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Sathiskumar R, Mohanty BP, Parija SC. Vasorelaxation of goat mesenteric artery is mediated by endothelial Na(+)-K(+)-ATPase. J Pharmacol Pharmacother 2016; 6:204-10. [PMID: 26816472 PMCID: PMC4714387 DOI: 10.4103/0976-500x.171884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the role of Na(+)-K(+)-ATPase and K(+) channels in mediating vasorelaxation in the superior mesenteric artery of Capra hircus. MATERIALS AND METHODS Goat superior mesenteric artery (GSMA) was cut into 1.5-2 mm circular rings and mounted in a thermostatically controlled (37°C ± 0.5°C) organ bath containing 20 ml of modified Krebs-Henseleit saline (MKHS) (pH 7.4), with continuous aeration under 1.5 g tension for 90 min. Endothelium-intact (ED+) or endothelium-denuded (ED-) GSMA ring was contracted with phenylephrine (PE) or 5-hydroxytryptamine (5-HT) (1 μM-0.1 mM) in the absence or presence of ouabain (0.1 μM). KCl (1 μM-10 mM) was added cumulatively to K(+)-free MKHS-pre-contracted (ED+/-) rings in the absence or presence of ouabain (0.1 μM) or barium (1 μM) or 4-aminopyridine (1 μM). RESULTS Ouabain did not alter the basal tone of the arterial ring. The contractile response induced by PE (Emax: 50.46 ± 2.68, pD2: 5.53 ± 0.04) and 5-HT (Emax: 30.86 ± 1.33, pD2: 6.17 ± 0.03) in ED+ ring was significantly (P < 0.001) augmented in ED- rings (PE: Emax: 93.30 ± 2.11, pD2: 6.41 ± 0.04; 5-HT: Emax: 95.07 ± 0.99, pD2: 6.27 ± 0.03). The contractile response induced by PE and 5-HT in ED+ or ED- rings in the presence of ouabain was almost identical with that of ED- rings. Vasorelaxation of KCl (Emax: 2.90 ± 1.14, pD2: 3.9 ± 0.03) was significantly attenuated in the presence of ouabain (Emax: 73.8 ± 5.16, pD2: 4.3 ± 0.04), Ba(2+) (Emax: 16.34 ± 4.7, pD2: 3.22 ± 0.02), 4-AP (Emax: 18.16 ± 2.4, pD2: 3.68 ± 0.03), ouabain and Ba(2+) (Emax: 70.09 ± 3.66, pD2: 4.41 ± 0.04), and ouabain and 4-AP (Emax: 66.98 ± 4.61, pD2: 4.13 ± 0.06). CONCLUSION The vasorelaxation in GSMA is mediated by the endothelium-derived hyperpolarizing factor (EDHFs) such as ouabain-sensitive Na(+)-K(+)-ATPase, KIR and Kv channels.
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Affiliation(s)
- R Sathiskumar
- Department of Pharmacology and Toxicology, Orissa University of Agriculture and Technology, Bhubaneswar, Odisha, India
| | - Bimal Prasanna Mohanty
- FREM Division, Central Inland Fisheries Research Institute, ICAR, Kolkata, West Bengal, India
| | - Subas Chandra Parija
- Department of Pharmacology and Toxicology, Orissa University of Agriculture and Technology, Bhubaneswar, Odisha, India
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Padilha A, Salaices M, Vassallo D, Batista P, Siman F. Hypertensive effects of the iv administration of picomoles of ouabain. Braz J Med Biol Res 2011; 44:933-8. [DOI: 10.1590/s0100-879x2011007500103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 07/20/2011] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | - D.V. Vassallo
- Universidade Federal do Espírito Santo, Brasil; Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Brasil
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Role of Low Ouabain-Sensitive Isoform of Na+-K+-ATPase in the Regulation of Basal Tone and Agonist-Induced Contractility in Ovine Pulmonary Artery. J Cardiovasc Pharmacol 2008; 52:167-75. [DOI: 10.1097/fjc.0b013e31818127dd] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schoner W, Scheiner-Bobis G. Endogenous and exogenous cardiac glycosides: their roles in hypertension, salt metabolism, and cell growth. Am J Physiol Cell Physiol 2007; 293:C509-36. [PMID: 17494630 DOI: 10.1152/ajpcell.00098.2007] [Citation(s) in RCA: 341] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cardiotonic steroids (CTS), long used to treat heart failure, are endogenously produced in mammals. Among them are