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Gambaryan S, Mohagaonkar S, Nikolaev VO. Regulation of the renin-angiotensin-aldosterone system by cyclic nucleotides and phosphodiesterases. Front Endocrinol (Lausanne) 2023; 14:1239492. [PMID: 37674612 PMCID: PMC10478253 DOI: 10.3389/fendo.2023.1239492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
The renin-angiotensin-aldosterone system (RAAS) is one of the key players in the regulation of blood volume and blood pressure. Dysfunction of this system is connected with cardiovascular and renal diseases. Regulation of RAAS is under the control of multiple intracellular mechanisms. Cyclic nucleotides and phosphodiesterases are the major regulators of this system since they control expression and activity of renin and aldosterone. In this review, we summarize known mechanisms by which cyclic nucleotides and phosphodiesterases regulate renin gene expression, secretion of renin granules from juxtaglomerular cells and aldosterone production from zona glomerulosa cells of adrenal gland. We also discuss several open questions which deserve future attention.
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Affiliation(s)
- Stepan Gambaryan
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, Saint Petersburg, Russia
| | - Sanika Mohagaonkar
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Viacheslav O. Nikolaev
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany
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Kallaras C, Angelopoulos N, Bountzioukas S, Mavroudis K, Karamouzis M, Guiba-Tziampiri O. Intracerebroventricular administration of atrial natriuretic peptide prevents increase of plasma ADH, aldosterone and corticosterone levels in restrained conscious dehydrated rabbits. J Endocrinol Invest 2004; 27:844-53. [PMID: 15648549 DOI: 10.1007/bf03346279] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In order to investigate the effects of centrally administered ANP on plasma ADH, aldosterone and corticosterone levels as well as on blood pressure and on heart rate, 20 male New Zealand White (NZW) rabbits were used. Measurements were made on restrained conscious animals one week after the implantation of an indwelling intracerebroventricular (icv) cannula and two indwelling intravascular catheters (intracarotid and intrajugular). Animals were classified into two main groups, those with water available ad libitum ("euhydrated" group) and those who were dehydrated for 24 h ("dehydrated" group) before blood pressure and heart rate recordings and blood sampling for hormonal determination. Each group's individuals were divided into two subgroups of five animals each. Blood samples were collected at 0 min (control) and 30, 60, 90, 120 min following icv administration of 25 microl of either artificial cerebrospinal fluid (aCSF) (subgroups "aCSF") or human (h) ANP (1 microg) in aCSF (25 microl) (subgroups "hANP"). Blood pressure and heart rate were also recorded at the same times. Plasma ADH, aldosterone and corticosterone concentrations were determined using RIA. The results were analysed by analysis of variance (ANOVA). Blood pressure and heart rate values were unaffected by water deprivation or by ANP administration. Mean plasma corticosterone levels at all times (30-120 min) were significantly higher (p<0.001) than those at 0 min time. Plasma corticosterone levels in the "dehydrated+aCSF" group were significantly higher (p<0.05) than in each of the other groups ("dehydrated+hANP", "euhydrated+aCSF", "euhydrated+hANP"). Plasma corticosterone levels in each of those other groups did not differ significantly from one another. Dehydration resulted in a tendency to increase in aldosterone levels (p<0.07), and icv administration of hANP tended (p<0.08) to prevent in the "dehydrated+hANP" experimental group the increase in aldosterone levels observed in the control "dehydrated+aCSF" group from 30 to 120 min. Dehydration resulted in an increase in ADH levels (p<0.0001), and icv administration of hANP prevented (p<0.05) in "dehydrated+hANP" experimental group the increase in ADH levels observed in the control "dehydrated+aCSF" group from 90 to 120 min. The increase of corticosterone and ADH and the tendency towards increase in aldosterone in the control dehydrated groups could possibly be due to the combined stress stimulus of dehydration and restriction in the restrain box. These results indicate that centrally administered ANP, at the concentration achieved in the present study, neither affects blood pressure and heart rate in conscious restrained euhydrated and 24 h-dehydrated NZW rabbits nor decreases the ADH, aldosterone and corticosterone response to dehydration, but does apparently modulate ADH, aldosterone and corticosterone responses to other stimuli in the dehydrated state. In conclusion, the results of this study confirm that brain ANP may have an inhibitory effect on stimulated ADH, aldosterone and corticosterone release.
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Affiliation(s)
- C Kallaras
- Department of Experimental Physiology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Calle RA, Bollag WB, White S, Betancourt-Calle S, Kent P. ANPs effect on MARCKS and StAR phosphorylation in agonist-stimulated glomerulosa cells. Mol Cell Endocrinol 2001; 177:71-9. [PMID: 11377822 DOI: 10.1016/s0303-7207(01)00454-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Atrial natriuretic peptide (ANP) is a cardiac hormone that inhibits aldosterone secretion induced by all physiologic agonists. The purpose of this study is to explore ANP-induced changes in the phosphorylation of myristoylated alanine-rich C-kinase substrate (MARCKS) and the steroidogenic acute regulatory protein (StAR), in AngII or K(+)-stimulated glomerulosa cells. The data show that ANP completely inhibits the phosphorylation of MARCKS and partially inhibits that of StAR in cells stimulated with K(+). ANP also partially inhibits MARCKS phosphorylation but does not affect StAR phosphorylation in cells stimulated with AngII. These effects appear to be cGMP-independent and at least partially dependent on inhibition of protein kinase C (PKC). To our knowledge, this is the first report of ANP modulating either MARCKS or StAR phosphorylation in [(32)P]-labeled cells. The data also support the hypothesis that ANP inhibits aldosterone secretion acting as a step involved in cholesterol transport to the mitochondria.
