Evidence of the Importance of Nox4 in Production of Hypertension in Dahl Salt-Sensitive Rats

This study reports the consequences of knocking out NADPH (nicotinamide adenine dinucleotide phosphate) oxidase 4 (Nox4) on the development of hypertension and kidney injury in the Dahl salt-sensitive (SS) rat. Zinc finger nuclease injection of single-cell SS embryos was used to create an 8 base-pair frame-shift deletion of Nox4, resulting in a loss of the ≈68 kDa band in Western blot analysis of renal cortical tissue of the knock out of Nox4 in the SS rat (SS(Nox4-/-)) rats. SS(Nox4-/-) rats exhibited a significant reduction of salt-induced hypertension compared with SS rats after 21 days of 4.0% NaCl diet (134±5 versus 151±3 mm Hg in SS) and a significant reduction of albuminuria, tubular casts, and glomerular injury. Optical fluorescence 3-dimensional cryoimaging revealed significantly higher redox ratios (NADH/FAD [reduced nicotinamide adenine dinucleotide/flavin adenine dinucleotide]) in the kidneys of SS(Nox4-/-) rats even when fed the 0.4% NaCl diet, indicating greater levels of mitochondrial electron transport chain metabolic activity and reduced oxidative stress compared with SS rats. Before the development of hypertension, RNA expression levels of Nox subunits Nox2, p67(phox), and p22(phox) were found to be significantly lower (P<0.05) in SS(Nox4-/-) compared with SS rats in the renal cortex. Thus, the mutation of Nox4 seems to modify transcription of several genes in ways that contribute to the protective effects observed in the SS(Nox4-/-) rats. We conclude that the reduced renal injury and attenuated blood pressure response to high salt in the SS(Nox4-/-) rat could be the result of multiple pathways, including gene transcription, mitochondrial energetics, oxidative stress, and protein matrix production impacted by the knock out of Nox4.

Null mutation of the nicotinamide adenine dinucleotide phosphate-oxidase subunit p67phox protects the Dahl-S rat from salt-induced reductions in medullary blood flow and glomerular filtration rate

Null mutations in the p67(phox) subunit of nicotinamide adenine dinucleotide phosphate-oxidase confer protection from salt sensitivity on Dahl salt-sensitive rats. Here, we track the sequential changes in medullary blood flow (MBF), glomerular filtration rate (GFR), urinary protein, and mean arterial pressure in SSp67(phox) null rats and wild-type littermates during 21 days of 4.0% NaCl high-salt (HS) diet. Optical fibers were implanted in the renal medulla and MBF was measured in conscious rats by laser Doppler flowmetry. Separate groups of rats were prepared with femoral venous catheters and GFR was measured by the transcutaneous assessment of fluorescein isothiocyanate-sinistrin disappearance curves. Mean arterial blood pressure was measured by telemetry. In wild-type rats, HS caused a rapid reduction in MBF, which was significantly lower than control values by HS day-6. Reduced MBF was associated with a progressive increase in mean arterial pressure, averaging 170±5 mm Hg by HS salt day-21. A significant reduction in GFR was evident on day-14 HS, after the onset of hypertension and reduced MBF. In contrast, HS had no significant effect on MBF in SSp67(phox) null rats and the pressor response to sodium was blunted, averaging 150±3 mm Hg on day-21 HS. GFR was maintained throughout the study and proteinuria was reduced. In summary, when p67(phox) is not functional in the salt-sensitive rats, HS does not cause reduced MBF and salt-sensitive hypertension is attenuated, and consequently renal injury is reduced and GFR is maintained.

Maternal diet during gestation and lactation modifies the severity of salt-induced hypertension and renal injury in Dahl salt-sensitive rats

Environmental exposure of parents or early in life may affect disease development in adults. We found that hypertension and renal injury induced by a high-salt diet were substantially attenuated in Dahl SS/JrHsdMcwiCrl (SS/Crl) rats that had been maintained for many generations on the grain-based 5L2F diet compared with SS/JrHsdMcwi rats (SS/Mcw) maintained on the casein-based AIN-76A diet (mean arterial pressure, 116±9 versus 154±25 mm Hg; urinary albumin excretion, 23±12 versus 170±80 mg/d). RNAseq analysis of the renal outer medulla identified 129 and 82 genes responding to a high-salt diet uniquely in SS/Mcw and SS/Crl rats, respectively, along with minor genetic differences between the SS substrains. The 129 genes responding to salt in the SS/Mcw strain included numerous genes with homologs associated with hypertension, cardiovascular disease, or renal disease in human. To narrow the critical window of exposure, we performed embryo-transfer experiments in which single-cell embryos from 1 colony (SS/Mcw or SS/Crl) were transferred to surrogate mothers from the other colony, with parents and surrogate mothers maintained on their respective original diet. All offspring were fed the AIN-76A diet after weaning. Salt-induced hypertension and renal injury were substantially exacerbated in rats developed from SS/Crl embryos transferred to SS/Mcw surrogate mothers. Conversely, salt-induced hypertension and renal injury were significantly attenuated in rats developed from SS/Mcw embryos transferred to SS/Crl surrogate mothers. Together, the data suggest that maternal diet during the gestational-lactational period has substantial effects on the development of salt-induced hypertension and renal injury in adult SS rats.

Abstract 480: NaCl-Independent Dietary Effects are Associated with Altered DNA Methylation in Dahl Salt-Sensitive (SS) Hypertension

Salt-sensitive hypertension and renal damage were compared in colonies of SS rats fed casein-and grain-based diets. When 6 week old rats were fed a low NaCl diet (n=7-11/group), mean arterial pressure (MAP) and urinary albumin (UAlb) excretion were not significantly different in grain-fed rats compared to values in casein-fed rats (107±2 mmHg and 6±2 mg/day). Increasing dietary NaCl intake to 4.0% for three weeks led to a significantly greater increase in MAP (171±7 vs 119±7 mmHg), UAlb (164±19 vs 24±6 mg/day) and renal histological damage in SS rats fed the casein diet (p<.05). To assess mechanisms of this NaCl independent effect, an RNA-Seq analysis of renal outer medullary tissue of rats (n=4/group) fed the grain- or casein-based diets was performed. Over 1500 known genes were differentially expressed between the casein- and grain-fed rats on low salt; over 2100 were different between the groups fed the 4.0% chow (FDR<0.05); and 897 genes were common to these two data sets. The differentially expressed genes were significantly enriched for genes related to hematopoietic cell lineage, the complement and coagulation cascade, B-cell signaling, NK cell-mediated cytotoxicity, and primary immunodeficiency. To understand potential mechanisms of the regulation of gene expression, a genome-wide DNA methylation analysis of the renal outer medulla at single-base resolution was performed. Of nearly 3,000 methylated CpG islands identified, 534 and 650 were differentially methylated between the casein and grain fed groups when comparing effects of low to high salt diets, respectively (FDR<0.05). Approximately 200 differentially methylated CpG islands were located in the proximity of transcriptional start sites. We first focused our attention on several genes which exhibited a reciprocal pattern of DNA methylation and RNA abundance. These include Klotho (an aging-related gene), and Cyp39a1 (a cytochrome P450) which exhibited significantly more 5-methylcytosine modifications in the transcription start site and reduced mRNA expression in rats fed the casein-based diet with low salt. These data provide evidence that epigenetic modifications due to NaCl-independent dietary effects may alter salt-sensitive blood pressure and renal disease phenotypes.

Progression of glomerular filtration rate reduction determined in conscious Dahl salt-sensitive hypertensive rats

Sequential changes in glomerular filtration rate during development of hypertension in the conscious Dahl salt-sensitive rats were determined using a new method for measurement. Using a miniaturized device, disappearance curves of fluorescein isothiocyanate-sinistrin were measured by transcutaneous excitation and real-time detection of the emitted light through the skin. Rats with implanted femoral venous catheters (dye injection and sampling) and carotid catheters (mean arterial pressure by telemetry) were studied, while maintained on a 0.4% NaCl diet and on days 2, 5, 7, 14, and 21 after switching to 4.0% (high-salt [HS]) diet. A separate group of rats were maintained on 0.4% for 21 days as a time control. Mean arterial pressure rose progressively from the last day of 0.4% (130±2 mm Hg) reaching significance by day 5 of HS and averaged 162±7 mm Hg by day 21. Urine albumin excretion was significantly elevated (×3) by day 7 of HS in Dahl salt-sensitive rats. Glomerular filtration rate reduced on day 14 of HS falling from 1.53±0.06 mL/min per 100 g body weight to 1.27±0.04. By day 21, glomerular filtration rate had fallen 28% to 1.1±0.04 mL/min per 100 g (t(1/2) 28.4±1.1 minute.) No significant reductions of creatinine clearance were observed throughout the study in response to HS demonstrating the insensitivity of creatinine clearance measurements even with creatinine measured using mass spectrometry. We conclude that the observed reduction of glomerular filtration rate was a consequence and not a cause of the hypertension and that this noninvasive approach could be used in these conscious Dahl salt-sensitive rats for a longitudinal assessment of renal function.