the hydrophilic cardenolide ouabain and the more hydrophobic cardenolide digoxin, as well as the bufadienolides marinobufagenin and telecinobufagin. The physiological effects of endogenous ouabain on blood pressure and cardiac activity are consistent with the "Na(+)-lag" hypothesis. This hypothesis assumes that, in cardiac and arterial myocytes, a CTS-induced local increase of Na(+) concentration due to inhibition of Na(+)/K(+)-ATPase leads to an increase of intracellular Ca(2+) concentration ([Ca(2+)](i)) via a backward-running Na(+)/Ca(2+) exchanger. The increase in [Ca(2+)](i) then activates muscle contraction. The Na(+)-lag hypothesis may best explain short-term and inotropic actions of CTS. Yet all data on the CTS-induced alteration of gene expression are consistent with another hypothesis, based on the Na(+)/K(+)-ATPase "signalosome," that describes the interaction of cardiac glycosides with the Na(+) pump as machinery activating various signaling pathways via intramembrane and cytosolic protein-protein interactions. These pathways, which may be activated simultaneously or selectively, elevate [Ca(2+)](i), activate Src and the ERK1/2 kinase pathways, and activate phosphoinositide 3-kinase and protein kinase B (Akt), NF-kappaB, and reactive oxygen species. A recent development indicates that new pharmaceuticals with antihypertensive and anticancer activities may be found among CTS and their derivatives: the antihypertensive rostafuroxin suppresses Na(+) resorption and the Src-epidermal growth factor receptor-ERK pathway in kidney tubule cells. It may be the parent compound of a new principle of antihypertensive therapy. Bufalin and oleandrin or the cardenolide analog UNBS-1450 block tumor cell proliferation and induce apoptosis at low concentrations in tumors with constitutive activation of NF-kappaB.
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Affiliation(s)
- Wilhelm Schoner
- Institut für Biochemie und Endokrinologie, Fachbereich Veterinärmedizin, Justus-Liebig-Universität Giessen, Frankfurter Str 100, Giessen, Germany.
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Ark M, Kubat H, Beydaği H, Ergenoğlu T, Songu-Mize E. Involvement of rho kinase in the ouabain-induced contractions of the rat renal arteries. Biochem Biophys Res Commun 2006; 340:417-21. [PMID: 16375858 DOI: 10.1016/j.bbrc.2005.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2005] [Accepted: 12/05/2005] [Indexed: 11/30/2022]
Abstract
Agonist and depolarization-induced vascular smooth muscle contractions include the activation of rho/rho kinase pathway. However, there are no reports addressing the question whether this pathway is involved in ouabain-induced vascular smooth muscle contractions. Therefore, in this study, the possible participation of the rho/rho kinase pathway in ouabain-induced contractions was evaluated in rat renal arteries. Effects of rho kinase inhibitors (fasudil and Y-27632) on ouabain-induced contractions, and phosphorylation of myosin binding subunits (MYPT/MBS85) of myosin phosphatase were determined using isolated tissue and Western blot experiments, respectively. Fasudil and Y-27632 inhibited ouabain-induced contractions in a concentration-dependent manner. The phosphorylation of MYPT was not altered by ouabain. However, ouabain significantly increased MBS85 phosphorylation of myosin phosphatase. The phosphorylation of both subunits of myosin phosphatase was inhibited by Y-27632. These results indicate that activation of rho kinase and the subsequent phosphorylation of MBS85 are involved in ouabain-induced contraction of rat renal arteries. This mechanism may be important in essential hypertension with elevated endogenous ouabain levels.
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Affiliation(s)
- Mustafa Ark
- Department of Pharmacology, Mersin University, Faculty of Medicine, Turkey.
