectable effect on renin expression in all 3 genotypes.
Histological Changes in the Adrenal Glands of AS/ Mice
The significant histological differences in adrenal structure between AS+/+ and AS/ mice on a NS diet, described in our previous article,15 were exaggerated by the LS diet. Thus, under sodium restriction, the AS/ mice showed an abnormal adrenal cortex with a marked increase in the zona glomerulosa and in the number of renin-producing cells (Figure 4C).
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ReninAngiotensin System Activation on LS Diet
Figure 5 compares the effects of the LS diet on the reninangiotensin system (RAS) and plasma glucocorticoids of the AS+/+, AS+/, and AS/ mice. On the LS diet, the level of renin mRNA in the kidney in wild-type mice became 126% but did not reach significance (P=0.19; Figure 5A). However, the renin mRNA level in the AS+/ mice significantly increased (P<0.01) by the LS diet compared with the NS diet, reaching
2 times the level of wild-type mice on the LS diet (P<0.01). The increased renin mRNA level of the AS/ mice on the NS diet was also further increased by the LS diet (P<0.01). The plasma concentration of Ang II in the AS-null mice on the NS diet was significantly higher than in wild-type mice (P<0.01) and was increased further by the LS diet (P<0.0001) (Figure 5B). The AS+/ heterozygous mice on the LS diet also showed a tendency toward an increased Ang II plasma concentration (P=0.09) compared with wild-type mice.
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Plasma aldosterone was not detectable in the AS/ mice on any diet. Plasma aldosterone concentration in heterozygous AS+/ mice on the NS diet did not differ significantly from that of wild-type mice, although the plasma aldosterone concentration in these mice on the LS diet tended to be lower (P=0.08) compared with wild-type mice (Figure 5C).
Absence of aldosterone in the AS/ mice on the NS diet resulted in an increased level of corticosterone compared with wild-type mice (Figure 5D). On the LS diet, the level of glucocorticoids in the AS/ mice further increased compared with AS/ mice on normal chow (P<0.01). However, the LS diet had no effects on the level of glucocorticoids in wild-type and heterozygous mice.
Abnormalities in Kidney Structure in AS-Null Mice Became More Severe on LS Diet
Histological study revealed that the abnormalities in kidney structure already apparent in AS/ mice on NS became more severe on the LS diet. Thus, as shown in Figure 4E and 4F, the marked hypertrophy of the juxtaglomerular apparatus and expansion of renin-producing cells along afferent arterioles seen in the AS/ mice on NS (Figure 4E) were markedly exaggerated when they were fed the LS diet (Figure 4F).
On the NS diet, AS-null mice showed strongly positive immunohistochemical COX-2 staining in macula densa cells as reported previously16 (Figure 4H). The LS diet resulted in a very strong positive signal for COX-2, as shown in Figure 4I, in agreement with the increased COX-2 mRNA in the kidney cortex of these mice when fed LS compared with NS (Table 2). However, no immunoreactive COX-2 was detectable in the macula densa region of the kidney cortex in wild-type (Figure 4G) and heterozygous mice (data not shown) on either diet. The LS diet also resulted in thickening of intrarenal artery walls in the AS/ mice (Figure 4L) compared with wild-type mice (Figure 4J). Histological examinations showed no significant differences between the kidneys of the AS+/+ and AS+/ mice on the LS diet.
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RNA Studies in the Kidney
To determine how the AS genotypes affect renal responses to the LS diet, we measured the expression levels of several genes potentially important for the control of Na+ and water reabsorption by the kidney. These included genes responsible for renal Na+ and K+ transport (NCC, Na+-K+-2Cl cotransporter [NKCC2], ENaC, and ROMK) and for water reabsorption (aquaporin water channels [AQPs] 1, 2, and 3). We also measured changes in renin and COX-2 expression. The level of mRNA expression for the
, ß, and
subunits of ENaC and NKCC2 did not differ significantly between the genotypes on either the NS or the LS diets (Table 2). NCC expression was decreased in the AS/ mice on the NS diet compared with AS+/+ mice, but the LS diet had no effect on this difference. The LS diet resulted in a significant increase in ROMK expression in all 3 of the genotypes (P<0.0001x2-way ANOVA), but the AS/ mice still had lower expression of the ROMK gene on the LS diet than wild-type mice (P<0.05). Of the 3 water channels tested, only the level of mRNA for AQP2 was affected by the AS genotype; it was 70% greater in the AS/ mice than in wild-type mice when the mice were fed the NS diet but was not significantly affected by the AS genotype in mice fed the LS diet (Table 2).