Increased renal medullary H2O2 leads to hypertension

We have recently reported that exaggerated oxidative stress in the renal medulla due to superoxide dismutase inhibition resulted in a reduction of renal medullary blood flow and sustained hypertension. The present study tested the hypothesis that selective scavenging of O2*- in the renal medulla would prevent hypertension associated with this exaggerated oxidative stress. An indwelling, aortic catheter was implanted in nonnephrectomized Sprague-Dawley rats for daily measurement of arterial blood pressure, and a renal medullary interstitial catheter was implanted for continuous delivery of the superoxide dismutase inhibitor diethyldithiocarbamic acid (DETC, 7.5 mg x kg(-1) x d(-1)) and a chemical superoxide dismutase mimetic, 4-hydroxytetramethyl piperidine-1-oxyl (TEMPOL, 10 mg. kg-1. d-1). Renal medullary interstitial infusion of TEMPOL completely blocked DETC-induced accumulation of O2*- in the renal medulla, as measured by the conversion rate of dihydroethidium to ethidium in the dialysate and by urinary excretion of 8-isoprostanes. However, TEMPOL infusion failed to prevent DETC-induced hypertension, unless catalase (5 mg x kg(-1) d(-1)) was coinfused. Direct infusion of H2O2 into the renal medulla resulted in increases of mean arterial pressure from 115+/-2.5 to 131+/-2.1 mm Hg, which was similar to that observed in rats receiving the medullary infusion of both TEMPOL and DETC. The results indicate that sufficient catalase activity in the renal medulla is a prerequisite for the antihypertensive action of TEMPOL and that accumulated H2O2 in the renal medulla associated with exaggerated oxidative stress might have a hypertensive consequence.

Increased renal medullary oxidative stress produces hypertension

The present study examined whether chronic increased oxidative stress within the medulla of the kidney lowers medullary blood flow and leads to hypertension. Optical fibers were implanted into the renal cortex and medulla of uninephrectomized Sprague-Dawley rats (Harlan Sprague-Dawley, Madison, Wis) for the daily measurement of blood flow to these regions using laser-Doppler flowmetry techniques, while arterial pressure was measured from an indwelling aortic catheter. A renal medullary interstitial catheter was implanted for the continuous delivery of the superoxide dismutase (SOD) inhibitor, diethyldithiocarbamic acid (DETC), at a dose of 7.5 mg/kg/d. Renal interstitial superoxide (O(2)(-)) levels were determined by perfusing an O(2)(-) sensitive fluorescent dye, dihydroethidium, through a microdialysis probe implanted into the medulla. Urine samples (24 hours) were collected for measurements of isoprostane excretion. The results indicate that medullary DETC infusions increased tissue O(2)(-) concentrations in the renal medulla (93.4 +/- 22.3,n=8, saline and 867.3 +/- 260.2, n=8, DETC; fluorescence units) and increased urinary 8-isoprostane excretion (4.1 +/- 0.4 ng/d, n=9, saline and 8.8 +/- 1.6 ng/d, n=10, DETC). Mean arterial pressure increased 24 hours after the start of intrarenal DETC infusion and remained nearly 20 mm Hg above control pressure throughout the 5 days of medullary SOD inhibition. During chronic medullary DETC infusion, medullary blood flow was significantly reduced (42.7%), whereas cortical blood flow was unchanged. Intravenous infusion of the same dose of DETC produced no changes in renal medullary or cortical blood flow or arterial blood pressure. The present experiments indicate that an increase in superoxide concentration within the renal medulla selectively reduces medullary blood flow resulting in chronic hypertension.

Tubulointerstitial injury and loss of nitric oxide synthases parallel the development of hypertension in the Dahl-SS rat

OBJECTIVE

Alterations in renal nitric oxide (NO) are involved in the hypertension of the Dahl salt-sensitive (Dahl-SS) rat We sought to identify the kinetics and sites of expression of the major NO synthase (NOS) isoforms.

DESIGN

The renal expression of the major NOS were examined in Dahl-SS and salt-resistant rats (Dahl-SR) while on a low salt (0.1% NaCl) diet at 3 and 9 weeks of age.

METHODS

Renal biopsies from Dahl-SS and Dahl-SR rats were compared for evidence of renal injury and for alterations in expression of the NOS enzymes by quantitative immunohistochemistry.

RESULTS

At 3 weeks of age Dahl-SS and Dahl-SR rats have normal renal histology and similar immunohistochemical expression of NOS1, -2, and -3. At 9 weeks Dahl-SS rats had significantly higher blood pressure than Dahl-SR rats (P< 0.005 ), and lower macula densa NOS1 (P< 0.05) and cortical and medullary NOS3 (P< 0.05). NOS2 was reduced in cortical tubules in biopsies showing severe tubulointerstitial damage, but was not significantly different between Dahl-SS and Dahl-SR groups as a whole. Dahl-SS rats also manifested glomerular and tubulointerstitial injury. Tubular expression of osteopontin (OPN), which is an inhibitor of NOS2, correlated with the systolic BP in individual Dahl-SS rats (r2 = 0.80, P < 0.0001 ).

CONCLUSION

Tubulointerstitial injury and the loss of NOS occur after birth and parallel the development of hypertension. We suggest that the structural and functional changes that occur with renal injury in the Dahl-SS rat may contribute to the development of hypertension.

Effects of long-term vasopressin receptor stimulation on medullary blood flow and arterial pressure

Studies were carried out using instrumented unanesthetized rats to determine the long-term effects of arginine vasopressin (AVP) and a specific vasopressin V1 receptor agonist (V1AG; [Phe2, Ile3, Orn8]- vasopressin) on the renal medullary blood flow and arterial blood pressure. It was hypothesized that the hypertension observed with chronic medullary infusion of a V1 receptor agonist may be associated with a sustained reduction of blood flow, whereas infusion of AVP may fail to produce a sustained reduction of blood flow and thereby be unable to produce hypertension. Uninephrectomized Sprague-Dawley rats were prepared with implanted renal cortical and medullary optical fibers for daily measurements of cortical and medullary blood flow using laser-Doppler flowmetry techniques. An implanted renal medullary interstitial infusion catheter delivered either AVP or a specific V1AG at a dose of 2 ng . kg-1 . min-1 over a period of 5 days. The V1AG produced no change of cortical blood flow but a chronic 35% reduction of medullary blood flow (P < 0.05) and mild hypertension (11 +/- 4 mmHg, P < 0.05). AVP produced only an initial, nonsignificant 1- to 2-day reduction of medullary blood flow (-13%) and failed to raise arterial pressure significantly. We conclude that a sustained V1AG response is necessary to achieve a chronic reduction of medullary blood flow and hypertension. The present data are consistent with the idea that chronic stimulation of V2 receptors by AVP offsets the vasoconstrictor and hypertension actions of AVP-induced stimulation of medullary V1 receptors.

Effects of daily sodium intake and ANG II on cortical and medullary renal blood flow in conscious rats

Implanted optical fibers and laser-Doppler flow measurement techniques were used for the sequential measurement of regional renal blood flow in conscious rats to determine the effects of an increase of daily NaCl intake on the renal cortical blood flow and blood flow to the outer and inner medulla. Cortical blood flow was increased significantly (32%) by the second day when NaCl intake was increased from 1 to 7 meq/day and was increased further (50%) on the second day after a further elevation of NaCl intake to 13 meq/day. Blood flow to the outer and inner medulla was not changed as NaCl intake was elevated. The increase in renal cortical flow was closely associated with significant reductions in circulating concentrations of ANG II from 31 to 16 pg/ml. Rats given a continuous infusion of nonpressor does of ANG II (5.0 ng.kg(-1).min-1) to maintain constant plasma concentrations of ANG II as sodium intake was increased exhibited no increase of cortical flow. We conclude that reductions of plasma ANG II associated with incremental increases of daily sodium intake result in a rise of renal cortical flow. The elevated blood flow to the renal cortex may enhance sodium excretion and contribute to long-term sodium homeostasis.

Localization of the vasopressin V1a and V2 receptors within the renal cortical and medullary circulation

Arginine vasopressin (AVP) is a potent vasoconstrictor that preferentially reduces renal medullary blood flow through the stimulation of the vasopressin V1a receptor (V1aR). Studies have also shown that the vasopressin V2 receptor (V2R) may modulate AVP-mediated vasoconstriction. At present, the distribution of the V1aR and V2R within the renal cortical and medullary microcirculation has not been determined. This study was designed to localize the transcriptional and translational sites of the V1aR and V2R in microdissected intrarenal vascular segments from both the cortex and medulla, specifically the interlobar, arcuate, and interlobular arteries; afferent and efferent arterioles; glomeruli; and single outer medullary vasa recta capillaries using reverse transcription-polymerase chain reaction and Western blot analyses. The results indicated that V1aR mRNA and proteins were present in the isolated cortical or medullary vasculature, but the V2R mRNA and proteins were not found. This study suggests that the vasoconstrictor action of AVP within the renal medulla is mediated through the V1aR and that the modulatory V2R-mediated vasodilation is probably through the release of paracrine hormones found within the renal interstitial or tubular cells.

