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Ilatovskaya DV, Levchenko V, Winsor K, Blass GR, Spires DR, Sarsenova E, Polina I, Zietara A, Paterson M, Kriegel AJ, Staruschenko A. Effects of elevation of ANP and its deficiency on cardiorenal function. JCI Insight 2022; 7:148682. [PMID: 35380994 PMCID: PMC9090260 DOI: 10.1172/jci.insight.148682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/30/2022] [Indexed: 11/17/2022] Open
Abstract
Atrial natriuretic peptide (ANP), encoded by Nppa, is a vasodilatory hormone that promotes salt excretion. Genome-wide association studies identified Nppa as a causative factor of blood pressure development, and in humans, ANP levels were suggested as an indicator of salt sensitivity. This study aimed to provide insights into the effects of ANP on cardiorenal function in salt-sensitive hypertension. To address this question, hypertension was induced in SSNPPA-/- (knockout of Nppa in the Dahl Salt-Sensitive (SS) rat background) or SSWT (wild type Dahl SS) rats by a high salt diet challenge (HS, 4% NaCl for 21 days). Chronic infusion of ANP in SSWT rats attenuated the increase in blood pressure and cardiorenal damage. Overall, SSNPPA-/- strain demonstrated higher blood pressure and intensified cardiac fibrosis (with no changes in ejection fraction) compared to SSWT rats. Furthermore, SSNPPA-/- rats exhibited kidney hypertrophy and higher glomerular injury scores, reduced diuresis, and lower sodium and chloride excretion than SSWT when fed a HS diet. Additionally, the activity of epithelial Na+ channel (ENaC) was found to be increased in the collecting ducts of the SSNPPA-/- rats. Taken together, these data show promise for the therapeutic benefits of ANP and ANP-increasing drugs for treating salt-sensitive hypertension.
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Affiliation(s)
- Daria V Ilatovskaya
- Department of Physiology, Medical College of Georgia, Augusta, United States of America
| | - Vladislav Levchenko
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
| | - Kristen Winsor
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
| | - Gregory R Blass
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
| | - Denisha R Spires
- Department of Physiology, Medical College of Georgia, Augusta, United States of America
| | - Elizaveta Sarsenova
- Department of Medicine, Medical University of South Carolina, Charleston, United States of America
| | - Iuliia Polina
- Department of Medicine, Medical University of South Carolina, Charleston, United States of America
| | - Adrian Zietara
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
| | - Mark Paterson
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
| | - Alison J Kriegel
- Department of Physiology, Medical College of Wisconsin, Milwaukee, United States of America
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Polina I, Spicer MJ, Domondon M, Schibalski RS, Sarsenova E, Sultanova RF, Ilatovskaya DV. Inhibition of neprilysin with sacubitril without RAS blockage aggravates renal disease in Dahl SS rats. Ren Fail 2021; 43:315-324. [PMID: 33541194 PMCID: PMC8901277 DOI: 10.1080/0886022x.2021.1879856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Salt-sensitive (SS) hypertension is accompanied with severe cardiorenal complications. In this condition, elevated blood pressure (BP) resulting from salt retention is associated with counterintuitively lower levels of atrial natriuretic peptide (ANP). In plasma, ANP is degraded by the neprilysin; therefore, pharmacological inhibition of this metalloprotease (i.e., with sacubitril) can be employed to increase ANP level. We have shown earlier that sacubitril in combination with valsartan (75 μg/day each) had beneficial effects on renal function in Dahl SS rats. The goal of this study was to evaluate the effects of a higher dose of sacubitril on renal damage in this model. To induce hypertension, male Dahl SS rats were fed a 4% NaCl diet (HS) for 21 days, and were administered sacubitril (125 μg/day) or vehicle via s.c. osmotic pumps. At the end of the HS challenge, both groups exhibited similar outcomes for GFR, heart weight, plasma electrolytes, BUN, and creatinine. Sacubitril exacerbated kidney hypertrophy, but did not affect levels of renal fibrosis. We also observed aggravated glomerular lesions and increased formation of protein casts in the sacubitril-treated animals compared to controls. Thus, in Dahl SS rats, administration of sacubitril without renin-angiotensin-system blockage had adverse effects on renal disease progression, particularly in regards to glomerular damage and protein cast formation. We can speculate that while ANP levels are increased because of neprilysin inhibition, there are off-target effects of sacubitril, which are detrimental to renal function in the SS hypertensive state.