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Affiliation(s)
- R A Calle
- Program in Cell Signaling, Institute of Molecular Medicine and Genetics, Medical College of Georgia, CB-2801, 1120 15th Street, Augusta, GA 30912, USA.
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Cherradi N, Capponi AM. The acute regulation of mineralocorticoid biosynthesis: scenarios for the StAR system. Trends Endocrinol Metab 1998; 9:412-8. [PMID: 18406315 DOI: 10.1016/s1043-2760(98)00099-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The zona glomerulosa cell of the adrenal cortex produces mineralocorticoids in response to physiological stimuli (angiotensin II and extracellular K(+)) activating the Ca(2+) messenger system. The mechanisms underlying the generation of the Ca(2+) signal have been analyzed extensively and recent developments have contributed to bridging the gap between intracellular signals and activation of the biological function. This article summarizes the current knowledge on the intracellular targets of the Ca(2+) messenger, obtained mainly in bovine glomerulosa cells. Ca(2+) appears to exert a dual effect, both at the intramitochondrial level and at the nuclear level, where it activates steroidogenic acute regulatory protein (StAR) gene transcription.
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Affiliation(s)
- N Cherradi
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Faculty of Medicine, University Hospital, Geneva 14, Switzerland
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Cherradi N, Brandenburger Y, Rossier MF, Vallotton MB, Stocco DM, Capponi AM. Atrial natriuretic peptide inhibits calcium-induced steroidogenic acute regulatory protein gene transcription in adrenal glomerulosa cells. Mol Endocrinol 1998; 12:962-72. [PMID: 9658401 DOI: 10.1210/mend.12.7.0132] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Atrial natriuretic peptide (ANP) is a potent inhibitor of mineralocorticoid synthesis induced in adrenal glomerulosa cells by physiological agonists activating the calcium messenger system, such as angiotensin II (Ang II) and potassium ion (K+). While the role of calcium in mediating Ang II- and K(+)-induced aldosterone production is clearly established, the mechanisms leading to blockade of this steroidogenic response by ANP remain obscure. We have used bovine adrenal zona glomerulosa cells in primary culture, in which an activation of the calcium messenger system was mimicked by a 2-h exposure to an intracellular high-calcium clamp. The effect of ANP was studied on the following parameters of the steroidogenic pathway: 1) pregnenolone and aldosterone production; 2) changes in cytosolic ([Ca2+]c) and mitochondrial ([Ca2+]m) Ca2+ concentrations, as assessed with targeted recombinant aequorin; 3) cholesterol content in outer mitochondrial membranes (OM), contact sites (CS), and inner membranes (IM); 4) steroidogenic acute regulatory (StAR) protein import into mitochondria by Western blot analysis; 5) StAR protein synthesis, as determined by [35S]methionine incorporation, immunoprecipitation, and SDS-PAGE; 6) StAR mRNA levels by Northern blot analysis with a StAR cDNA; 7) StAR gene transcription by nuclear run-on analysis. While clamping Ca2+ at 950 nM raised pregnenolone output 3.5-fold and aldosterone output 3-fold, ANP prevented these responses with an IC50 of 1 nM and a maximal effect of 90% inhibition at 10 nM. In contrast, ANP did not affect the [Ca2+]c or [Ca2+]m changes occurring under Ca2+ clamp or Ang II stimulation in glomerulosa cells. The accumulation of cholesterol content in CS (139.7 +/- 10.7% of control) observed under high-Ca2+ clamp was prevented by 10 nM ANP (92.4 +/- 4% of control). Similarly, while Ca2+ induced a marked accumulation of StAR protein in mitochondria of glomerulosa cells to 218 +/- 44% (n = 3) of controls, the presence of ANP led to a blockade of StAR protein mitochondrial import (113.3 +/- 15.0%). This effect was due to a complete suppression of the increased [35S]methionine incorporation into StAR protein that occurred under Ca2+ clamp (94.5 +/- 12.8% vs. 167.5 +/- 17.3%, n = 3). Furthermore, while the high-Ca2+ clamp significantly increased StAR mRNA levels to 188.5 +/- 8.4 of controls (n = 4), ANP completely prevented this response. Nuclear run-on analysis showed that increases in intracellular Ca2+ resulted in transcriptional induction of the StAR gene and that ANP inhibited this process. These results demonstrate that Ca2+ exerts a transcriptional control on StAR protein expression and that ANP appears to elicit its inhibitory effect on aldosterone biosynthesis by acting as a negative physiological regulator of StAR gene expression.
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Affiliation(s)
- N Cherradi
- Division of Endocrinology and Diabetology, Faculty of Medicine, Geneva, Switzerland.