COX-2derived prostaglandins in the renal cortex have been shown to play a role in the adjustment of the renin system to sodium restriction.20,21 The COX-2 mRNA in renal cortex in the AS-null mice was 422±56% of wild-type and was even further increased on the LS diet to 723±132% (P<0.05; Table 2). However, the level of COX-2 expression in the renal cortex of the AS+/ mice did not differ significantly from wild-type mice and was not affected by the LS diet. The expression of the genes listed in Table 2 did not differ between the AS+/ heterozygotes and wild-type mice on either the NS or the LS diets.
| Discussion |
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Our data demonstrate that the abnormalities already present in AS/ mice become more severe on the LS diet, but they are still compatible with survival. Thus, the BP of AS/ mice was further reduced by the sodium restriction and was now accompanied by a detectable decrease in plasma sodium concentration. However, despite this lower plasma Na+ concentration, the levels of renal
, ß, and
ENaC mRNAs on the LS diet in the AS/ mice were not significantly different from wild-type mice, although in the AS/ mice the LS diet increased
ENaC. Berger et al22 have similarly reported that mRNA levels for ENaC were not changed in MR-null mice on an NS diet. It has been shown that Ang II23 and glucocorticoids24 can increase the abundance of
ENaC mRNA. Therefore, it is possible that the increase in the plasma concentration of glucocorticoids and of Ang II that occurs in the AS/ mice on an LS diet is sufficient to maintain normal RNA levels of sodium channels. Circulating plasma vasopressin levels were markedly increased in both the AS/ and AS+/+ mice when fed the LS diet, but this increase was not affected by absence of aldosterone. This suggests that the decrease in plasma Na+ observed in the AS/ mice on the LS diet is because of urinary sodium wasting caused by absence of aldosterone action in the kidney epithelium rather than because of abnormal regulation of vasopressin secretion in the central nervous system.
One of the most striking findings of our study is how critical aldosterone is for water retention, for urine concentration, and for adjustments to an LS diet. Thus, the abnormalities in water handling (increased urine volume and decreased urine osmolality) present in the AS/ mice on an NS diet become markedly more dramatic on the LS diet. These findings have allowed us to use the AS/ mice to investigate how aldosterone contributes to the urinary concentrating mechanism. To test the possibility that the decrease in urinary osmolality is caused by changes in the central control of drinking behavior, we restricted the water consumption of the AS/ mice to the level of wild-type mice having similar body weights. This caused the AS/ mice to lose weight but did not significantly change the osmolality of their urine; we conclude that the increased water consumption of the AS/ is not the cause of their inability to concentrate urine.
Vasopressin and aldosterone have interacting effects. Thus, it has been demonstrated that mineralocorticoids affect the vasopressin-induced transport of water in rabbit collecting ducts in vitro.25,26 We, therefore, evaluated the responses of the AS+/+ and AS/ to the V2 receptorspecific agonist dDAVP. Injection of dDAVP resulted in significant increases in urinary osmolality in both the AS/ and AS+/+ mice, although maximal urinary osmolality was not achieved in AS/ mice; we conclude that absence of aldosterone does not prevent vasopressin from affecting water transport in the kidney.
Decreased responsiveness to vasopressin in AS/ mice may be partly because of structural changes in their kidneys (some AS/ mice are hydronephrotic16) or to changes in reabsorption of sodium in the thick-ascending limb of Henle (TAL) and in the distal convoluted tubule (DCT), which is critical for urinary concentration. Reabsorption of Na+ in TAL and in DCT is mediated primarily by the NKCC2 cotransporter expressed in TAL, which requires K recycling through K channels (ROMK), and by the NCC transporter expressed in DCT.27 We, therefore, examined the effects of a decreased amount or absence of AS on the renal mRNA levels of these transporters. We found no differences in NKCC2 mRNA expression among genotypes. However, absence of aldosterone caused decreases in NCC expression in the whole kidney and in cortical ROMK in the AS/ mice on NS and LS, both of which could contribute to the defect in urinary concentration that we observe. In support of this, we note that Wald et al28 have already demonstrated that cortical ROMK expression is regulated by aldosterone and K+. Thus, our data show that absence of aldosterone leads to urinary concentrating abnormalities mediated in part by decreases in the expression of NCC and ROMK.