In vivo diuretic actions of renal vasopressin V1 receptor stimulation in rats

The specific vasopressin V1 receptor agonist (V1AG; [Phe2,Ile3,Orn8]vasopressin) was infused (2.0 ng.kg-1.min-1) into the renal medullary interstitial space to determine the effects of selective medullary V1 receptor stimulation on sodium and water excretion in normal rats. Responses were compared with those of arginine vasopressin (AVP) and vasopressin V2 receptor stimulation resulting from infusion of a V1 receptor antagonist with AVP. Medullary infusion of V1AG or AVP in euvolemic rats produced no changes in hemodynamics or glomerular filtration rate. V1AG increased urine flow > 60% in euvolemic rats, whereas no change was observed with AVP. This response could not be explained by a rise of arterial pressure or by volume retention. With V2 stimulation in euvolemic rats, urine flow was decreased. In water diuretic rats, V1AG produced no change, whereas AVP infusion decreased urine flow. The results provide in vivo evidence that tubular V1 vasopressin receptor activity results in increased urine flow and thereby modulates the antidiuretic actions of vasopressin in the euvolemic state.

Hypertension induced by high salt intake in absence of volume retention in reduced renal mass rats

Reduction of renal mass (RRM) combined with a high-salt diet results in volume retention, a rise of cardiac output, and hypertension. The present studies were designed to determine whether prevention of volume retention would alter the rise of mean arterial pressure (MAP) in RRM rats given high salt. Rats were studied in a modified metabolic cage to permit continuous determination of total body weight (TBW). In group 1, NaCl was increased from 1 to 14.5 meq/day and delivered isotonically. In group 2, NaCl was increased while TBW was servo-controlled to a constant level. Group 3 was also servo-controlled, but rats received an intravenous infusion of an arginine vasopressin V1 antagonist throughout the study. MAP in group 1 rose 24 mmHg by day 4 of high salt with a parallel increase of TBW of 26 g. In group 2, MAP rose 48 mmHg by day 4 of high salt, while TBW was controlled to within 0.6% of control body weight. With inhibition of vasopressin V1 receptors (group 3), MAP rose 39 mmHg. Nearly equivalent amounts of NaCl were retained in all groups, which was associated with no change of plasma Na in group 1 but an increase of nearly 7 meq/ml in groups 2 and 3. Hematocrit fell nearly 9% in groups 2 and 3 compared with a 4% reduction in group 1. The results suggest that under conditions where net retention cannot occur, high salt intake increases MAP by an osmotically driven fluid transfer from cells, which results in an even greater expansion of blood volume.(ABSTRACT TRUNCATED AT 250 WORDS)

Prolonged stimulation of intrarenal V1 vasopressin receptors results in sustained hypertension

In an earlier study, we reported that chronic intravenous administration of the V1 agonist [Phe2,Ile3,Orn8]vasopressin (V1AG) results in sustained hypertension. The present study was designed to determine whether V1-induced hypertension may be related specifically to intrarenal actions of this peptide. Chronic infusion of the V1 agonist into the medullary interstitial space of a single remaining kidney of normal, conscious Sprague-Dawley rats at the rate of 2 ng.kg-1.min-1 for 14 days resulted in a sustained rise of 18 mmHg of mean arterial pressure (MAP). After withdrawal of V1AG, MAP returned to the baseline level. During the first day of V1AG infusion, there was a net loss of body sodium and no evidence of fluid retention throughout the period of hypertension. Plasma osmolality, sodium and potassium concentration, and water intake and body weight were not significantly affected by medullary interstitial infusion of V1AG. Renal medullary interstitial infusion of an equimolar amount of arginine vasopressin (AVP) did not affect MAP. Chronic medullary interstitial infusion of the selective V1 antagonist d(CH2)5[Tyr(Me)2,Ala-NH(2)9]AVP in equimolar amounts (2.5 ng.kg-1.min-1) prevented the MAP increase elicited by intravenous V1AG. However, intravenous administration of the V1 antagonist at the same rate together with V1AG (n = 7) failed to prevent hypertension. The results indicate that hypertension can be elicited by chronic stimulation of renal medullary V1 vasopressin receptors. They also suggest that some V2 agonistic properties of AVP may restrict the hypertensive action of this hormone. The mechanism for the rise of arterial pressure remains to be determined.

Physiopathogenesis of acute aortic coarctation hypertension in conscious rats

We investigated the role of vasopressin, angiotensin II, and catecholamines in the onset of acute (45-minute) aortic coarctation hypertension in conscious rats. Partial aortic constriction was performed by means of a pneumatic cuff placed around the abdominal aorta above the renal arteries for 15 or 45 minutes. A sham-operated group was used as control. Mean carotid pressure before aortic constriction did not differ between rat groups. Aortic constriction produced a similar increase of mean carotid pressure during 15 minutes (36 +/- 3 to 37 +/- 3 mm Hg above basal levels) and 45 minutes (37 +/- 2 to 39 +/- 3 mm Hg). Plasma vasopressin concentration after 15 minutes of coarctation (4.4 +/- 0.5 pg/mL) did not differ from that observed in control rats (3.0 +/- 0.8 pg/mL), whereas after 45 minutes, it was significantly higher (14.3 +/- 3.3 pg/mL). Plasma renin activity increased significantly after coarctation (21.7 +/- 4.1 and 29.9 +/- 2.9 ng angiotensin I/mL per hour, at 15 and 45 minutes, respectively) when compared with control rats (3.9 +/- 0.5 ng angiotensin I/mL per hour). After coarctation, plasma norepinephrine concentration was consistently reduced, whereas plasma epinephrine concentration did not differ from control rats. In conclusion, these data provide evidence for an effective vasopressor role for vasopressin in the genesis of acute (45-minute) aortic coarctation hypertension in conscious rats. In addition, although the results confirm that the renin-angiotensin system participates earlier in the onset of coarctation hypertension, they rule out a significant vasopressor role for catecholamines in the early development of hypertension.

Chronic pressure-natriuresis relationship in dogs with inherited essential hypertension

A genetic model of essential hypertension in the dog was studied to describe the phenotypic expression of the arterial pressure, as well as to determine the relationship between mean arterial blood pressure (MAP), hormone, and renal excretory responses to four different levels of sodium intake (5, 40, 120, 240 mEq/day) delivered intravenously and isotonically. This model was developed at the University of Pennsylvania (U/Penn) and termed Pennsylvania hypertensive dogs (PHD). The MAP was recorded beat-by-beat, 24 h/day, in 16 dogs. Water and sodium balances were determined daily for 4 days at each level of intake and blood samples were collected on the last day of each salt step for analysis of plasma renin activity (PRA), atrial natriuretic peptide (ANP), aldosterone (ALDO), and vasopressin (AVP). After the study, the dogs were designated as hypertensive (PHD-HT) when the 24-h average MAP was greater than 110 mm Hg and systolic pressure was greater than 160 mm Hg. Dogs that failed to meet both criteria were designated as normotensive genetic controls (PHD-NT). Although sodium was retained during the first day of each increase of salt intake in both groups, a return to balance was observed within the 4 days. There was no apparent change in the slope of the chronic renal function curve in either group of PHD studied, although the PHD-HT exhibit a curve shifted to a higher level of MAP. Plasma hormone levels in both groups of PHD studied responded in a manner similar to normal mongrel dogs with reductions of PRA, ALDO, elevations of ANP, and no change in AVP.(ABSTRACT TRUNCATED AT 250 WORDS)

Saline diuresis and natriuresis in unanesthetized dogs: a missing atrial factor?