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Ehrhart-Bornstein M, Hinson JP, Bornstein SR, Scherbaum WA, Vinson GP. Intraadrenal interactions in the regulation of adrenocortical steroidogenesis. Endocr Rev 1998; 19:101-43. [PMID: 9570034 DOI: 10.1210/edrv.19.2.0326] [Citation(s) in RCA: 315] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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8
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Kallaras C, Angelopoulos N, Apostolakis M, Bountzioukas S, Guiba-Tziampiri O, Kontoleon-Vakalopoulou H, Mavroudis K. Effects of intracerebroventricular administration of atrial natriuretic peptide (ANP) on blood pressure, heart rate and plasma ADH and corticosterone levels in normal and dehydrated rabbits. J Endocrinol Invest 1998; 21:200-10. [PMID: 9624593 DOI: 10.1007/bf03347304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In order to investigate the effects of centrally administered Atrial Natriuretic Peptide (ANP) on plasma ADH and corticosterone levels as well as on blood pressure and on heart rate, 20 male New Zealand White (NZW) rabbits were used. Measurements were made on restrained conscious animals one week after the implantation of an indwelling intracerebroventricular (i.c.v.) cannula and two indwelling intravascular catheters (intracarotid and intrajugular). Animals were classified into two main groups, those with water available ad libitum ("euhydrated" group) and those who were dehydrated for 24h ("dehydrated" group) before blood pressure and heart rate recordings and blood sampling for hormonal determination. Each group's individuals were divided into two subgroups of five animals each. Blood samples were collected at 0 min (control) and 30; 60, 90, 120 min following i.c.v. administration of 25 microliters of either artificial cerebrospinal fluid (aCSF) (subgroups "aCSF") or human (h) ANP (1 microgram) in aCSF (25 microliters) (subgroups "hANP"). Blood pressure and heart rate were also recorded at the same times. Plasma ADH and corticosterone concentrations were determined by RIA. The results were analysed by ANOVA. Blood pressure and heart rate values were unaffected by water deprivation or by ANP administration. Mean plasma corticosterone levels at all times (30-120 min) were significantly higher (p < 0.001) than at 0 min time. Plasma corticosterone levels in the "dehydrated + aCSF" group were significantly higher (p < 0.05) than in each of the other groups ("dehydrated + hANP", "euhydrated + aCSF", "euhydrated + hANP"). Plasma corticosterone levels in each of those other groups did not differ significantly from one another. Dehydration resulted in an increase in ADH levels (p < 0.0001) and i.c.v. administration of hANP prevented (p < 0.05) in "dehydrated + hANP" experimental group, the increase in ADH levels observed in the control "dehydrated + aCSF" group from 90 to 120 min. The increase of corticosterone and ADH in the control dehydrated groups could possibly be due to the combined stress stimulus of dehydration and restriction in the restrain box. These results indicate that centrally administered ANP, at the concentration achieved in the present study, neither affects blood pressure and heart rate in conscious restrained euhydrated and 24h-dehydrated NZW rabbits nor decreases the ADH and corticosterone response to dehydration, but does apparently modulate ADH and corticosterone responses to other stimuli in the dehydrated state. In conclusion, the results of this study confirm that brain ANP may have an inhibitory effect on stimulated ADH and corticosterone release.
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Affiliation(s)
- C Kallaras
- Department of Experimental Physiology, Faculty of Medicine, Aristotelion University of Thessaloniki, Greece
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9
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Jacob G, Robertson D, Mosqueda-Garcia R, Ertl AC, Robertson RM, Biaggioni I. Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system. Am J Med 1997; 103:128-33. [PMID: 9274896 DOI: 10.1016/s0002-9343(97)00133-2] [Citation(s) in RCA: 119] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Orthostatic intolerance is the cause of significant disability in otherwise normal patients. Orthostatic tachycardia is usually the dominant hemodynamic abnormality, but symptoms may include dizziness, visual changes, discomfort in the head or neck, poor concentration, fatigue, palpitations, tremulousness, anxiety and, in some cases, syncope. It is the most common disorder of blood pressure regulation after essential hypertension. There is a predilection for younger rather than older adults and for women more than men. Its cause is unknown; partial sympathetic denervation or hypovolemia has been proposed. METHODS AND MATERIALS We tested the hypothesis that reduced plasma renin activity, perhaps from defects in sympathetic innervation of the kidney, could underlie a hypovolemia, giving rise to these clinical symptoms. Sixteen patients (14 female, 2 male) ranging in age from 16 to 44 years were studied. Patients were enrolled in the study if they had orthostatic intolerance, together with a raised upright plasma norepinephrine (> or = 600 pg/mL). Patients underwent a battery of autonomic tests and biochemical determinations. RESULTS There was a strong positive correlation between the blood volume and plasma renin activity (r = 0.84, P = 0.001). The tachycardic response to upright posture correlated with the severity of the hypovolemia. There was also a correlation between the plasma renin activity measured in these patients and their concomitant plasma aldosterone level. CONCLUSIONS Hypovolemia occurs commonly in orthostatic intolerance. It is accompanied by an inappropriately low level of plasma renin activity. The degree of abnormality of blood volume correlates closely with the degree of abnormality in plasma renin activity. Taken together, these observations suggest that reduced plasma renin activity may be an important pathophysiologic component of the syndrome of orthostatic intolerance.