We also investigated the expression of 3 major water channels, the AQPs, in AS+/+, AS+/, and AS/ mice. The results showed an increase in AQP2 mRNA in the AS/ mice fed the NS diet relative to wild-type mice, despite the absence of any differences in their vasopressin levels. Previous studies have shown that several pathways in addition to the vasopressin pathway29 can affect the expression of AQP2. It is, therefore, likely that the increased level of AQP-2 mRNA in the AS/ mice is because of a compensatory mechanism other than via vasopressin. Mineralocorticoid deficiency in rats was also found to cause increased expression of the renal AQP-2 water channel,30 although in this case vasopressin was also increased.
Despite their failure to completely adjust to sodium restriction, the LS diet clearly caused the AS-null mice to increase the activity of their compensatory mechanisms, including more extensive RAS activation. Thus, the marked hypertrophy of the juxtaglomerular apparatus and expansion of renin-producing cells along afferent arterioles in the AS/ mice on an NS diet were further exaggerated under sodium restriction in parallel with the increased level of renin mRNA in the kidneys of these mice. The increase in renin production likely occurs by recruitment of additional renin-producing cells from vascular smooth muscle cells as suggested previously by Gomez et al.31 Recruitment of renin-producing cells was also observed in the adrenal cortex of the AS/ mice on the LS diet. Several studies have suggested a role for prostanoids produced by COX-2 in stimulating the renin system when salt is restricted.20,21 Our data are consistent with these studies and demonstrate a further increase of COX-2 expression in the kidney cortex of AS/ mice when they are fed the LS diet. On the LS diet, AS/ mice also developed thickening of walls of the intrarenal arteries. The same arterial phenotype has also been seen in mice lacking MR,32 angiotensinogen,3335 angiotensin-converting enzyme,36,37 Ang II type 1a receptors,38 and Ang II type 1a and type 1b receptors39 on NS diets. Although an increase in Ang II concentration may be partly responsible for this vessel wall thickening, it cannot account for its occurrence in animals lacking angiotensinogen or angiotensin-converting enzyme. An additional possibility, suggested by Pentz et al40 to account for their observation that mice with ablation of renin cells do not have arteriolar hypertrophy, is that the cells that normally produce renin during development may also secrete factors that stimulate vessel thickening.
In our previous work, we have shown that the heterozygous AS+/ mice are able to maintain normal BPs and plasma electrolyte concentrations on NS diets.16 However, our present work demonstrates that these mice are unable to maintain either normal BP or their AS mRNA level when fed an LS diet, despite an
2-fold increase in their expression of renin mRNA. Several investigators have published data suggesting that variations in the human AS gene (CYP11B2) contribute to dysregulation of aldosterone synthesis and can result in cardiovascular abnormalities.6,41,42 One of these polymorphisms, T-344C, is located in the promoter region and may affect the binding of transcriptional protein SF-1.43 Another polymorphism, A6547G, is located in the 3-untranslated region and may play a role in RNA stability.10 Gene conversion in intron 2 (Int2 W/C) is the result of mispairing between AS and the 11-ß hydroxylase genes; therefore, intron 2 may contain regulatory elements of the 11-ß hydroxylase gene.44 However, the association of CYP11B2 polymorphisms with BP remains unexplained. Thus, in some studies,10,45 there was no significant correlation of plasma aldosterone with the genotype. Our study demonstrates that a modest reduction in the level of AS mRNA affects BP during sodium restriction, although we also are unable to detect a significant reduction in plasma aldosterone concentration. Thus, our data suggest that genetic variations that reduce AS gene expression in humans could affect BP when sodium is limited.
Perspectives
Our study demonstrates that on an LS diet the abnormalities in homozygous AS/ mice become more severe, including low BP, decreased plasma Na+, increased plasma K+, strong RAS activation, and increased plasma glucocorticoid concentration, but these changes are still compatible with survival. The most striking finding of this study is that the aldosterone seems critical for urine concentration. Thus, abnormalities in water handling (increased urine volume and decreased urine osmolality) present in AS/ mice on the NS become more dramatic on an LS diet, and these abnormalities are intrinsic to the kidney. On the LS diet, BP in the heterozygous AS+/ mice becomes 5 mm Hg lower than in wild-type mice, although LS in the diet increases expression of renin mRNA in the AS+/ kidneys to 2 times wild-type mice. Our data suggest that genetic differences in AS levels in humans may influence the manner in which BP responds to changes in dietary salt.
| Acknowledgments |
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Source of Funding
This work was supported by National Heart, Lung, and Blood Institute grant HL-49277 (to O.S.).
