title: Endothelin a receptor blockade and endothelin B receptor blockade improve hypokalemic nephropathy by different mechanisms.
abstract: Hypokalemia causes renal tubulointerstitial injury with an elevation in renal endothelin-1 (ET-1). It was hypothesized that hypokalemic tubulointerstitial injury is ameliorated by the blockade of ET-A receptors (ETA), whereas ET-B receptor (ETB) antagonism may exacerbate the injury, because ETB is thought to mediate vasodilation. Rats were fed a K(+)-deficient diet alone (LC) or with an ETA-selective antagonist ABT-627 (LA) or an ETB-selective antagonist A-192621 (LB) for 8 wk. Control rats were on a normal K(+) diet alone or with the ETA-selective or ETB-selective antagonists. The severity of hypokalemia was not significantly different among LA, LB, and LC. LC developed tubulointerstitial injury with an elevation of renal preproET-1 mRNA level. There was an increase in tubular osteopontin expression, macrophage infiltration, collagen accumulation, and tubular cell hyperplasia. ETA blockade significantly ameliorated all parameters for renal injury in the cortex without suppressing local ET-1 and ETA expression. By contrast, ETB blockade significantly reduced local ET-1 and ETA expression and improved the injury to a similar extent in the cortex. In the medulla, ETA or ETB blockade only partially blocked renal injury. ETA blockade did not affect BP in normokalemic or hypokalemic rats. ETB blockade induced a BP elevation with a decrease in urinary Na(+) excretion in normokalemic but not in hypokalemic rats. These results indicate that ET-1 can mediate hypokalemic renal injury in two different ways: by directly stimulating ETA and by locally promoting endogenous ET-1 production via ETB. Thus, ETA as well as ETB blockade may be renoprotective in hypokalemic nephropathy.
authors.affiliation: National Cardiovascular Center Research Institute, Department of Medicine, National Cardiovascular Center, Suita, Osaka, Japan. ssuga@ri.ncvc.go.jp
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Suga
authors.forename: Naomi
authors.initials: N
authors.lastname: Yasui
authors.forename: Fumiki
authors.initials: F
authors.lastname: Yoshihara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Horio
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
authors.forename: Kenji
authors.initials: K
authors.lastname: Kangawa
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D000419:Albuminuria / Q000652:urine; D000818:Animals; D000077868:Atrasentan; D065128:Endothelin Receptor Antagonists; D019332:Endothelin-1 / Q000096:biosynthesis; D006973:Hypertension / Q000139:chemically induced; D006984:Hypertrophy; D007008:Hypokalemia / Q000150:complications* / Q000378:metabolism; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology* / Q000652:urine; D007684:Kidney Tubules / Q000187:drug effects / Q000473:pathology; D008297:Male; D011188:Potassium / Q000378:metabolism; D011507:Proteinuria / Q000652:urine; D011759:Pyrrolidines / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D044022:Receptor, Endothelin A; D044023:Receptor, Endothelin B
chemical_list: C120508:A 192621; D065128:Endothelin Receptor Antagonists; D019332:Endothelin-1; D011759:Pyrrolidines; D044022:Receptor, Endothelin A; D044023:Receptor, Endothelin B; D011188:Potassium; D000077868:Atrasentan