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Affiliation(s)
- G Jacob
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 97232-2195, USA
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Bornstein SR, Ehrhart-Bornstein M, Scherbaum WA. Morphological and functional studies of the paracrine interaction between cortex and medulla in the adrenal gland. Microsc Res Tech 1997; 36:520-33. [PMID: 9142698 DOI: 10.1002/(sici)1097-0029(19970315)36:6<520::aid-jemt9>3.0.co;2-l] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Within the last years it has become evident that besides the hypothalamo-pituitary-adrenal axis, extrapituitary mechanisms exist that regulate the activity of the adrenal cortex. In this context, intra-adrenal regulatory mechanisms play an important role. Several secretory products from adrenomedullary cells are able to influence adrenocortical steroidogenesis. Since the main blood flow within the adrenal is directed centripetally from the cortex to the medulla, chromatin cells should act on cortical cells in a paracrine manner. The morphological prerequisite for this regulatory pathway is seen in the close apposition of the two tissues. Within the mammalian adrenal, the two endocrine tissues are interwoven to an astonishing degree with cortical cells located within the medulla and vice versa. It is concluded from morphological and functional studies that paracrine interactions between cortex and medulla play an important role in the regulation of adrenocortical steroidogenesis.
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Affiliation(s)
- S R Bornstein
- Universität Leipzig, Medizinische Klinik und Poliklinik III, Leipzig, Germany
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Bähr V, Sander-Bähr C, Ardevol R, Tuchelt H, Beland B, Oelkers W. Effects of atrial natriuretic factor on the renin-aldosterone system: in vivo and in vitro studies. J Steroid Biochem Mol Biol 1993; 45:173-8. [PMID: 8386932 DOI: 10.1016/0960-0760(93)90138-m] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We investigated the effect of high physiological plasma levels of human varies; is directly proportional to atrial natriuretic factor (ANF) on renin and aldosterone secretion in normal sodium deplete men. In short term infusion studies (2 or 8 h duration), ANF plasma levels as observed after sodium loading (50-70 pg/ml) lowered basal renin (PRA) and aldosterone, but had only a marginal effect on angiotensin II-stimulated aldosterone secretion. Preliminary results of a study with long term infusion (6 days) of ANF during a period of dietary sodium depletion argue against a significant tonic inhibitory effect of ANF on the renin-aldosterone system in the preceding period of sodium repletion: the plasma aldosterone response to sodium depletion was similar with and without ANF infusion. The second messenger of ANF for the direct inhibition of aldosterone secretion from zona glomerulosa cells is still unknown. To test the hypothesis, that cGMP is the second messenger of ANF, we produced a rise in intracellular cGMP in rat and rabbit zona glomerulosa cells using the unspecific phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX) and the more cGMP specific phosphodiesterase specific inhibitor M + B2948 (Zaprinast). Both inhibitors simulated the action of ANF in suppressing steroid secretion and elevating cGMP levels. The results are compatible with the view that cGMP is of importance as a second messenger for ANF in adrenal zona glomerulosa cells. Selective inhibition of phosphodiesterases in combination with endopeptidase inhibition may be an interesting principle to enhance the action of endogenous and exogenous ANF.
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Affiliation(s)
- V Bähr
- Department of Internal Medicine, Klinikum Steglitz, Freie Universität Berlin, Germany
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Tipnis UR, Gentry JB, Gutkowska J. Effect of difluoromethylornithine on atrial natriuretic peptide in rat atria. REGULATORY PEPTIDES 1993; 43:157-67. [PMID: 8441821 DOI: 10.1016/0167-0115(93)90150-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Polyamines are aliphatic cations known to have a role in cellular growth and differentiation. In this study, difluoromethylornithine (DFMO), an inhibitor of polyamine synthesis, was used to investigate its effect on atrial natriuretic peptide (ANP) in atria of rat. The rats were given DFMO (2%) in drinking water for 10 days and three intraperitoneal administrations (200 mg/kg), 24, 18 and 1 h prior to experiment. Radioimmunoassay of ANP in atrial extracts indicated that DFMO treatment increased ANP contents of atria. ANP from atrial extracts was immunoprecipitated using ANP antibody and the immunoprecipitate was resolved and detected by SDS-PAGE and Western blotting. The predominant ANP peptide in both control and DFMO group migrated at 17 kDa. The synthesis of ANP was studied following the intravenous administration of [35S]methionine. ANP in atrial extracts was immunoprecipitated by ANP antibody. The incorporation of ANP into control and DFMO group peaked at 30 min and returned to a basal level by 60 min. DFMO decreased the incorporation of [35S]methionine into ANP. At 30 min following the administration of [35S]methionine, putrescine restored the synthesis of tricholoroprecipitable atrial proteins, but had no effect on the synthesis of ANP. At 60 min following, the amount of labeled ANP in DFMO + putrescine-treated group was significantly lower than that in DFMO group. These results indicate that polyamines influence both the synthesis and secretion of ANP.
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Affiliation(s)
- U R Tipnis
- Department of Pathology, University of Texas Medical Branch, Galveston
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Tipnis UR, Boor PJ. Inhibition of polyamine synthesis impairs the secretion of atrial natriuretic peptide. REGULATORY PEPTIDES 1992; 37:227-36. [PMID: 1532663 DOI: 10.1016/0167-0115(92)90617-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The aim of the present study was to evaluate in vivo the role of polyamines in the secretion of atrial natriuretic peptide (ANP). alpha-Difluoromethylornithine (DFMO) which inhibits ornithine decarboxylase activity and polyamine synthesis was given in drinking water and through intraperitoneal administration to Sprague-Dawley rats. Carotid artery was cannulated for collection of blood samples and measurement of blood pressure following the administration of arginine-vasopressin (AVP). Analysis of polyamines in cardiac tissue indicated that DFMO treatment decreased contents of putrescine and spermidine in cardiac tissue by 80% and 48%, respectively. Quantitation of ANP in plasma by radioimmunoassay indicated that both basal and stimulated levels of ANP in DFMO-treated animals were 21.5% and 50% of those in control rats. The administration of putrescine restored the levels of basal and AVP-stimulated levels of ANP in plasma which confirmed that DFMO effect on ANP secretion occurred specifically through the polyamine pathway.