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Rossoni LV, dos Santos L, Barker LA, Vassallo DV. Ouabain changes arterial blood pressure and vascular reactivity to phenylephrine in L-NAME-induced hypertension. J Cardiovasc Pharmacol 2003; 41:105-16. [PMID: 12500028 DOI: 10.1097/00005344-200301000-00014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ouabain is an endogenous compound that has been associated with the genesis and maintenance of hypertension. This compound inhibits the Na+ pump activity, which leads to an accumulation of intracellular Na and ultimately might increase vascular tone. In nanomolar concentrations, it enhances vasopressor responses to phenylephrine in some vascular beds from normotensive and hypertensive rats. However, it is not known whether this action of ouabain is a common mechanism for all models of hypertension. The aim of this work was to determine whether ouabain can alter pressor responses to phenylephrine in rats with Nomega-nitro-l-arginine methyl ester (L-NAME)-induced hypertension. In anesthetized rats, ouabain (0.18 microg/kg, i.v.) increased arterial blood pressure in L-NAME-treated rats but not in controls. Ganglionic blockade by hexamethonium (5 mg/kg, i.v.) prevented the increase in arterial blood pressure produced by ouabain in L-NAME-treated rats. Additional studies using isolated perfused tail artery preparations were performed to investigate which factors are involved in the action of ouabain in L-NAME-treated rats. The effects of 10 nM ouabain on the vasoconstrictor actions of phenylephrine were determined on preparations with intact or damaged endothelium or in the presence of tetraethylammonium (a K+-channel blocker). Ouabain reduced pressor actions of phenylephrine in preparations with an intact endothelium. However, after endothelial damage or infusing tetraethylammonium, the response to phenylephrine was increased after ouabain. In tails from L-NAME-treated rats, the functional activity of the Na, K+-ATPase was reduced, and 10 nM ouabain did not produce any further reduction. In conclusion, in this model of hypertension, a low dose of ouabain (0.18 microg/kg) increased arterial blood pressure in vivo probably as a result of increased sympathetic tone. However, this effect was not accompanied by an enhanced action of phenylephrine on the tail vascular bed with an intact endothelium. The results suggest that this was due to the release of an endothelium-derived K+-channel opener.
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Affiliation(s)
- Luciana V Rossoni
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, Brazil.
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Rossoni LV, Salaices M, Miguel M, Briones AM, Barker LA, Vassallo DV, Alonso MJ. Ouabain-induced hypertension is accompanied by increases in endothelial vasodilator factors. Am J Physiol Heart Circ Physiol 2002; 283:H2110-8. [PMID: 12384489 DOI: 10.1152/ajpheart.00454.2002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The involvement of nitric oxide (NO), prostaglandins, and calcium-dependent potassium channel (K(Ca)) activators on the negative modulation of phenylephrine-induced contractions was evaluated on the isolated aorta and caudal (CAU) artery obtained from rats treated with ouabain for 5 wk to induce hypertension. In ouabain-treated rats, the reactivity to phenylephrine was reduced in the endothelium-intact aorta but not the CAU segments. Endothelial modulation of phenylephrine contraction, as demonstrated by endothelium removal, NO synthase (NOS) inhibition with N(omega)-nitro-L-arginine methyl ester and aminoguanidine, as well as K(Ca) inhibition with tetraethylammonium, was more pronounced in segments from ouabain-treated animals, and here greater effects were seen in the aorta than in CAU. An increased expression of endothelial NOS and neuronal NOS was seen in the aorta after ouabain treatment. In CAU, only endothelial NOS was detected and ouabain treatment did not alter its expression. These results suggest that ouabain-induced hypertension is accompanied by increased NO release derived from endothelial NOS and neuronal NOS and increased release of an endothelial hyperpolarizing factor that presumably opens K(Ca), all of which contribute to the increased negative modulation of the phenylephrine contraction.
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Affiliation(s)
- Luciana V Rossoni
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Autonomous University of Madrid, C/Arzobispo Morcillo 4, 28029 Madrid, Spain
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Cargnelli G, Trevisi L, Debetto P, Luciani S, Bova S. Effect of long-term ouabain treatment on contractile responses of rat aortae. J Cardiovasc Pharmacol 2000; 35:538-42. [PMID: 10774782 DOI: 10.1097/00005344-200004000-00004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Male Sprague-Dawley rats were infused with 50 microg/kg/day of ouabain for 4 weeks to address the question whether prolonged exposure to the drug affects blood pressure, the in vitro contractile responses to agonists and high K+ of their aortae, and the influence of endothelium on these responses. Systolic blood pressure was not affected by ouabain treatment. The responsiveness of endothelium-intact aortae from ouabain-treated rats to endothelin-1 increased, that to phenylephrine decreased, and that to high K+ was unchanged, as compared with control. The responses of endothelium-free aortae to endothelin-1, phenylephrine, and high K+ were lower in ouabain-treated than in control rats. The removal of endothelium increased the response to phenylephrine and decreased that to high K+ in either control or ouabain-treated rat aortae, whereas it did not affect the response to endothelin-1 in control rat aortae and decreased it in ouabain-treated rat aortae. The response to caffeine was unaffected by either ouabain treatment or endothelium removal. Thus rat ouabain long-term treatment induces opposing effects on the responsiveness of their intact aortae to an alpha-adrenergic agonist and endothelin-1. If these effects observed in the ex vivo experiments occur also in vivo on rat microvasculature, they could balance out and contribute to the lack of effect on systolic blood pressure of prolonged ouabain treatment.