Recent studies in our laboratory indicated that a blunted (40-50%) renal excretory response to isotonic intravenous saline loads occurred in conscious, renal-denervated dogs after 70% of the atrial mass was removed. The blunted responses could not be explained by differences in the responses of arterial pressure, renal nerve activity, or by measured changes of plasma immunoreactive atrial natriuretic peptide (iANP), arginine vasopressin (AVP), plasma renin activity (PRA), or aldosterone (Aldo). The present study was designed to determine whether the central nervous system (CNS) was the source of an unidentified substance, which could account for the blunting of the urine excretory response seen in the atrial-resected dogs. Renal denervation was performed in all dogs to eliminate alterations in efferent renal sympathetic nerve activity derived from reflexes activated during volume expansion. Cardiac denervation (CDX) was used to eliminate sensory cardiac afferent nerve activity to the CNS. A group of five renal-denervated dogs was given an isotonic volume load (400 ml/30 min) before and after complete CDX. Plasma AVP was fixed at normal plasma levels of 3 pg/ml by continuous intravenous infusion. Na and H2O excretion were not different in renal-denervated dogs compared with combined renal and cardiac denervation during the 5 h after the saline load. Plasma AVP and Aldo were unchanged with the volume loads, although PRA rose gradually over the 5 h after the saline loads. Plasma iANP increased transiently in the combined renal and cardiac-denervated state rising from a control of 65-120 pg/ml at the end of the load period.(ABSTRACT TRUNCATED AT 250 WORDS)

Fluid-regulating hormones during exercise when central blood volume is increased by water immersion

To examine the influence of an increase in central blood volume with head-out water immersion (WI) on fluid-regulating hormones during exercise, 10 healthy men underwent upright leg cycle exercise on land and with WI. Venous plasma renin activity and plasma venous concentrations of atrial natriuretic peptide, plasma aldosterone, and arginine vasopressin were determined at exercise intensities corresponding to approximately 40, 60, 80, and 100% peak oxygen consumption (VO2) and at minutes 1 and 5 of seated rest recovery within each environment. Peak VO2 did not differ on land and with WI. Atrial natriuretic peptide concentration was higher (P less than 0.05) and plasma renin activity was lower (P less than 0.05) in water than on land at 40% peak VO2 through minute 5 of recovery. Plasma aldosterone and arginine vasopressin concentrations were lower (P less than 0.05) in water at peak exercise and at minutes 1 and 5 of recovery. Osmolality and plasma sodium and potassium concentrations during exercise were similar in water and on land. The results indicate that WI alters the circulating levels of several hormones involved in fluid and electrolyte regulation during exercise. These hormonal alterations can best be explained by stimulation of low-pressure baroreceptors and atrial stretch due to increased central blood volume with head-out WI.

Dominance of colloid osmotic pressure in renal excretion after isotonic volume expansion

Studies were carried out in unanesthetized dogs to determine the relative importance of neural, endocrine, and colloid osmotic pressure (COP) in the diuretic and natriuretic responses associated with volume expansion. Renal excretory responses to 30-min intravenous infusions of isotonic saline (400 ml) or whole blood (100 ml) were compared while various controllers of sodium and water excretion were either eliminated or held constant. Dogs were studied in the normal state; with plasma arginine vasopressin (AVP) fixed by intravenous infusion; with bilateral renal denervation and plasma AVP fixed; renal denervated with plasma AVP, angiotensin II, aldosterone, atrial natriuretic factor fixed; and renal denervated with these same hormones fixed and with renal arterial pressure servo-controlled at a constant level. Normal uncontrolled dogs increased sodium and water excretion nearly fourfold by the end of the saline load and excreted 85% of the load within 5 h. Urine excretion was minimally affected when the various neural and endocrine controllers were fixed or eliminated. There were no changes of mean arterial pressure with the saline volume loads, but COP fell 2.5 mmHg. Equivalent expansion of the blood volume (100 ml) with whole blood in which COP was unchanged resulted in nearly no increase of urine excretion in renal-denervated dogs with plasma hormones fixed and renal perfusion pressure held constant. We conclude that the rapid diuresis and natriuresis following isotonic volume expansion is predominantly a result of plasma protein dilution and a reduction of COP.

Cortisol inhibition of vasopressin and ACTH responses to arterial hypotension in conscious dogs

We evaluated the role of cortisol as a feedback inhibitor of the vasopressin response to arterial hypotension. Conscious dogs (n = 5) were each studied on 10 different days. There were five different pretreatments: 1) isotonic saline (control), 2) 5.5 or 3) 11 nmol cortisol.kg-1.min-1 iv for 30 min, 4) 6.8 pmol ACTH-(1-24).kg-1.min-1 iv for 30 min, or 5) 1.5 mg dexamethasone im given the night before experimentation. These pretreatments were followed by a stimulus period (30 min) during which mean arterial pressure was decreased a moderate (-19 +/- 1 mmHg) or severe (-29 +/- 1 mmHg) degree with a controlled infusion of intravenous sodium nitroprusside. The vasopressin response to moderate hypotension was not consistently inhibited by any of the pretreatments. In contrast, the large vasopressin response to severe hypotension in the control experiments (from 3.1 +/- 0.3 to 270 +/- 113 pg/ml) was significantly attenuated by cortisol infusion in a dose-dependent manner. Adrenocorticotropin infusion was more effective than dexamethasone as an inhibitor of the vasopressin response to severe hypotension. The data suggest that physiological increases in cortisol inhibit the large increase in vasopressin in response to severe arterial hypotension.

Stimulation of atrial natriuretic peptide and vasopressin during percutaneous transluminal aortic valvuloplasty

The objective of this study was to determine the effects of transient aortic valve occlusion (balloon valvuloplasty) on vasoactive hormones in patients with heart failure. Plasma atrial natriuretic peptide, vasopressin, aldosterone, adrenocorticotropic hormone (ACTH), and plasma renin activity were measured before, immediately after, and 30 minutes and 18 to 24 hours following balloon inflation in 18 patients. Mean right atrial and pulmonary wedge pressures were 6 and 18 mm Hg before inflations, respectively, and were unchanged after balloon inflations (5 and 13 mm Hg, respectively). Systemic systolic/diastolic pressures were 139 +/- 8/65 +/- 4 mm Hg before occlusion, decreased to 47 +/- 5/34 +/- 3 mm Hg during occlusion, and returned to baseline after occlusions. Baseline atrial natriuretic peptide levels were 267 +/- 43 pg/ml and increased to 513 +/- 71 pg/ml after balloon inflations. Vasopressin levels before occlusion were 9.1 +/- 2.2 pg/ml and increased to 21.4 +/- 4.8 pg/ml after balloon inflations. Plasma renin activity was 5.4 +/- 1.4 ng/ml/hr before inflations and was not significantly changed after balloon inflations. No clinically significant changes in plasma sodium, potassium, creatinine, and osmolality were observed after the procedure. Aldosterone increased from 23 +/- 4 to 40 +/- 7 ng/dl 10 minutes after the last inflation. Plasma ACTH measured in seven patients with increased aldosterone was 28 +/- 8 pg/ml before and increased to 295 +/- 157 pg/ml 10 minutes after balloon inflations. The increases in natriuretic peptide and vasopressin were likely due to elevated intracardiac and decreased arterial pressures, respectively; they persisted in spite of no clinically significant changes in filling pressures 12 to 24 hours after the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of plasma sodium on aldosterone secretion during angiotensin II stimulation in normal humans

Studies were carried out in normal male subjects (n = 6, age 20-35 years) to determine the interaction of angiotensin II and plasma sodium on aldosterone secretion. These relations were quantified by elevation of plasma sodium with an infusion of 5% sodium chloride (4 ml/kg/30 min i.v.) with measurements of plasma aldosterone, atrial natriuretic factor (ANF), and arginine vasopressin (AVP) over 3 hours. Two hours before sodium chloride infusion, an intravenous infusion of angiotensin II was begun at 0.5 or 5.0 ng/kg/min and continued throughout the study. Plasma potassium was maintained constant by the addition of potassium to the infusate. NaCl/KCl infusion raised plasma sodium 4 meq/l with no decreases of plasma potassium. Plasma aldosterone averaged 7 +/- 1.8 ng/dl before NaCl infusion in subjects infused with 0.5 ng angiotensin II and was not significantly reduced with sodium chloride infusion. Angiotensin II infused at 5 ng/kg/min resulted in average plasma aldosterone levels of 31 +/- 3.6 ng/dl, which sodium chloride infusion decreased to 16.6 +/- 1.3 ng/dl (p less than 0.05) in 60 minutes. Plasma aldosterone remained depressed for the remaining period of study. Plasma ANF increased from 40 to 60 pg/ml with sodium chloride infusion. We conclude that small physiological elevations of plasma sodium concentrations can signal substantial decreases of plasma aldosterone in normal human subjects in situations where plasma angiotensin II is moderately elevated. The precise mechanisms of these responses remain to be determined.