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Affiliation(s)
- U R Tipnis
- Department of Pathology, University of Texas Medical Branch, Galveston 77550
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14
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Kloas W, Hanke W. Effects of atrial natriuretic factor on corticosteroid and catecholamine secretion by the adrenals of Xenopus laevis. Gen Comp Endocrinol 1992; 85:269-77. [PMID: 1534778 DOI: 10.1016/0016-6480(92)90011-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The effects of atrial natriuretic factor (ANF) on the adreno-corticosteroid and catecholamine secretion of Xenopus laevis were studied in vitro and in vivo. In vitro, the effects of rANF(99-126), from 0.1 to 50 nM, on corticosteroid secretion was investigated using a perifusion system. The basal secretion of aldosterone but not corticosterone was dose dependently decreased. A prolonged perifusion with 1 nM rANF(99-126) alternated ACTH(1-28) stimulation of secretion of both corticosteroids. Only ANF analogues with intact disulfide bridges (rANF(99-126), hANF(99-126), Atriopeptin II, frogANF(21)), and an extract of Xenopus laevis hearts significantly inhibited aldosterone release; the N-terminal (99-109) and the C-terminal ANF(116-126) fragments had no effects. In vitro norepinephrine (NE) and epinephrine (E) were released but dopamine (D) was not detected. rANF(99-126) at concentrations up to 1 microM affected neither basal nor acetylcholine stimulated catecholamine secretion. In vivo, a single injection of 3 nmol rANF(99-126) per 100 g body weight was given and the serum concentrations of corticosterone, aldosterone, D, NE, and E were determined 1, 3, 6, 12, and 24 hr later. Both steroids decreased after 12 hr, whereas the catecholamine concentrations were not significantly changed. ANF is concluded to act on steroidogenic but not chromaffin cells in Xenopus laevis.
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Affiliation(s)
- W Kloas
- Department of Zoology, The University, Karlsruhe, Federal Republic of Germany
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15
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Andersen AC, Tonon MC, Pelletier G, Conlon JM, Fasolo A, Vaudry H. Neuropeptides in the amphibian brain. INTERNATIONAL REVIEW OF CYTOLOGY 1992; 138:89-210, 315-26. [PMID: 1280630 DOI: 10.1016/s0074-7696(08)61588-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A C Andersen
- European Institute for Peptide Research, C.N.R.S. URA 650, U.A. INSERM, University of Rouen, Mont-Saint-Aignan, France
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16
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Brochu M, Ong H, De Léan A. Sites of action of angiotensin II, atrial natriuretic factor and guanabenz, on aldosterone biosynthesis. J Steroid Biochem Mol Biol 1991; 38:575-82. [PMID: 1828176 DOI: 10.1016/0960-0760(91)90315-v] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It is well known that atrial natriuretic factor (ANF) inhibits aldosterone biosynthesis. Recent studies showed that amiloride can also inhibit adrenal steroidogenesis. Since the antihypertensive agent, guanabenz, is structurally related to amiloride, we have examined its action on aldosterone biosynthesis. The aim of this work was to localize the sites of action of angiotensin II (AII) and of ANF on steroidogenesis and to compare the effects of guanabenz to ANF. Trilostane, an inhibitor of 3 beta-hydroxysteroid dehydrogenase was used to separately study the early and late pathways of aldosterone biosynthesis. The different steps of steroidogenesis are stimulated by AII. ANF inhibits the formation of pregnenolone, the steps between progesterone and deoxycorticosterone, deoxycorticosterone and corticosterone and finally, corticosterone and aldosterone with ED50 of 114 +/- 17, 199 +/- 90, 14 +/- 3 and 92 +/- 34 pM of ANF, respectively, and around 70% of inhibition. These steps are also inhibited by guanabenz with ED50 of 66 +/- 17 microM for the formation of pregnenolone, 1.6 +/- 1.3, 3.3 +/- 1.7 and 29 +/- 4 microM for the last 3 steps. The percentage of inhibition by guanabenz was at least 80% for all the steps except for progesterone to deoxycorticosterone which is less than 35%. These results indicate that the major site of action of both AII and ANF could be at the level of intracellular signal transduction for the activation of mitochondrial steroidogenic enzymes or for the transport of steroids to mitochondria. We also showed that guanabenz mimics the inhibitory effects of ANF. This study with guanabenz suggests that it might be a prototype for a new family of antihypertensive agents.