Disclosures
None.
Received March 24, 2006; first decision April 20, 2006; accepted October 3, 2006.
| References |
|---|
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2. Kim GH, Masilamani S, Turner R, Mitchell C, Wade JB, Knepper MA. The thiazide-sensitive Na-Cl cotransporter is an aldosterone-induced protein. Proc Natl Acad Sci U S A. 1998; 95: 1455214557.
3. Longhurst PA, Rice PJ, Taylor DA, Fleming WW. Sensitivity of caudal arteries and the mesenteric vascular bed to norepinephrine in DOCA-salt hypertension. Hypertension. 1988; 12: 133142.
4. Ullian ME, Walsh LG, Morinelli TA. Potentiation of angiotensin II action by corticosteroids in vascular tissue. Cardiovasc Res. 1996; 32: 266273.
5. Gomez-Sanchez EP, Gomez-Sanchez CE. Is aldosterone synthesized in the CNS regulated and functional? Trends Endocrinol Metab. 2003; 14: 444446.[CrossRef][Medline] [Order article via Infotrieve]
6. Davies E, Holloway CD, Ingram MC, Inglis GC, Friel EC, Morrison C, Anderson NH, Fraser R, Connell JM. Aldosterone excretion rate and blood pressure in essential hypertension are related to polymorphic differences in the aldosterone synthase gene CYP11B2. Hypertension. 1999; 33: 703707.
7. Fardella CE, Rodriguez H, Montero J, Zhang G, Vignolo P, Rojas A, Villarroel L, Miller WL. Genetic variation in P450c11AS in Chilean patients with low renin hypertension. J Clin Endocrinol Metab. 1996; 81: 43474351.[Abstract]
8. Tamaki S, Iwai N, Tsujita Y, Kinoshita M. Genetic polymorphism of CYP11B2 gene and hypertension in Japanese. Hypertension. 1999; 33: 266270.
9. Komiya I, Yamada T, Takara M, Asawa T, Shimabukuro M, Nishimori T, Takasu N. Lys(173)Arg and 344T/C variants of CYP11B2 in Japanese patients with low-renin hypertension. Hypertension. 2000; 35: 699703.
10. Kumar NN, Benjafield AV, Lin RC, Wang WY, Stowasser M, Morris BJ. Haplotype analysis of aldosterone synthase gene (CYP11B2) polymorphisms shows association with essential hypertension. J Hypertens. 2003; 21: 13311337.[CrossRef][Medline] [Order article via Infotrieve]
11. Patel S, Steeds R, Channer K, Samani NJ. Analysis of promoter region polymorphism in the aldosterone synthase gene (CYP11B2) as a risk factor for myocardial infarction. Am J Hypertens. 2000; 13: 134139.[CrossRef][Medline] [Order article via Infotrieve]
12. Payne JR, Dhamrait SS, Toor IS, Cooper J, Jones A, Miller GJ, Humphries SE, Montgomery HE. The 344T>C promoter variant of the gene for aldosterone synthase (CYP11B2) is not associated with cardiovascular risk in a prospective study of UK healthy men. Atherosclerosis. 2004; 174: 8186.[CrossRef][Medline] [Order article via Infotrieve]
13. Isaji M, Mune T, Takada N, Yamamoto Y, Suwa T, Morita H, Takeda J, Whitewhite PC. Correlation between left ventricular mass and urinary sodium excretion in specific genotypes of CYP11B2. J Hypertens. 2005; 23: 11491157.[Medline] [Order article via Infotrieve]
14. Rosler A. The natural history of salt-wasting disorders of adrenal and renal origin. J Clin Endocrinol Metab. 1984; 59: 689700.
15. Lee G, Makhanova N, Caron K, Lopez ML, Gomez RA, Smithies O, Kim HS. Homeostatic responses in the adrenal cortex to the absence of aldosterone in mice. Endocrinology. 2005; 146: 26502656.
