Membrane transport of ions in hypertension

Platelet sodium pump and sodium potassium cotransport activity in nonpregnant, normotensive, and hypertensive pregnant women

OBJECTIVE

To determine ouabain-sensitive sodium pump and bumetanide-sensitive sodium potassium cotransport activity in platelets from nonpregnant and normotensive pregnant women and from women with pregnancy-induced hypertension (PIH).

METHODS

Blood was collected from 9 normotensive nonpregnant subjects, 24 normotensive pregnant subjects in both second and third trimesters, 9 subjects who developed proteinuric PIH, and 9 subjects who developed moderate nonproteinuric PIH. Platelet sodium pump activity was determined by the difference in the uptake of rubidium-86 in the presence and absence of ouabain; sodium potassium cotransport (SPC) activity is that component that is inhibitable by bumetanide.

RESULTS

SPC activity was similar in normotensive subjects in the second [median (range) 78 mmol Rb/h/mg protein (18-140)] and third trimesters [85 (39-134)] but was significantly (p < 0.001) higher than in nonpregnant subjects [22 (4-107)]. In addition, SPC was significantly (p < 0.001) lower in subjects with nonproteinuric [42 (4-67)] or proteinuric PIH [59 (33-102)] compared to those who remained normotensive. Sodium pump activity was significantly higher (p < 0.05) in nonpregnant subjects [263 (188-430)] compared with the other groups of subjects. Total rubidium uptake was significantly higher (p < 0.05) in third-trimester normotensive subjects [471 (243-560)] compared with second-trimester subjects [405 (278-608)].

CONCLUSION

Our results suggest that the lower SPC activity in both nonproteinuric and proteinuric PIH may be an early sign of abnormality in the transport of sodium and potassium across the vascular smooth-muscle cell membrane, which is responsible for the maintenance of blood pressure.

Alterations in sodium metabolism as an etiological model for hypertension

An adequate matching for race, sex, stage of the menstrual cycle, family history of hypertension, and the amount of sodium and other electrolytes in the diet should be a prerequisite for valid conclusions when interpreting the erythrocyte concentration and fluxes of sodium in essential hypertensive patients in comparison with normal subjects. Alterations in intracellular sodium concentration and transmembrane sodium transport systems as causes of essential hypertension are postulated. This review article describes how this abnormal sodium and calcium metabolism translates into increased systemic vascular resistance through altered vasoactive responses and/or vasculature structural changes.

Alterations of membrane properties in erythrocytes of salt hypertensive Sabra rats

This study was designed to investigate the effects of a hypertensive stimulus, high salt intake, in hypertension-prone (SBH) and -resistant (SBN) Sabra rats on erythrocyte Na+ content (Na+i), Ca2+ influx and cytosolic Ca2+ concentration ([Ca2+]i). The relationships of these parameters to plasma lipids, circulating digoxin-like immunoreactivity and membrane microviscosity, determined by the fluorescence anisotropy of trimethylamino-diphenylhexatriene (TMA-DPH) and diphenylhexatriene (DPH), were also evaluated. Erythrocytes of SBH rats were characterized by increased [Ca2+]i, unchanged Ca2+ influx and reduced Na+i. There were no significant differences in the plasma digoxin-like immunoreactivity between the two strains. High-salt intake decreased membrane microviscosity (DPH anisotropy) in SBH rats but did not alter the above parameters. Erythrocyte [Ca2+]i correlated positively with diastolic blood pressure and negatively with erythrocyte Na+i. Membrane dynamics evaluated by the two fluorescent probes did not correlate with [Ca2+]i, Ca2+ influx or Na+i whereas DPH anisotropy was inversely related to blood pressure. These relationships were independent of plasma cholesterol or triglycerides. It can be concluded that 1) similarly to earlier observations in essential hypertension and spontaneously hypertensive rats, erythrocyte [Ca2+]i correlates positively with blood pressure in salt-dependent hypertension, and 2) increased erythrocyte Na+ content need not be a hallmark of hypertension.

Red cell ion transport abnormalities in experimental hypertension

The original attractive hypothesis on the important role of elevated cell Na+ concentration in the pathogenesis of hypertension stimulated a search for generalized membrane defects and ion transport abnormalities in various easily accessible cells including erythrocytes. An attempt is made here to compare this hypothesis with the data on red cell ion transport alterations that were observed in experimental hypertension over the last 15 years. Several methodological (presence of extracellular Na+ in incubation media, kinetic approach to the evaluation of transport systems) and physiological problems (potassium depletion, age-dependent changes) are discussed in more detail because they can substantially modify the results obtained. Available data suggest a possible contribution of augmented Na+ leak to the development of both genetic and salt-dependent experimental hypertension. The role of alterations in the activity of the Na(+)-K+ pump or the Na(+)-K+ cotransport system still remains unclear.

Regulation of the dynamic properties of platelet plasma membrane by intracellular sodium ions

Our previous experiments in human and rat platelets demonstrated that the absence of extracellular Na+ increased the fluorescence anisotropy of TMA-DPH (trimethylamino-diphenylhexatriene, probe preferentially incorporated into the outer leaflet of the plasma membrane). Here we investigated further the in vitro effects of Na+ ions on membrane dynamic properties. Na(+)-dependent changes were reversible and they required about 10-20 min to be induced. They were specifically located in the TMA-DPH environment because they were not observed with diphenylhexatriene (probe non-selectively incorporated into all hydrophobic domains of the cell). To evaluate the possible influence of the intracellular Na+, the effects of sodium replenishment, monensin, ouabain and thrombin on TMA-DPH anisotropy were measured. A rise in intracellular Na+ above the physiological level was associated with unchanged or slightly decreased TMA-DPH anisotropy whereas its decrease was accompanied by a pronounced rise in TMA-DPH anisotropy. Our data indicate that the changes in intracellular Na+ concentration, rather than those in extracellular Na+ concentration, are responsible for the alterations in platelet membrane fluidity probed by TMA-DPH.