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Affiliation(s)
- M Brochu
- Laboratory of Molecular Pharmacology, Clinical Research Institute of Montréal, Montréal, Québec, Canada
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17
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Sergev O, Rácz K, Varga I, Kiss R, Fütö L, Gutkowska J, Gláz E. Dissociation of plasma atrial natriuretic peptide responses to upright posture and furosemide administration in patients with normal-, low renin essential hypertension and primary aldosteronism. CLINICAL AND EXPERIMENTAL HYPERTENSION. PART A, THEORY AND PRACTICE 1991; 13:409-23. [PMID: 1832596 DOI: 10.3109/10641969109045060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Plasma levels of atrial natriuretic peptide (ANP) were measured in patients with normal renin essential hypertension (n = 12), low renin essential hypertension (n = 11) and primary aldosteronism due to aldosterone producing adenoma (APA, n = 8) and idiopathic hyperaldosteronism (IHA, n = 3) after overnight rest in the supine position and after 4 h upright posture and furosemide administration. Plasma renin activity (PRA) and aldosterone (Aldo) levels were also determined. Compared to normal renin essential hypertension (33.6 +/- 2.2 pg/ml), basal plasma ANP was significantly higher in low renin essential hypertension (66.8 +/- 6 pg/ml), IHA (54.1 +/- 6.3 pg/ml) and APA before (62.4 +/- 4.9 pg/ml) but not after adrenal surgery (22 +/- 3 pg/ml). After upright posture and furosemide administration plasma ANP was decreased (p less than 0.01) in patients with low renin and, less markedly, with normal renin essential hypertension, however not in IHA and APA. In about half of the patients with low renin essential hypertension, unchanged PRA after upright posture and furosemide administration was associated with increased plasma Aldo and decreased ANP levels. We conclude that (i) the relatively high basal plasma ANP levels in low renin essential hypertension, IHA and APA may reflect the presence of volume expansion in these patients; (ii) the hormonal responses to upright posture and furosemide administration in patients with normal and low renin essential hypertension may indicate a counterregulatory role of ANP during activation of the renin-angiotensin-aldosterone system; (iii) the high plasma ANP, which is unresponsive to upright posture and furosemide administration, in patients with APA and IHA may be a potentially interesting new finding whose pathophysiological significance remains to be established.
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Affiliation(s)
- O Sergev
- Second Department of Medicine, Semmelweis University Medical School, Budapest, Hungary
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18
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Nunez DJ, Davenport AP, Brown MJ. Atrial natriuretic factor mRNA and binding sites in the adrenal gland. Biochem J 1990; 271:555-8. [PMID: 2146954 PMCID: PMC1149591 DOI: 10.1042/bj2710555] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The factor inhibiting aldosterone secretion produced by the adrenal medulla may be atrial natriuretic factor (ANF), since the latter abolishes aldosterone release in response to a number of secretagogues, including angiotensin II and K+. In this study we have shown that cells in the adrenal medulla contain ANF mRNA and therefore have the potential to synthesize this peptide. The presence of binding sites for ANF predominantly in the adrenal zona glomerulosa suggests that, if ANF is synthesized in the medulla and transferred to the cortex, it may affect mineralocorticoid status.
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Affiliation(s)
- D J Nunez
- Department of Medicine, University of Cambridge Clinical School, Addenbrooke's Hospital, U.K
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19
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Stasch JP, Hirth-Dietrich C, Kazda S, Neuser D. Role of endogenous ANP on endocrine function investigated with a monoclonal antibody. Peptides 1990; 11:577-82. [PMID: 2166279 DOI: 10.1016/0196-9781(90)90061-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Substantial volume expansion in conscious rats induces a strong natriuresis, cyclic GMP excretion, increase in cyclic GMP in plasma and kidney tissue, decrease in plasma renin activity and plasma aldosterone concentration. These effects are directly related to an increase in plasma levels of atrial natriuretic peptides. The renal response and the changes in plasma and kidney cyclic GMP, plasma renin activity and aldosterone could be totally blocked by simultaneous administration of monoclonal antibodies directed against ANP. From this study it seems to be clear that the rise in cyclic GMP and the inhibition of the renin-aldosterone system is not a direct effect of volume expansion but is specifically mediated by the released ANP. The great importance of ANP in acute volume expansion made us wonder about the role of ANP in chronic volume expansion and under basal conditions without volume loading. Chronic volume loading was induced pharmacologically by the sodium retaining vasodilatator minoxidil. Under both chronic volume expansion and basal conditions the neutralization of the circulation ANP by antibody administration leads to reduced plasma cyclic GMP levels. No alterations in urinary sodium excretion, plasma renin activity and plasma aldosterone concentration could be observed: In conclusion, the monoclonal antibody directed against ANP is a useful tool for the investigation of the physiological role of endogenous ANP.
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Affiliation(s)
- J P Stasch
- Bayer AG, Institute of Pharmacology, Wuppertal, FRG
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20
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Rocco S, Opocher G, D'Agostino D, Leone L, Mantero F. Lack of aldosterone inhibition by atrial natriuretic factor in primary aldosteronism: in vitro studies. J Endocrinol Invest 1989; 12:13-7. [PMID: 2545763 DOI: 10.1007/bf03349905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Several studies demonstrated that aldosterone secretion, by bovine, rat and human glomerulosa cells, is inhibited in vitro by atrial natriuretic factor (ANF). This effect has also been investigated with conflicting results in cells taken from aldosterone-producing tumors. In the present study, atrial natriuretic factor has been tested on aldosteronoma cells obtained from 4 patients with primary aldosteronism. The cells were studied both with perfusion and incubation systems. Aldosterone secretion was stimulated by ACTH, angiotensin II and potassium with or without ANF 10 microM. In this study ANF lacked to inhibit either basal and stimulated aldosterone secretion, indicating some alterations of ANF-adrenal interaction in this syndrome.