Feedback control of vasopressin and corticotrophin secretion in conscious dogs: effect of hypertonic saline

Glucocorticoids are known to inhibit the ACTH response to a variety of stimuli. It has been suggested that vasopressin secretion is also inhibited by glucocorticoid negative feedback. The purpose of this study was to (1) determine the ACTH response to hypertonic saline and its sensitivity to glucocorticoid negative feedback and (2) to determine whether physiological elevations of plasma cortisol inhibit subsequent vasopressin responses to hypertonic saline. Five mongrel dogs (15-18 kg) were prepared with chronic arterial and venous catheters and studied while conscious. Ten experiments were performed on each dog in a randomized design separated by at least 5 days. Each experiment consisted of a pretreatment period (from -60 to -30 min except for dexamethasone administration) during which a glucocorticoid feedback signal was applied and a stimulus period (from 0 to 30 min) during which hypertonic saline was infused. The pretreatment and stimulus periods were separated by 30 min. Pretreatments were as follows: isotonic saline (control), half-maximal and maximal cortisol infusion (5.5 or 11 nmol/kg per min), ACTH(1-24) infusion (6.8 pmol/kg per min) which produces increases in endogenous cortisol, and dexamethasone (1.5 mg i.m.) given at 17.00 h the day before experimentation. Stimuli were as follows: hypertonic saline was infused at 0.2 or 0.4 mmol/kg per min which increased plasma sodium by about 6 or 12 mmol/l respectively. NaCl infusion at 0.2 mmol/kg per min had no effect on plasma ACTH or cortisol except when subsequent to ACTH(1-24) pretreatment when plasma ACTH actually increased to 41.4 +/- 2.9 pmol/l in response to hypertonic saline.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemodynamic, renal, and hormonal responses to incremental ANF infusions in humans

The effects of incremental exogenous alpha-human atrial natriuretic factor (ANF) infusion (10 and 25 ng.kg-1. min-1) on the cardiovascular, renal, and hormonal systems were examined in 22 healthy males. Successive 45-min infusions of ANF increased plasma levels five- and ninefold from a basal 42 +/- 5 pg/ml (P less than 0.01 and P less than 0.001). Hemodynamic responses provoked by ANF consisted solely of progressive reductions in central venous pressure (CVP) (P less than 0.05). Heart rate and mean arterial pressure were unaltered. Plasma renin activity, aldosterone, and vasopressin were not modified by either dose of ANF. However, plasma norepinephrine increased 32% during the 10-ng.kg-1.min-1 infusion (P less than 0.05) and remained elevated during the higher dose of ANF. Renal function was unaltered by the 10-ng.kg-1.min-1 infusion of ANF when compared with base line and placebo responses. The 25-ng.kg-1. min-1 infusion of ANF increased sodium excretion 100% from base line (P less than 0.05), whereas potassium excretion decreased 47% (P less than 0.05). Urine output increased significantly from 7.7 +/- 0.6 to 12.5 +/- 0.7 ml/min (P less than 0.05). These responses were not observed in the placebo group or in an additional group of four volunteers who received a continuous low-dose infusion of ANF (10 ng.kg-1.min-1) for two consecutive 45-min periods. Neither dose of ANF altered creatinine clearance or free water clearance. The data indicate that fivefold elevations (physiological levels) of plasma ANF do not influence renal or hormonal function.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute saline loading in normal and bilaterally atrial-resected conscious dogs

Acute isotonic saline volume loads (400 ml) were intravenously administered to conscious, renal-denervated dogs before and after bilateral removal of the atrial free walls and atrial appendages to determine the role of atrial-mediated hormonal factors in the renal excretory response. In one group of dogs (n = 11), the volume was given in 10 min; in another group (n = 5), the volume was given in 30 min while arginine vasopressin (AVP) was infused to maintain plasma AVP at a fixed, normal level (3 pg/ml). Sodium and water excretion, mean arterial pressure, and plasma hormone levels were determined before and for 5 h after volume loads. Atrial resection resulted in a 40-50% reduction of sodium and water excretion in both groups during the first 2 h after volume expansion. The blunted renal excretory responses could not be explained by differences in arterial pressure, renal sympathetic nerve activity, or by hormonal differences of plasma immunoreactive atrial natriuretic factor (iANP), plasma AVP, plasma renin activity, or plasma aldosterone. Plasma iANP was not significantly increased by the volume load in either the normal or atrial-resected state. Atrial-resected dogs exhibited normal plasma levels of iANP. The data indicate the presence of an unidentified diuretic and natriuretic substance, which is released with volume expansion from either the cardiac atria or via the central nervous system, and that the release of this factor is removed by atrial resection.

Dynamic cardiovascular responses to infusions of atrial natriuretic factor in humans

We sought to demonstrate a hypotensive effect from infusions of atrial natriuretic factor (ANF) into humans and to describe the mechanism(s) of this effect. Cardiovascular and hormonal responses to human ANF-(99-126) (125 ng/kg bolus followed by a 30-minute infusion at 25 ng/kg/min) were determined in eight conscious volunteers and compared with responses of eight time-control subjects who received isotonic saline. Baseline levels of ANF (52.8 +/- 5.5 pg/ml) increased 8.8-fold after 30 minutes of ANF infusion but were unchanged in the time controls. Plasma levels of renin, aldosterone, vasopressin, sodium, potassium, and osmolality did not change during infusions. A transient 5% reduction in mean arterial pressure related to a 12% reduction in peripheral resistance was observed 10 minutes after the priming bolus of ANF. This response was not sustained during the remainder of the ANF infusion period, nor did it occur in two additional subjects who received ANF infusions without the priming bolus. Steady state responses consisted of significant reductions in central venous pressure (15%), stroke volume (13%), and cardiac output (10%), but no reduction in blood pressure. Plasma norepinephrine levels and peripheral resistance increased (34% and 9%, respectively) during ANF administration. These data indicate that steady state responses to ANF in humans consist of decreases in cardiac filling pressures, which reduce cardiac output, unload cardiopulmonary baroreceptors, and activate the sympathetic nervous system. Blood pressure is well maintained despite striking increases in plasma ANF.

Diarrheal infections

Infectious agents usually cause diarrhea by invading and damaging the intestinal mucosa or by producing enterotoxins that alter the secretory and absorptive capacities of the intestinal mucosa. Some infectious agents may do both. Physical malabsorption produced by proliferative outgrowth of bacteria or protozoa may also occur. Rotavirus is the most common cause of pediatric infectious diarrhea in the United States. Escherichia coli and Campylobacter species are the most common bacterial agents.

Control of adrenocorticotropin secretion and adrenocortical sensitivity in neurohypophysectomized conscious dogs: effects of acute and chronic vasopressin replacement

We examined the effect of neurohypophysectomy with and without vasopressin replacement on the ACTH response to hypotension and ovine CRF infusion and on the adrenocortical response to ACTH and angiotensin II infusion in conscious dogs. Nitroprusside hypotension (decrease in mean arterial pressure of 25 mm Hg) in the intact state resulted in large increases in plasma arginine vasopressin (pAVP; from 2.6 +/- 0.3 to 296 +/- 63 pg/ml) and ACTH (from 35 +/- 6 to 395 +/- 92 pg/ml). Neurohypophysectomy resulted in greatly attenuated pAVP (8.4 +/- 1.6 pg/ml) and ACTH (80 +/- 10 pg/ml) responses to hypotension which were not normalized by physiological low dose vasopressin replacement (6-18 pg/kg.min continuously, iv, for 2 weeks). However, acute administration of vasopressin (4-6 ng/kg.min) simultaneously with hypotension in the neurohypophysectomized (neurohypox) dog, which produced pAVP levels equivalent to the hypotensive response to intact dogs, almost completely normalized the ACTH response to hypotension (to 248 +/- 74 pg/ml). The ACTH response to 20 ng/kg.min ovine CRF, iv (from 43 +/- 8 to 268 +/- 77 pg/ml), was not attenuated by neurohypophysectomy. The cortisol responses to infusion of 0.5 and 2 ng/kg.min ACTH-(1-24), iv, were essentially normal in neurohypox dogs. However, the ACTH and aldosterone responses to 5 ng/kg.min angiotensin II infusion iv were attenuated in neurohypox dogs off AVP replacement. Histological examination revealed normal adrenal glands and anterior pituitaries in neurohypox dogs. Immunocytochemical staining for vasopressin and neurophysin revealed normal cell bodies in the paraventricular and supraoptic nuclei of the hypothalami from neurohypox dogs. However, median eminence staining for AVP and neurophysin was greatly diminished in neurohypox dogs. In summary, neurohypophysectomy 1) attenuated the ACTH response to hypotension and angiotensin II, but not to CRF, and 2) attenuated the aldosterone response to high dose angiotensin II. Furthermore, the deficit in ACTH secretion was almost completely normalized by increasing plasma AVP levels to those observed in the intact dogs. We conclude that an action of circulating pAVP increases ACTH secretion by a direct effect at the pituitary and by activating afferent input to the hypothalamus.