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Affiliation(s)
- Iuliia Polina
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Morgan J Spicer
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Mark Domondon
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Ryan S Schibalski
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
| | - Elizaveta Sarsenova
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA.,Saint-Petersburg State Chemical Pharmaceutical University, St. Petersburg, Russia
| | - Regina F Sultanova
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA.,Saint-Petersburg State Chemical Pharmaceutical University, St. Petersburg, Russia
| | - Daria V Ilatovskaya
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC, USA
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Polina I, Domondon M, Fox R, Sudarikova AV, Troncoso M, Vasileva VY, Kashyrina Y, Gooz MB, Schibalski RS, DeLeon-Pennell KY, Fitzgibbon WR, Ilatovskaya DV. Differential effects of low-dose sacubitril and/or valsartan on renal disease in salt-sensitive hypertension. Am J Physiol Renal Physiol 2020; 319:F63-F75. [PMID: 32463726 PMCID: PMC7468826 DOI: 10.1152/ajprenal.00125.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 12/15/2022] Open
Abstract
Diuretics and renin-angiotensin system blockers are often insufficient to control the blood pressure (BP) in salt-sensitive (SS) subjects. Abundant data support the proposal that the level of atrial natriuretic peptide may correlate with the pathogenesis of SS hypertension. We hypothesized here that increasing atrial natriuretic peptide levels with sacubitril, combined with renin-angiotensin system blockage by valsartan, can be beneficial for alleviation of renal damage in a model of SS hypertension, the Dahl SS rat. To induce a BP increase, rats were challenged with a high-salt 4% NaCl diet for 21 days, and chronic administration of vehicle or low-dose sacubitril and/or valsartan (75 μg/day each) was performed. Urine flow, Na+ excretion, and water consumption were increased on the high-salt diet compared with the starting point (0.4% NaCl) in all groups but remained similar among the groups at the end of the protocol. Upon salt challenge, we observed a mild decrease in systolic BP and urinary neutrophil gelatinase-associated lipocalin levels (indicative of alleviated tubular damage) in the valsartan-treated groups. Sacubitril, as well as sacubitril/valsartan, attenuated the glomerular filtration rate decline induced by salt. Alleviation of protein cast formation and lower renal medullary fibrosis were observed in the sacubitril/valsartan- and valsartan-treated groups, but not when sacubitril alone was administered. Interestingly, proteinuria was mildly mitigated only in rats that received sacubitril/valsartan. Further studies of the effects of sacubitril/valsartan in the setting of SS hypertension, perhaps involving a higher dose of the drug, are warranted to determine if it can interfere with the progression of the disease.
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Affiliation(s)
- Iuliia Polina
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Mark Domondon
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Rebecca Fox
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Anastasia V Sudarikova
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Miguel Troncoso
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Valeriia Y Vasileva
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Yuliia Kashyrina
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Monika Beck Gooz
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Ryan S Schibalski
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Kristine Y DeLeon-Pennell
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Wayne R Fitzgibbon
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Daria V Ilatovskaya
- Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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Baudrand R, Pojoga LH, Vaidya A, Garza AE, Vöhringer PA, Jeunemaitre X, Hopkins PN, Yao TM, Williams J, Adler GK, Williams GH. Statin Use and Adrenal Aldosterone Production in Hypertensive and Diabetic Subjects. Circulation 2015; 132:1825-33. [PMID: 26432671 DOI: 10.1161/circulationaha.115.016759] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/20/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Statins substantially reduce cardiovascular mortality and appear to have beneficial effects independent of their lipid-lowering properties. We evaluated the hypothesis that statin use may modulate the secretion of aldosterone, a well-known contributor to cardiovascular disease. METHODS AND RESULTS We measured adrenal hormones in 2 intervention studies. In study 1 in hypertensive subjects, aldosterone was analyzed at baseline and after angiotensin II stimulation on both high- and low-sodium diets (1122 observations, 15% on statins for >3 months). Statin users had 33% lower aldosterone levels in adjusted models (P<0.001). Cortisol was not modified by statins. In secondary analyses, the lowest aldosterone levels were seen with lipophilic statins and with higher doses. Statin users had lower blood pressure and reduced salt sensitivity of blood pressure (both P<0.001). In study 2, aldosterone was measured in diabetic patients on a high-sodium diet, before and after angiotensin II stimulation (143 observations, 79% statin users). Again, statin users had 26% lower aldosterone levels (P=0.006), particularly those using lipophilic statins. Ex vivo studies in rat adrenal glomerulosa cells confirmed that lipophilic statins acutely inhibited aldosterone, but not corticosterone, in response to different secretagogues. CONCLUSIONS Statin use among hypertensive and diabetic subjects was associated with lower aldosterone secretion in response to angiotensin II and a low-sodium diet in 2 human intervention studies. This effect appeared to be most pronounced with lipophilic statins and higher doses. Future studies to evaluate whether aldosterone inhibition may partially explain the robust cardioprotective effects of statins are warranted.
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Affiliation(s)
- Rene Baudrand
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.).
| | - Luminita H Pojoga
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Anand Vaidya
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Amanda E Garza
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Paul A Vöhringer
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Xavier Jeunemaitre
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Paul N Hopkins
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Tham M Yao
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Jonathan Williams
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Gail K Adler
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.)
| | - Gordon H Williams
- From Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (R.B., L.H.P., A.V., A.E.G., T.M.Y., J.W., G.K.A., G.H.W.); Department of Endocrinology, School Of Medicine, Pontificia Universidad Catolica De Chile, Santiago, Chile (R.B.); Hospital Clinico, Facultad Medicina Universidad de Chile, Santiago, Chile and Tufts Medical Center, Tufts University School of Medicine, Boston, MA (P.A.V.); Centre Investigation Clinique, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Universite Paris Descartes, Paris, France (X.J.); and Cardiovascular Genetics Research, University of Utah School of Medicine Salt Lake City (P.N.H.).
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