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Affiliation(s)
- S Rocco
- Istituto di Semeiotica Medica, Università di Padova, Italy
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21
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Cantin M, Genest J. The heart as an endocrine gland. PHARMACOLOGICAL RESEARCH COMMUNICATIONS 1988; 20 Suppl 3:1-22. [PMID: 2852372 DOI: 10.1016/s0031-6989(88)80103-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M Cantin
- Clinical Research Institute of Montreal, Quebec, Canada
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22
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Lihrmann I, Netchitaïlo P, Feuilloley M, Cantin M, Delarue C, Leboulenger F, De Léan A, Vaudry H. Effect of atrial natriuretic factor on corticosteroid production by perifused frog interrenal slices. Gen Comp Endocrinol 1988; 71:55-62. [PMID: 2842221 DOI: 10.1016/0016-6480(88)90294-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In order to investigate a possible role of atrial natriuretic factor (ANF) in the control of corticosteroid biosynthesis in amphibians, we have examined the effect of synthetic ANF (Arg 101-Tyr 126) on perifused frog interrenal slices. ANF did not affect the spontaneous secretion of corticosterone and aldosterone. In contrast, ANF (10(-6) M) inhibited ACTH-and angiotensin II-stimulated corticosteroid production. ANF was more potent in suppressing aldosterone than corticosterone secretion. Immunocytochemical studies using a specific ANF antiserum revealed the presence of ANF-like immunoreactive fibers in the vicinity of interrenal cells. It is thus proposed that, in amphibians, both "hormonal" ANF secreted by myocytes and "neurohormonal" ANF delivered by peptidergic nerve terminals coursing among interrenal cells may partake in the regulation of corticosteroidogenesis.
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Affiliation(s)
- I Lihrmann
- Université de Rouen, Mont-Saint-Aignan, France
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23
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Schiebinger RJ, Kem DC, Brown RD. Effect of atrial natriuretic peptide on ACTH, dibutyryl cAMP, angiotensin II and potassium-stimulated aldosterone secretion by rat adrenal glomerulosa cells. Life Sci 1988; 42:919-26. [PMID: 2830448 DOI: 10.1016/0024-3205(88)90391-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We examined the effect of rat atrial natriuretic peptide (ANP) on ACTH, dibutyryl cAMP, angiotensin II and potassium-stimulated aldosterone secretion by dispersed rat adrenal glomerulosa cells. ANP inhibited ACTH, angiotensin II and potassium-stimulated aldosterone secretion with IC50's between 0.15-0.20 nM. Inhibition by 10 nM ANP could not be overcome with higher concentrations of these stimuli. ANP shifted the dibutyryl cAMP dose-response curve slightly to the right but did not blunt the maximal aldosterone secretory response. The sites of ANP inhibition in the aldosterone biosynthetic pathway for these stimuli were also examined. ANP inhibited activation of the cholesterol desmolase (CD) enzyme complex by ACTH, angiotensin II and potassium. Activation of the corticosterone methyl oxidase (CMO) enzyme complex by potassium was inhibited by ANP, however, activation by ACTH was not blocked. We concluded that: 1) ANP is a potent inhibitor of ACTH, angiotensin II and potassium-stimulated aldosterone secretion; 2) inhibition of ACTH stimulation is primarily due to lower cAMP levels and; 3) inhibition of angiotensin II and potassium stimulation reflects a block in the activating mechanism of the CMO and/or CD enzyme complexes, whereas CD but not CMO activation by ACTH is inhibited by ANP.
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24
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Genest J, Cantin M. The atrial natriuretic factor: its physiology and biochemistry. Rev Physiol Biochem Pharmacol 1988; 110:1-145. [PMID: 2835808 DOI: 10.1007/bfb0027530] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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25
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Stasch JP, Hirth C, Kazda S, Neuser D. The reduction of renin and aldosterone as a response to acute hypervolemia is blocked by a monoclonal antibody directed against atrial natriuretic peptides. Life Sci 1988; 42:511-6. [PMID: 2828795 DOI: 10.1016/0024-3205(88)90091-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We have previously reported that the strong diuresis, natriuresis and urinary cyclic GMP excretion after acute volume loading in rats are caused by ANP and can be blocked by additionally given monoclonal antibodies directed against ANP. The present report describes that in contrast to the changes in ANP and cyclic GMP, the plasma renin activity and aldosterone concentration are decreased after volume loading. This decrease is completely blocked by simultaneous administration of the monoclonal antibodies. Plasma cyclic AMP levels are not affected. From this study it seems to be clear that the inhibition of the renin-aldosterone system is not a direct effect of volume expansion but is specially mediated by the released ANP.
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Affiliation(s)
- J P Stasch
- Bayer AG, Pharma Research Centre, Wuppertal, Federal Republic of Germany
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26
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Mazzocchi G, Rebuffat P, Nussdorfer GG. Atrial natriuretic factor (ANF) inhibits the growth and the secretory activity of rat adrenal zona glomerulosa in vivo. JOURNAL OF STEROID BIOCHEMISTRY 1987; 28:643-6. [PMID: 2961946 DOI: 10.1016/0022-4731(87)90392-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A prolonged infusion with ANF induced atrophy of zona glomerulosa cells of rat adrenals and lowering of plasma concentration of aldosterone, without provoking significant changes in PRA. It also notably reduced the rise in the aldosterone plasma level caused by the acute stimulation with angiotensin II. Zona fasciculata cells and the blood concentration of corticosterone did not display any significant change. These findings are interpreted to indicate that ANF exerts an inhibitory effect on the growth and secretory activity of rat zona glomerulosa.