Role of vasopressin in regulation of sodium excretion

It has been proposed that arginine vasopressin (AVP) contributes to the regulation of renal sodium excretion by direct intrarenal actions, by neural-hormonal interactions, and via secondary effects of fluid volume retention. The present studies were designed to determine the extent to which the natriuretic effects of AVP are secondary to volume expansion. Three groups of dogs were studied: the first was infused with AVP for 2 weeks in amounts that increased plasma levels from 3 to 15 pg/mL, while water intake was maintained constant by intravenous (iv) water infusion. The second group received the same amount of AVP and was permitted to drink ad libitum. The third group was infused with the same amount of AVP, while total body weight and volume were maintained at a constant level by use of an electronically servo-controlled water infusion system. The results showed a large increase in total body weight (+1.5 kg) and arterial pressure (mean arterial pressure (MAP); +40 mm Hg) in dogs receiving a fixed water intake. This was accompanied by a continuing natriuresis over a 2-week period and severe hyponatremia (115 mEq/L). Dogs allowed ad libitum drinking retained much less fluid (+0.5 kg). MAP was not significantly elevated, and natriuresis did not occur in this group, but hyponatremia was observed (130 mEq/L), and plasma renin activity (PRA) was suppressed. Servo-controlled dogs exhibited no change in MAP, plasma sodium, or PRA, and only a small (-15 mEq) natriuresis occurred on day 1 of AVP infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II sensitization of aldosterone responsiveness to plasma sodium in conscious dogs

Studies were performed to quantify the interaction of angiotensin II (ANG II) and plasma sodium (Na+) on the adrenal gland's ability to secrete aldosterone (Aldo). Two groups of normal conscious dogs were used in which plasma Na+ was independently elevated in the face of differing background levels of ANG II. In group 1 (n = 6), plasma Na+ was increased progressively over a 1-h period (from 143 +/- 1 to 152 +/- 1.2 meq/l), whereas plasma K+ was maintained at a constant level by intravenous infusion. With low background levels of ANG II (0.5 ng.kg-1.min-1), plasma Aldo remained unchanged with the increase in plasma Na+. With high ANG II (20.0 ng.kg-1.min-1), plasma Na+ changed in a similar manner (143.1 +/- 1.2 to 154.3 +/- 0.7 meq/l), whereas plasma Aldo decreased progressively from 35.3 +/- 2.3 to 27.9 +/- 3.8 ng/dl (P less than 0.05). In group 2 (n = 5), plasma Na+ was increased abruptly (144.9 +/- 0.6 to 152.1 +/- 0.5) and maintained at the elevated level for 3 h, and plasma K+ was held constant. Again, at low steady-state levels of ANG II (0.5 ng.kg-1.min-1), plasma Aldo levels remained unchanged. But, at intermediate levels of ANG II (5.0 ng-kg-1.min-1), producing plasma ANG II levels similar to those seen with dietary NaCl restriction, plasma Aldo decreased from 20.4 +/- 4.3 to 9.0 +/- 1.3 ng/dl (P less than 0.05). This rate of infused ANG II has been shown to result in plasma ANG II levels similar to that seen with dietary NaCl restriction. At the highest dose of ANG II (20 ng.kg-1.min-1), the ability of plasma Na+ to lower plasma Aldo was blunted to the extent that the decrease from 27.5 +/- 2.2 to 21.3 +/- 1.6 was not statistically significant. These studies indicate that physiological elevation of ANG II appears to sensitize the adrenal aldosterone responsiveness to changes in plasma Na+.

Hormonal responses and blood pressure maintenance in normal and hypertensive subjects during acute blood loss

Blood pressure (BP) and plasma indices of three major pressure control systems--plasma norepinephrine and epinephrine, plasma renin activity (PRA), and plasma arginine vasopressin--were measured simultaneously in 12 normal and 15 mildly essential hypertensive subjects before and after removal of 480 ml of blood by phlebotomy, to determine if there were differences in the compensatory response to acute blood loss. Responses to postural stress (change from supine to sitting position) following phlebotomy were also compared in a second group of subjects. Before phlebotomy, supine plasma hormone levels did not differ in the two groups. After phlebotomy, both groups exhibited only slight decreases (5 mm Hg) in systolic BP and a transient rise in heart rate. Only plasma norepinephrine increased significantly in both groups (35% above control in normal and 43% in hypertensive subjects). Similar results were obtained in a second group of normal and hypertensive subjects, who were also subjected to a 10-minute postural challenge after phlebotomy. After 10 minutes in a sitting position, BP in these subjects remained unchanged but heart rate and plasma norepinephrine increased further to levels almost twice that produced by phlebotomy alone. Plasma epinephrine levels and PRA also increased with this additional stress, but plasma vasopressin remained unchanged. Changes in BP, heart rate, plasma norepinephrine and epinephrine, and PRA did not differ significantly between the two groups. These data indicate that hypertensive subjects are as capable as normal subjects of maintaining BP when subjected to standard phlebotomy, the sympathetic nervous system appears to be the predominant pressor mechanism activated following an acute, nonhypotensive blood loss in both groups of subjects,(ABSTRACT TRUNCATED AT 250 WORDS)

Water loading and restriction in essential hypertension

Blood pressure, plasma arginine vasopressin (AVP), and renal excretory responses to short-term water loading (oral load of 20 ml/kg body weight over 30-45 minutes) were compared in 10 normotensive and 13 mild to moderately essential hypertensive subjects. In addition, we examined the renal concentrating ability of an additional group of 10 normotensive subjects and 12 hypertensive subjects in response to a 24-hour water restriction and intranasal administration of 10 micrograms of [1-deamino,8-D-arginine]vasopression. The hypertensive subjects exhibited both an exaggerated diuresis and natriuresis to the water load. At 20- and 60-minutes after water loading, hypertensive subjects had excreted 34 and 55% of the load, respectively, compared with 15 and 35% in normotensive subjects. Mean blood pressure rose significantly in both groups and hypertensive subjects exhibited a greater rise of systolic blood pressure (16 mm Hg) than normotensive subjects (8 mm Hg) 20 minutes after water loading. The maximum diuresis and natriuresis corresponded to the period in which the rise of blood pressure was greatest. The hypertensive subjects diluted and concentrated their urine as well as normotensive subjects did, indicating normal renal responsiveness to AVP. Plasma Na, osmolality, and AVP decreased similarly in both groups after water loading and rose similarly in the two groups after water restriction. This finding suggests that osmotic responsiveness of AVP is not altered in hypertensive subjects. In conclusion, the data suggest that the exaggerated renal response to water loading could be explained by the greater rise of blood pressure in hypertensive subjects rather than by altered AVP responses.

Hemodynamic effects of vasopressin compared with angiotensin II in conscious rats

The mechanisms whereby arginine vasopressin influences hemodynamic and autonomic function were investigated in conscious rats. In normal rats, 60-min intravenous infusions produced dose-related increases of arterial pressure and total peripheral resistance with marked decreases of both heart rate and cardiac output. Cholinergic blockade with methscopolamine attenuated the bradycardia at higher doses of vasopressin, whereby the fall of cardiac output was not affected. beta-Adrenergic blockade with atenolol attenuated the fall of heart rate seen with lower doses of vasopressin but did not prevent the fall of cardiac output. Ganglionic blockade with methscopolamine and hexamethonium resulted in nearly a 60-fold enhancement of vasopressin pressor sensitivity. This was related to a greater rise of peripheral resistance, since the fall of cardiac output was not altered compared with normal rats. Hemodynamic responses to angiotensin II were determined in other groups of conscious, normal rats and rats with ganglionic blockade. Peripheral resistance increased in the normal rats, whereas the related decreases in cardiac output and heart rate were only 30% of the responses seen with equipressor doses of vasopressin. Ganglionic blockade increased pressor activity only two- to eightfold compared with the 60-fold increase observed with vasopressin. We conclude that vasopressin is a more potent vasoconstrictor than angiotensin II, decreases cardiac output independent of neural mechanisms, and results in withdrawal of sympathetic vascular tone to buffer rises of arterial pressure.

Vasopressin responses to corticotropin releasing factor and hyperosmolality in conscious dogs

We recently reported that ovine corticotropin releasing factor (CRF) infusion in conscious dogs elevated plasma vasopressin. The present study examines the vasopressin, adrenocorticotropic hormone (ACTH), and cortisol responses to CRF infusion (20 ng X kg-1 X min-1), to hypertonic saline infusion (NaCl 0.054 meq X kg-1 X min-1), and to simultaneous coinfusion of CRF and NaCl (CRF + NaCl) without (no-dex) or with (dex-treated) dexamethasone pretreatment in six conscious dogs (6-8 experiments/dog). CRF had no significant effect on plasma sodium or osmolality, blood pressure, or heart rate. NaCl increased plasma sodium from 146 +/- 1 to 151 +/- 1 meq/l and plasma osmolality from 298 +/- 3 to 305 +/- 3 mosmol/kg. Vasopressin increased significantly during CRF (2.1 +/- 0.5 to 4.8 +/- 1.1 pg/ml) and NaCl (1.9 +/- 0.3 to 5.0 +/- 0.8 pg/ml). Coinfusion of CRF and NaCl resulted in a response larger than the sum of the two infusions alone (3.0 +/- 1.6 to 31.4 +/- 18.5 pg/ml). The ACTH response to CRF (45 +/- 8 to 288 +/- 88 pg/ml) was not augmented by coinfusion with NaCl. DEX attenuated the vasopressin and ACTH responses to each infusion. We conclude that CRF-induced increases in vasopressin are augmented by a simultaneous osmotic stimulus. In addition, the plasma vasopressin responses to CRF and/or hypertonic saline infusion are inhibited by glucocorticoid pretreatment.