16. Makhanova N, Lee G, Takahashi N, Sequeira Lopez ML, Gomez RA, Kim HS, Smithies O. Kidney function in mice lacking aldosterone. Am J Physiol Renal Physiol. 2006; 290: F61F69.
17. Krege JH, Hodgin JB, Hagaman JR, Smithies O. A noninvasive computerized tail-cuff system for measuring blood pressure in mice. Hypertension. 1995; 25: 11111115.
18. Kim HS, Lee G, John SW, Maeda N, Smithies O. Molecular phenotyping for analyzing subtle genetic effects in mice: application to an angiotensinogen gene titration. Proc Natl Acad Sci U S A. 2002; 99: 46024607.
19. Oliverio MI, Delnomdedieu M, Best CF, Li P, Morris M, Callahan MF, Johnson GA, Smithies O, Coffman TM. Abnormal water metabolism in mice lacking the type 1A receptor for ANG II. Am J Physiol Renal Physiol. 2000; 278: F75F82.
20. Freeman RH, Davis JO, Villarreal D. Role of renal prostaglandins in the control of renin release. Circ Res. 1984; 54: 19.
21. Linas SL. Role of prostaglandins in renin secretion in the isolated kidney. Am J Physiol Renal Fluid Electrolyte Physiol. 1984; 246: F811F818.
22. Berger S, Bleich M, Schmid W, Cole TJ, Peters J, Watanabe H, Kriz W, Warth R, Greger R, Schutz G. Mineralocorticoid receptor knockout mice: pathophysiology of Na+ metabolism. Proc Natl Acad Sci U S A. 1998; 95: 94249429.
23. Beutler KT, Masilamani S, Turban S, Nielsen J, Brooks HL, Ageloff S, Fenton RA, Packer RK, Knepper MA. Long-term regulation of ENaC expression in kidney by angiotensin II. Hypertension. 2003; 41: 11431150.
24. Schulz-Baldes A, Berger S, Grahammer F, Warth R, Goldschmidt I, Peters J, Schutz G, Greger R, Bleich M. Induction of the epithelial Na+ channel via glucocorticoids in mineralocorticoid receptor knockout mice. Pflugers Arch. 2001; 443: 297305.[CrossRef][Medline] [Order article via Infotrieve]
25. Schwartz MJ, Kokko JP. Urinary concentrating defect of adrenal insufficiency. Permissive role of adrenal steroids on the hydroosmotic response across the rabbit cortical collecting tubule. J Clin Invest. 1980; 66: 234242.[Medline] [Order article via Infotrieve]
26. Chen L, Williams SK, Schafer JA. Differences in synergistic actions of vasopressin and deoxycorticosterone in rat and rabbit CCD. Am J Physiol. 1990; 259: F147F156.[Medline] [Order article via Infotrieve]
27. Hebert SC. Roles of Na-K-2Cl and Na-Cl cotransporters and ROMK potassium channels in urinary concentrating mechanism. Am J Physiol. 1998; 275: F325F327.[Medline] [Order article via Infotrieve]
28. Wald H, Garty H, Palmer LG, Popovtzer MM. Differential regulation of ROMK expression in kidney cortex and medulla by aldosterone and potassium. Am J Physiol. 1998; 275: F239F245.[Medline] [Order article via Infotrieve]
29. Nielsen S, Frokiaer J, Marples D, Kwon TH, Agre P, Knepper MA. Aquaporins in the kidney: from molecules to medicine. Physiol Rev. 2002; 82: 205244.
30. Ohara M, Cadnapaphornchai MA, Summer SN, Falk S, Yang J, Togawa T, Schrier RW. Effect of mineralocorticoid deficiency on ion and urea transporters and aquaporin water channels in the rat. Biochem Biophys Res Commun. 2002; 299: 285290.[CrossRef][Medline] [Order article via Infotrieve]
31. Gomez RA, Lynch KR, Chevalier RL, Everett AD, Johns DW, Wilfong N, Peach MJ, Carey RM. Renin and angiotensinogen gene expression and intrarenal renin distribution during ACE inhibition. Am J Physiol. 1988; 254: F900F906.[Medline] [Order article via Infotrieve]
32. Hubert C, Gasc JM, Berger S, Schutz G, Corvol P. Effects of mineralocorticoid receptor gene disruption on the components of the renin-angiotensin system in 8-day-old mice. Mol Endocrinol. 1999; 13: 297306.