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Affiliation(s)
- G Mazzocchi
- Department of Anatomy, University of Padua, Italy
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27
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Abstract
The sequence of atrial natriuretic factor (ANF) has been determined, as well as the complete structure of the rat and human complementary DNA and gene. ANF and ANF messenger RNA are present not only in atria but also in ventricles. The circulating form of ANF has been identified as the C-terminal of the molecule, ANF (Ser 99-Tyr 126). The isolated secretory granules of rat atrial cardiocytes contain only pro-ANF (Asn 1-Tyr 126). An enzyme (IRCM-SP1) has been isolated from heart atria and ventricles. This enzyme is highly specific in cleaving ANF (Asn 1-Tyr 126), to yield ANF (103-126), (102-126), and (99-126). In target cells, ANF produces a rise in cyclic guanosine 3',5'-monophosphate (cGMP) due to activation of particulate guanylate cyclase, and inhibition of adenylate cyclase leading in some cases to a decrease in cyclic adenosine 3',5'-monophosphate (cAMP). ANF produces relaxation of rabbit and rat aortic strips, inhibits steroidogenesis in both zona glomerulosa and zona fasciculata cells, and inhibits the release of arginine vasopressin from the isolated rat hypothalamohypophysial preparation in vitro but decreases AVP release in vivo only at pharmacological doses. In all forms of experimental hypertension, plasma levels of ANF are increased and, at some time periods, atrial levels are also decreased. The ventricular levels of immunoreactive ANF are also increased in renal hypertension. Infusion of ANF by minipumps decreases the blood pressure near control levels in several models of experimental hypertension. In cardiomyopathic hamsters with heart failure, the atrial levels of immunoreactive ANF are decreased while the plasma and ventricular levels are increased.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Cantin
- Laboratory of Pathobiology, Clinical Research Institute of Montreal, Quebec, Canada
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28
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Pandey KN, Inagami T, Girard PR, Kuo JF, Misono KS. New signal transduction mechanisms of atrial natriuretic factor: inhibition of phosphorylation of protein kinase C and A 240 kDa protein in adrenal cortical plasma membrane by cGMP dependent and independent mechanisms. Biochem Biophys Res Commun 1987; 148:589-95. [PMID: 2825665 DOI: 10.1016/0006-291x(87)90917-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The effects of synthetic atrial natriuretic factor (ANF) on the state of protein phosphorylation in plasma membranes of bovine adrenal cortex have been studied in vitro. ANF (1x10(-8)M - 1x10(-7)M) specifically inhibited the phosphorylation of two distinct proteins of 78 kDa and 240 kDa. Immunoblotting with specific antiserum to protein kinase C produced evidence that 78 kDa protein is most likely the protein kinase C whose phosphorylation is inhibited by both ANF and cGMP. However, cGMP did not affect the phosphorylation of 240 kDa protein, indicating a new cGMP-independent mechanism of ANF action in the adrenal, which is compatible with the lack of action of cGMP and its analogs in ANF-induced inhibition of aldosterone secretion from adrenal cortex. The inhibition of phosphorylation of putative protein kinase C by ANF or cGMP indicates a hitherto unknown signal transduction mechanism of ANF.
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Affiliation(s)
- K N Pandey
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232
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29
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Lauber M, Sugano S, Ohnishi T, Okamoto M, Müller J. Aldosterone biosynthesis and cytochrome P-45011 beta: evidence for two different forms of the enzyme in rats. JOURNAL OF STEROID BIOCHEMISTRY 1987; 26:693-8. [PMID: 3613569 DOI: 10.1016/0022-4731(87)91041-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Whereas cytochrome P-45011 beta has been recently shown to catalyze the two-step conversion of corticosterone to aldosterone in the bovine and porcine adrenal cortex, the identity of the enzyme involved in the two final steps of aldosterone biosynthesis in the rat adrenal cortex is as yet unknown. Mitochondria from capsular adrenals of sodium-deficient, potassium-replete rats converted corticosterone to 18-hydroxycorticosterone and aldosterone at markedly higher rates than mitochondria from capsular adrenals of sodium-replete, potassium-deficient rats. However, the same preparations exhibited no difference in the 11 beta-hydroxylase activity, i.e. the conversion of deoxycorticosterone to corticosterone. Only mitochondria of zona glomerulosa from rats with stimulated aldosterone biosynthesis contained a 49K protein which showed a strong cross-reactivity with a monoclonal antibody raised against purified bovine cytochrome P-45011 beta. By contrast, a crossreactive protein with a molecular weight of 51K was found in mitochondria of zona fasciculata and in mitochondria of zona glomerulosa from rats with a suppressed aldosterone biosynthesis. These findings indicate the existence of two different forms of cytochrome P-45011 beta in the rat adrenal cortex, with only one of them, i.e. the 49K form, being capable of catalyzing the two final steps of aldosterone biosynthesis in situ.
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30
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Atrial Natriuretic Factor Receptor Heterogeneity and Stimulation of Particulate Guanylate Cyclase and Cyclic GMP Accumulation. Endocrinol Metab Clin North Am 1987. [DOI: 10.1016/s0889-8529(18)30496-1] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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