Osmoregulation during high salt intake: relative importance of drinking and vasopressin secretion

Studies determined the relative contribution of drinking vs. vasopressin secretion in the regulation of extracellular osmolality in response to changes of Na intake. Daily Na intake was increased from 30 to 200 meq in dogs maintained under three conditions: normal dogs with ad libitum drinking, normal dogs with "fixed drinking," and neurohypophysectomized dogs with "fixed drinking" and vasopressin replaced by continuous infusion. (Drinking was fixed to that amount consumed during the normal Na control period.) The mechanisms of osmoregulation were highly nonlinear. As daily Na intake increased from 30 to 100 meq, renal natriuretic mechanisms predominated with only small contributions from either the thirst or vasopressin systems. At high levels of Na intake (200 meq/day), both drinking and vasopressin release contributed significantly to osmoregulation. The studies also determined that, in the absence of excess vasopressin secretion and increased drinking, plasma osmolality rose to nearly twice the levels as those observed in normal dogs that increased vasopressin secretion. We conclude that vasopressin-related renal conservation of water contributes to buffering the rise of osmolality when Na intake is increased without increased drinking. The studies also confirm that with available water to drink, the thirst mechanism together with renal Na excretory mechanisms are the predominant controllers of osmolality in situations of high sodium intake.

Vagal regulation of arginine vasopressin in conscious dogs

To determine whether removal of inhibition of arginine vasopressin (AVP) by vagal afferents results in persistent elevation of plasma AVP, effects of bilateral cervical vagal denervation (VD) on plasma AVP were examined in 10 dogs with sinoaortic baroreceptor denervation (SAD). VD increased plasma AVP levels by 98 +/- 16 from 3.8 +/- 1.0 pg/ml (P less than 0.01) at 15 min after VD. By 4 h after VD there were no significant differences from control values. Responses of plasma AVP were also examined in response to acute volume expansion in conscious dogs with all reflexes intact, SAD, and SAD plus VD. In intact and SAD dogs, when blood volume was expanded by 20% with a rapid infusion of isotonic, isooncotic 3% dextran in saline, mean left atrial pressure rose transiently and plasma AVP fell insignificantly. With more prolonged stimulation to cardiopulmonary receptors, i.e., when left atrial pressure was maintained at elevated levels for 1 h by volume loading, plasma AVP fell by 0.9 +/- 0.3 pg/ml. However, after correction for hemodilution was made, AVP did not change with volume expansion, indicating that secretion rate was unchanged. Thus acute, but not chronic, interruption of vagal pathways induces striking release of AVP, but a resetting mechanism rapidly returns plasma AVP to control levels. Furthermore, stimulation of vagally innervated receptors by means of acute volume expansion suppresses plasma AVP when the elevation in atrial pressure is sustained, but this fall in plasma AVP can be accounted for entirely by the concomitant hemodilution.

Humoral control of water and electrolyte excretion during water restriction

The goals of the present study were twofold: first, to assess the renal excretory and hormonal responses to chronic water restriction in dogs whose sodium retaining mechanisms had been stimulated through dietary sodium (Na+) deprivation; second, to determine the mediator(s) of the natriuresis which was observed with water restriction in these sodium deprived dogs. Three groups of dogs maintained on a low Na+ diet (5 mEq/day) for two weeks underwent a three day period of water restriction. In normal, intact dogs Group 1 (N = 5), water restriction resulted in a significant increase in Na+ excretion with a net cumulative loss of 26.3 +/- 2.6 mEq over three days. The natriuresis was associated with a significant increase in plasma vasopressin (PAVP) (1.7 to 10.2 pg/mliter) and a significant fall in plasma aldosterone (PALDO) from the levels observed with Na+ restriction alone (24.9 to 12.4 ng/dliter). The natriuresis could not be explained by decreases in food intake as determined by control studies in four dogs. Group 2 (N = 6) dogs had a decrease in PALDO with water restriction that was prevented by means of continuous i.v. aldosterone infusion (6.0 micrograms/kg/day). Dogs in this group failed to demonstrate a natriuresis during three days of water restriction, despite the fact that PAVP rose from 3.3 +/- 0.8 to a peak level of 14.95 +/- 1.9 pg/mliter. Group 3 (N = 6) dogs underwent selective neurohypophysectomy, thus preventing the rise in PAVP during three days of water restriction. In this group, PALDO also remained unchanged from the Na+ deprived level during water restriction, and no natriuresis was observed. We conclude: 1) that the natriuresis which occurs with water restriction is a potent physiological response that occurs even in the Na+ restricted state; and 2) this natriuresis can be explained by a fall in PALDO and not the rise in PAVP.

Are hypertensive effects of aldosterone, angiotensin, vasopressin, and norepinephrine chronically additive?

The effects of chronic combined administration of angiotensin II, norepinephrine, aldosterone, and arginine vasopressin were compared with the response to each of these hormones administered alone. The studies were performed in dogs to determine the extent to which moderately inappropriate elevations of these hormones could enhance each other's ability to produce chronic hypertension and influence Na and water homeostasis. Blood pressure sensitivity to Na intake was also evaluated by infusing the hormones for 11 days at normal levels of Na intake followed by 11 days at high Na intake with ad libitum drinking. Combined hormone administration did not enhance each hormone's singular hypertensive actions. With aldosterone infusion alone and normal Na intake, mean arterial pressure rose nearly 15 mm Hg and an additional 3 mm Hg during high Na intake. Combined hormone infusion also resulted in a nearly 15 mm Hg rise during normal Na intake and an additional 3 mm Hg rise in mean arterial pressure during high Na intake. Marked Na retention and hypernatremia were observed with aldosterone infusion, while hyponatremia characterized arginine vasopressin infusion. The combined hormone infusion resulted in a tendency toward hypernatremia, although daily Na balance was not significantly changed. Daily water turnover was substantially increased and urine osmolality fell to hypoosmotic levels, despite elevated arginine vasopressin levels. Even with high Na intake, dogs receiving either angiotensin II, arginine vasopressin, or norepinephrine at the same concentrations showed 4 to 10 mm Hg increases in mean arterial pressure. Thus, humoral summation or synergism of these hormones probably does not play a major role in the development of chronic hypertension.

Sex differences in the endocrine predictors of essential hypertension. Vasopressin versus renin

The relationships between arterial pressure (BP) and plasma vasopressin levels, plasma renin activity, and other variables were determined in 96 untreated essential hypertensive men (146/100 mm Hg) and women (153/102 mm Hg) whose average age was 44 years, 80 normal men and women (121/79 mm Hg; mean age, 47 +/- 2 years), and 40 subjects defined as borderline hypertensive. An analysis of variance indicated significant sex differences in the population. Levels of plasma vasopressin were significantly elevated in hypertensive men, with 26% (high plasma vasopressin hypertensive) exhibiting levels greater than 2 SD of the normal mean, and multivariate regression analysis indicated a significant positive correlation between plasma vasopressin levels and systolic and diastolic blood pressure. Hypertensive men had a larger daily urine volume than normal men. Diastolic pressure and heart rate were significantly elevated in a subgroup of 12 weight-matched and age-matched hypertensive men in the high plasma vasopressin group compared with levels in normal plasma vasopressin hypertensive men. Hypertensive women had lower plasma renin activity than normal women, and multivariate analysis indicated a significant negative correlation between plasma renin activity and systolic and diastolic blood pressure. Other significant abnormalities in both sexes were noted: hypertensive men and women weighed more and excreted more sodium per day, and both had higher heart rates. With a discriminant analysis of 18 variables in male subjects, plasma vasopressin levels, urinary sodium excretion, and heart rate correctly classified 71% of normal and hypertensive subjects. In women, plasma renin activity, urinary sodium excretion, and heart rate correctly classified 77% of normal and hypertensive subjects. Despite the inability to ascertain causal relationships, the ability of the three variables in combination to correctly classify normal and hypertensive subjects indicates that these combined variables are reproducibly altered in persons with essential hypertension.