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Affiliation(s)
- G Cargnelli
- Department of Pharmacology, University of Padova, Italy
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Rossoni LV, Cunha V, Franca A, Vassallo DV. The influence of nanomolar ouabain on vascular pressor responses is modulated by the endothelium. J Cardiovasc Pharmacol 1999; 34:887-92. [PMID: 10598134 DOI: 10.1097/00005344-199912000-00017] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Ouabain has been shown to be an endogenous hormone that is synthesized and released from the adrenal cortex and is present in nanomolar to subnanomolar concentrations in plasma. It has been proposed that endogenous ouabain can increase vascular resistance and induce hypertension. This substance inhibits the Na(+)-pump activity, which leads to intracellular Na+ accumulation and ultimately to increased vascular tone. It is also suggested that circulating ouabain influences the vascular smooth muscle response to vasopressor substances. However, the mechanisms by which low concentrations of ouabain influence the smooth muscle, directly or acting through the endothelium, have not been completely elucidated. We tested the hypothesis that the endothelium exerts a modulatory effect on the actions of ouabain. In these studies, isolated rat-tail vascular bed preparations obtained from normotensive animals were used. The effects of 10 nM ouabain on the reactivity of the vascular smooth muscle to phenylephrine were determined under conditions in which endothelial function was preserved or reduced by endothelial removal and treatment with N(omega)-nitroL-arginine methyl ester (L-NAME) or potassium channel blocker (tetraethylammonium; TEA). Results showed that ouabain enhanced the reactivity to phenylephrine. The enhancement of the reactivity to phenylephrine produced by ouabain was potentiated by deendothelialization and by using TEA, but it was reduced by treatment with L-NAME. The effect of 10 nM ouabain on the functional activity of the Na+,K(+)-adenosine triphosphatase (ATPase) also was evaluated. Na+,K(+)-ATPase activity was reduced after 1-h treatment with ouabain. These results suggested that low concentrations of ouabain reduced the functional activity of the Na+,K(+)-ATPase and stimulated the release of a potassium channel opener, suggesting that the effects of ouabain are partially modulated by the endothelium.
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Affiliation(s)
- L V Rossoni
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
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Pérez-Vizcaíno F, Cogolludo A, Tamargo J. Modulation of arterial Na+-K+-ATPase-induced [Ca2+]i reduction and relaxation by norepinephrine, ET-1, and PMA. THE AMERICAN JOURNAL OF PHYSIOLOGY 1999; 276:H651-7. [PMID: 9950867 DOI: 10.1152/ajpheart.1999.276.2.h651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Na+-K+-ATPase plays a major role in regulating membrane potential and vascular tone. We analyzed the modulation by norepinephrine (NE), endothelin-1 (ET-1), and phorbol 12-myristate 13-acetate (PMA) of Na+-K+-ATPase-induced cytoplasmic free Ca2+ concentration ([Ca2+]i) reduction and relaxation in isolated endothelium-denuded piglet mesenteric arteries. KCl (0.2-8.8 mM)-induced [Ca2+]i reduction and relaxation in arteries incubated in K+-free solution were used as functional indicators of Na+-K+-ATPase activity. KCl-induced relaxations after exposure to K+-free solution were associated with a reduction in [Ca2+]i, as measured by fura 2 fluorescence. However, KCl reduced [Ca2+]i below resting values, whereas force was reduced to near resting values. NE, ET-1, and PMA inhibited the relaxant effects of KCl, and this effect was attenuated by the protein kinase C inhibitor staurosporine but not by the phospholipase A2 inhibitor quinacrine. However, ET-1 and PMA potentiated the [Ca2+]i-reducing effect of KCl. In conclusion, ET-1, PMA, and NE are functional inhibitors of Na+-K+-ATPase activity in endothelium-denuded piglet mesenteric arteries, even when the direct effect on the enzyme activity may be stimulatory rather than inhibitory. This can be explained because ET-1, PMA, and NE induce Ca2+ sensitization for smooth muscle contraction, and therefore relaxations do not parallel the reductions in [Ca2+]i after the activation of Na+-K+-ATPase.