33. Kim HS, Krege JH, Kluckman KD, Hagaman JR, Hodgin JB, Best CF, Jennette JC, Coffman TM, Maeda N, Smithies O. Genetic control of blood pressure and the angiotensinogen locus. Proc Natl Acad Sci U S A. 1995; 92: 27352739.
34. Niimura F, Labosky PA, Kakuchi J, Okubo S, Yoshida H, Oikawa T, Ichiki T, Naftilan AJ, Fogo A, Inagami T, Hogan BLM, Ichikawa I. Gene targeting in mice reveals a requirement for angiotensin in the development and maintenance of kidney morphology and growth factor regulation. J Clin Invest. 1995; 96: 29472954.[Medline] [Order article via Infotrieve]
35. Kihara M, Umemura S, Sumida Y, Yokoyama N, Yabana M, Nyui N, Tamura K, Murakami K, Fukamizu A, Ishii M. Genetic deficiency of angiotensinogen produces an impaired urine concentrating ability in mice. Kidney Int. 1998; 53: 548555.[CrossRef][Medline] [Order article via Infotrieve]
36. Krege JH, John SW, Langenbach LL, Hodgin JB, Hagaman JR, Bachman ES, Jennette JC, OBrien DA, Smithies O. Male-female differences in fertility and blood pressure in ACE-deficient mice. Nature. 1995; 375: 146148.[CrossRef][Medline] [Order article via Infotrieve]
37. Esther CR Jr, Howard TE, Marino EM, Goddard JM, Capecchi MR, Bernstein KE. Mice lacking angiotensin-converting enzyme have low blood pressure, renal pathology, and reduced male fertility. Lab Invest. 1996; 74: 953965.[Medline] [Order article via Infotrieve]
38. Inokuchi S, Kimura K, Sugaya T, Inokuchi K, Murakami K, Sakai T. Hyperplastic vascular smooth muscle cells of the intrarenal arteries in angiotensin II type 1a receptor null mutant mice. Kidney Int. 2001; 60: 722731.[CrossRef][Medline] [Order article via Infotrieve]
39. Oliverio MI, Kim HS, Ito M, Le T, Audoly L, Best CF, Hiller S, Kluckman K, Maeda N, Smithies O, Coffman TM. Reduced growth, abnormal kidney structure, and type 2 (AT2) angiotensin receptor-mediated blood pressure regulation in mice lacking both AT1A and AT1B receptors for angiotensin II. Proc Natl Acad Sci U S A. 1998; 95: 1549615501.
40. Pentz ES, Moyano MA, Thornhill BA, Sequeira Lopez ML, Gomez RA. Ablation of renin-expressing juxtaglomerular cells results in a distinct kidney phenotype. Am J Physiol Regul Integr Comp Physiol. 2004; 286: R474R483.
41. Pojoga L, Gautier S, Blanc H, Guyene TT, Poirier O, Cambien F, Benetos A. Genetic determination of plasma aldosterone levels in essential hypertension. Am J Hypertens. 1998; 11: 856860.[CrossRef][Medline] [Order article via Infotrieve]
42. Rajput C, Makhijani K, Norboo T, Afrin F, Sharma M, Pasha ST, Pasha MA. CYP11B2 gene polymorphisms and hypertension in highlanders accustomed to high salt intake. J Hypertens. 2005; 23: 7986.[CrossRef][Medline] [Order article via Infotrieve]
43. Lala DS, Rice DA, Parker KL. Steroidogenic factor I, a key regulator of steroidogenic enzyme expression, is the mouse homolog of fushi tarazu-factor I. Mol Endocrinol. 1992; 6: 12491258.
44. Pascoe L, Curnow KM. Genetic recombination as a cause of inherited disorders of aldosterone and cortisol biosynthesis and a contributor to genetic variation in blood pressure. Steroids. 1995; 60: 2227.[CrossRef][Medline] [Order article via Infotrieve]
45. Schunkert H, Hengstenberg C, Holmer SR, Broeckel U, Luchner A, Muscholl MW, Kurzinger S, Doring A, Hense HW, Riegger GA. Lack of association between a polymorphism of the aldosterone synthase gene and left ventricular structure. Circulation. 1999; 99: 22552260.
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