Long-term influence of vasopressin on the control of arterial blood pressure independent of volume changes

Studies were performed to ascertain the extent to which arterial blood pressure, and fluid and electrolyte changes seen with chronic elevations of plasma vasopressin (AVP) were caused by volume expansion or some other more direct cardiovascular or neural interactions of AVP. Group 1 (n = 7) dogs were infused with AVP (0.36 ng/kg/min) while total body weight and volume were maintained at a constant level by the use of an electronically controlled servocontrol system. Dogs in Group 2 (n = 6) were permitted to drink ad libitum during AVP infusion. Group 3 (n = 6) dogs were maintained with a constant level of H2O intake by intravenous infusion during two weeks AVP administration. The results indicate that chronic elevation of plasma AVP resulted in a prolonged elevation of arterial pressure only when there was a large expansion of total body water. Dogs with total body volume servocontrolled to a constant level (Group 1) and those with a moderate increase in volume (Group 2) exhibited no measureable change in mean arterial pressure during AVP infusion. Dogs with Fixed H2O intake (Group 3) retained a large fluid volume. They exhibited renal escape from AVP and large decreases of plasma osmolality, sodium concentration and plasma renin activity. With as libitum drinking (Group 2), only mild volume expansion occurred which resulted in a partial escape from the volume-retaining effects and smaller decreases of plasma osmolality and sodium. When total body weight and volume were servocontrolled to a constant level, no renal escape occurred and hype-osmolality, hyponatraemia and hyporeninaemia were not observed (Group 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term blood pressure and metabolic effects of vasopressin with servo-controlled fluid volume

Studies were performed in normal mongrel dogs (n = 8) to assess whether changes observed with chronic administration of vasopressin (AVP) were a result of direct actions of AVP or the consequence of changes in body fluid volume. AVP was infused continuously for 2 wk (0.36 ng X kg-1 X min-1 iv), while total body weight and body water (TBW) were maintained constant (+/- 50 g) using a servo-controlled system. A metabolic cage was mounted on sensitive force transducers for continuous monitoring of TBW. The summed voltage output of these transducers was used to servo control an intravenous infusion pump that adjusted the rate of water intake required for maintenance of a constant TBW. AVP infused under these conditions chronically increased plasma AVP levels from 2 to 22 pg/ml but resulted in no change of average 24-h mean arterial pressure, plasma sodium, or osmolality. Urine excretion decreased from 800 to 200 ml/day, whereas urine osmolality increased from 430 to 1,200 mosmol/kg and remained at these levels throughout the 2-wk AVP infusion. A net loss of 20 meq sodium occurred during the 1st day of AVP infusion but thereafter was unchanged. Plasma sodium and osmolality were unchanged from control during AVP infusions. We conclude that AVP-induced changes of arterial pressure, plasma sodium concentration and osmolality, renal escape, suppression of renin activity, and most of the observed natriuresis are events normally dependent on volume expansion.

Osmotic control of vasopressin with chronically altered volume states in anephric dogs

Continuous peritoneal dialysis has been used to maintain anephric dogs at chronically sustained low, normal, and high volume states in order to study the long-term interaction of volume and osmotic stimuli in the control of plasma vasopressin (PAVP). Bilaterally nephrectomized dogs were maintained for 1-3 mo with normal plasma sodium and potassium levels and blood urea nitrogen of 70.1 +/- 10.8 mg/dl. During the first month, the dogs were dialysized to each of the three volume states. After each volume state had been maintained for 7 days, an osmotic forcing with intravenous distilled H2O and hypertonic NaCl was performed in the conscious state to quantitate the relationship between plasma osmolality (Posm) and PAVP. During the osmotic forcings left atrial pressure (LAP) averaged -2.4 +/- 0.5, 2.6 +/- 0.8, and 11.9 +/- 1.1 cmH2O; mean arterial pressure averaged 113 +/- 11, 125 +/- 10, and 148 +/- 8 mmHg, both respective for the low, normal, and high volume states. The slope of the normovolemic Posm-PAVP relationship was determined to be 0.047 pg X ml-1 X mosmol-1 X kg-1, and neither the hypovolemic or hypervolemic relationships were significantly different. The results demonstrate two additional points that must be considered in the control of PAVP. First, the severely depressed sensitivity of osmotic PAVP control suggests that either the dialysis procedures or the absence of the kidneys suppressed or eliminated some factor normally important to the secretion of vasopressin.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of daily sodium intake on vasopressin secretion and drinking in dogs

Studies were carried out to determine the relationship between daily sodium intake, drinking, and vasopressin (AVP) secretion in normal conscious dogs. Chronic responses to 5-day elevations of daily sodium intake (200 meq/day) and 2-wk decreases in daily sodium intake (5 meq/day) were determined. Dogs were studied with ad libitum drinking and with water intake restricted to the amount drunk during the normal-sodium (30 meq/day) control period. Although acute elevations of plasma AVP occurred after a normal (40 meq Na) gastric load, chronic high-sodium intake resulted in no change of steady-state plasma AVP levels or daily AVP excretion (UAVP) with ad libitum drinking. Total water intake and frequency of drinking, however, increased nearly fourfold. In the absence of excess drinking, plasma AVP and UAVP both exhibited a nearly sixfold increase during the period of high-sodium intake. Despite elevations of plasma AVP, daily urine volume increased and urine osmolality rose only gradually during the 5 days of high-sodium intake. Chronic low-sodium intake also did not alter plasma AVP, but total water intake was reduced 20%. The data indicate that with water available, extracellular osmolality is controlled predominantly by drinking rather than by AVP secretion, that either osmolality or sodium concentration is the predominant controller of drinking and AVP secretion, and that daily water excretion need not be related directly to plasma AVP.

Role of vasopressin in cardiovascular regulation

Although we are just beginning to appreciate the potential role that arginine vasopressin (AVP) could play in the normal regulation of arterial pressure, a number of points appear already relatively well established. There is now little doubt that AVP can exert significant vasoconstrictor actions at physiological plasma concentrations, although in normal states, AVP-induced elevations of total peripheral resistance do not raise arterial pressure because of strong reflex suppression of cardiac output. It is also clear that AVP can be released in sufficient amounts in hypovolemic states to contribute significantly to the normalization of arterial pressure by direct vasoconstriction. The interaction of AVP with autonomic reflex pathways and the enhancement of baroreceptor reflex gain appear to be an important way in which AVP can also contribute to the short-term stabilization of pressure. Finally, the rapid reflex suppression of AVP and the withdrawal of antidiuretic actions in response to volume loading may serve as another mechanism whereby AVP participates in arterial pressure stabilization.

Vasopressin elevation in essential hypertension and increased responsiveness to sodium intake

The relationship of arterial pressure (AP) to plasma arginine vasopressin (AVP) and sodium (Na) intake was determined in untreated essential hypertensive (H) and normotensive (N) subjects. The AP of H subjects averaged 147/101 mm Hg and that of N subjects, 124/79 mm Hg. Plasma AVP was elevated significantly in H subjects, averaging 8.5 pg/ml compared to 4.7 pg/ml in N subjects. Multivariant regression analysis yielded a significant correlation (r2 = 0.34) between diastolic pressure, urine Na concentration, and changes in plasma AVP. Plasma Na of H subjects averaged 2.0 mEq/liter less and urine Na concentration 22 mEq/liter less than in N subjects. Sodium intake appeared to have no influence on the plasma AVP of N subjects, but H subjects excreting Na in excess of 250 mEq/day averaged a plasma AVP twice as high as that in H subjects excreting less than 150 mEq/day. In H subjects, the influence of Na intake appeared to be related to age. In subjects less than 50 years of age, Na intake did not appear to influence chronic levels of plasma AVP, while in subjects older than 50 years who were excreting Na in excess of 250 mEq/day, plasma AVP levels were twice (13.5 pg/ml) those observed in hypertensives of the same age excreting less than 150 mEq/ day (6.5 pg/ml). The data indicate that plasma AVP tends to be elevated in moderate essential hypertension. Reduced concentrating ability of the kidneys of these subjects is suggested by decreased urine Na concentrations despite elevated plasma AVP. The observed increases of plasma AVP could be exerting a direct influence on extra- and intravascular volumes by renal and systemic vasoconstriction.

Vasopressin, fluid, and electrolyte response to chronic angiotensin II infusion

The chronic interrelationships between blood-borne angiotensin (AII), plasma arginine vasopressin (AVP), fluid and electrolyte balance, and mean arterial pressure (AP) were studied in mongrel dogs by continuous intravenous infusion of AII for 7 days. Two groups of dogs were infused: group 1 and group 2 received 5.0 and 20.0 ng AII . kg-1 . min-1, respectively, and each were studied first on ad lib H2O intake and then several weeks later with "fixed" water intake. Plasma AVP was determined utilizing a sensitive radioimmunoassay procedure described herein, Group 1 (5.0 ng AII): AP rose to a steady-state level nearly 20 mmHg above control by the 3rd day of AII infusion with both ad lib and "fixed" H2O intake. With ad lib H2O, AVP was chronically unchanged while with fixed H2O a significant decrease had occurred by the 2nd day of AII infusion. Plasma [Na] and osmolality were not significantly changed in either state. Group 2 (20.0 ng AII): AP rose nearly 40 mmHg above control by the 3rd day of infusion with both ad lib and fixed water intake. AVP did not change significantly from a control of 0.8 microU/ml throughout AII infusion with ad lib H2O intake but drinking was more than doubled. With fixed H2O intake, plasma AVP rose from a control of 0.8 microU/ml to an average of 1.3 microU/ml over the last 4 days of AII infusion. A negative correlation was obtained between the "cumulative H2O balance" and plasma AVP obtained during AII infusion. We conclude first that circulating AII is not directly involved in the long-term control of AVP secretion and, second, neither AVP nor enhanced drinking contributes significantly to AII-induced hypertension.