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Affiliation(s)
- F Pérez-Vizcaíno
- Departamento de Farmacología, Facultad de Medicina, Instituto de Farmacología y Toxicología, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Mayol V, Duran MJ, Gerbi A, Dignat-George F, Lévy S, Sampol J, Maixent JM. Cholesterol and omega-3 fatty acids inhibit Na, K-ATPase activity in human endothelial cells. Atherosclerosis 1999; 142:327-33. [PMID: 10030384 DOI: 10.1016/s0021-9150(98)00253-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We have investigated the effects of cholesterol and omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexenoic acid (DHA) on Na, K-ATPase activity in human endothelial cells (HUVEC). Cultured HUVEC were incubated for 18 h with pure egg phosphatidylcholine (PC), or cholesterol-enriched liposomes (4 mg PC/ml). EPA and DHA alpha-tocopherol-acetate were emulsified with PC and incubated with HUVEC (10 mM). Na, K-ATPase and 5'-nucleotidase activities were determined using the coupled assay method on microsomal fractions obtained from cultured cells using non treated cells as control. Cholesterol enrichment significantly reduced both Na, K-ATPase and 5'-nucleotidase activities by a similar level (- 40%), whereas pure phospholipid liposomes inhibited this activity only by 22%. The dose-response curves of Na, K-ATPase activity were all biphasic assuming the presence of two independent sites exhibiting different affinities for ouabain of nM and microM respectively. The cholesterol induced inhibitory effect was greater for low affinity sites (-54%) as compared to that of the high affinity sites (-24%) whereas omega-3 fatty acids reduced the activity of both sites by 22%. Short term effects of EPA and DHA on Na, K-ATPase activity were determined by incubating microsomal fractions from untreated cells with various concentrations of free fatty acids (from 1 to 200 microM) for 20 min. Both EPA and DHA significantly reduced Na, K-ATPase activity but inhibition by EPA seems to be more effective than DHA. These results suggest that cholesterol and omega-3 fatty acids reduce Na, K-ATPase activity in HUVEC.
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Affiliation(s)
- V Mayol
- Laboratoire de Recherche Cardiologique, Faculté de Médecine, IFR Jean Roche, Université de la Méditerranée, Marseille, France
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Glavind-Kristensen M, Petersen OB, Forman A. Effects of ouabain on the isolated human uteroplacental vasculature. Am J Obstet Gynecol 1998; 178:892-8. [PMID: 9609556 DOI: 10.1016/s0002-9378(98)70520-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We sought to describe the effects of ouabain on the human uteroplacental vasculature. STUDY DESIGN Stem villous vessels and intramyometrial arteries isolated from placental and myometrial biopsy specimens at term were mounted in organ baths. Moreover, isolated human placental cotyledons were perfused. RESULTS Contractions induced by the thromboxane A2 analog U46619 were unaffected by pretreatment with ouabain 10(-10) to 10(-6) mol/L. In fetal vessels nitric oxide (10(-8) to 3 x 10(-5) mol/L) induced relaxation of vascular tonus induced by U46619 and potassium. This relaxation was inhibited by pretreatment with ouabain 10(-7) to 10(-6) mol/L. These associations were unaffected by removal of the endothelium. In maternal arteries ouabain (10(-6) mol/L) failed to significantly affect nitric oxide-induced relaxation. Ouabain (10(-9) mol/L) significantly affected pressure-flow relationships in perfused cotyledons. CONCLUSIONS Ouabain impairs nitric oxide-induced relaxation of human stem villous arteries and veins, which may explain the changes induced by therapeutically relevant concentrations of the drug on pressure-flow relationships in the perfused cotyledon. Thus treatment with cardiac glycosides in pregnancy may impair uteroplacental blood flow.
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Affiliation(s)
- M Glavind-Kristensen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus N, Denmark
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Ibrahim B, Guiet-Bara A, Leveteau J, Bara M. Membrane potential of smooth muscle cells of human allantochorial placental vessels. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/0302-4598(95)01899-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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