Insulin-induced renin release: blockade by indomethacin in the rat

Effect of insulin-induced hypokalemia on lumbar sympathetic nerve activity in anesthetized rats

OBJECTIVE

Acute euglycemic hyperinsulinemia produces sympathoexcitation and a profound fall in plasma potassium levels. Because hypokalemia may activate the renin-angiotensin system to produce the observed increases in sympathetic nerve activity (SNA), the present study was designed to determine whether acute euglycemic-hyperinsulinemia in rats causes decreases in plasma potassium accompanied by increases in plasma renin activity (PRA) as well as elevations in SNA, and whether these alterations would be prevented by maintaining normokalemia with an exogenous potassium infusion.

METHODS

We infused vehicle (control; n = 10) or insulin (10 mU/min) in anesthetized untreated rats (insulin; n = 11), or in rats receiving simultaneous KCl infusion (Insulin + K+; n = 10), while measuring mean arterial pressure (MAP), heart rate (HR), SNA, plasma potassium, and PRA during euglycemic clamp.

RESULTS

As expected, insulin rats had a large fall in plasma potassium (4.6 +/- 0.1 to 3.9 +/- 0.1 mEq/l), contrasting with no change in the control (4.8 +/- 0.2 to 4.8 +/- 0.2 mEq/l) and insulin + K+ (4.4 +/- 0.1 to 4.6 +/- 0.2 mEq/l) groups. However, PRA levels at study completion were not different in the three experimental groups. In addition, insulin rats had large increases in lumbar SNA (194 +/- 11% from 100% baseline) compared with modest elevations in control rats (122 +/- 10%), and prevention of hypokalemia failed to affect sympathetic increases (213 +/- 20%) in insulin + K+ rats. MAP and HR did not change in any of the experimental groups.

CONCLUSIONS

These findings indicate that insulin per se, rather than insulin-induced hypokalemia or hormonal and compensatory adjustments secondary to hypokalemia, is the main mechanism that triggers increases in lumbar SNA.

Insulin-exacerbated hypertension in captopril-treated spontaneously hypertensive rats: role of sympathoexcitation

Insulin excess exacerbates hypertension in spontaneously hypertensive rats (SHR). This study examined the relative contribution of the renin–angiotensin system and the sympathetic nervous system in this phenomenon. In SHR, daily subcutaneous injections of insulin were initiated either before short-term angiotensin-converting enzyme inhibition with captopril or after lifetime captopril treatment. Insulin treatment resulted in significant increases in mean arterial pressure and heart rate and captopril treatment lowered arterial pressure, but captopril did not lower arterial pressure more in the insulin-treated compared with control rats. To test the contribution of the sympathetic nervous system to this form of hypertension, each rat was intravenously infused with either a ganglionic blocker (i.e., hexamethonium) or a centrally acting α2-adrenergic receptor agonist (i.e., clonidine). Administration of either agent largely eliminated the differences in mean arterial pressure and heart rate between the insulin-treated and saline-treated SHR, irrespective of captopril treatment. These data indicate that in SHR, the ability of insulin to increase blood pressure is closely related to sympathoexcitation, which is unresponsive to blockade of angiotensin-converting enzyme.Key words: blood pressure, insulin, captorpil, hexamethonium, clonidine, rat.

Renal function in spontaneously hypertensive rats with insulin-exacerbated hypertension

This study tests the hypothesis that in spontaneously hypertensive rats (SHR), insulin decreases natriuresis and diuresis and thereby contributes importantly to the hypertensive response to exogenous insulin administration. Seven week old SHR were given daily subcutaneous injections of either insulin (mixture of 5 U/Kg regular and 10 U/Kg NPH) or vehicle (isotonic saline). Within one week of treatment, systolic arterial pressure (SAP) was significantly higher in the insulin, compared to saline, treated SHR (184.2 +/- 2.5 vs. 158.3 +/- 4.0 mm Hg). However, twenty-four hour sodium and fluid excretion and the natriuretic and diuretic responses to an intravenous saline load were not affected either before or after the insulin-induced exacerbation of hypertension in SHR. Insulin treatment did not affect glomerular filtration rate, effective renal blood flow, or fractional excretion of Na+ or fluid. Therefore, our data do not support a major role for sodium and fluid retention in the insulin-induced exacerbation of hypertension in SHR.

Contribution of the sympathetic nervous system to hypertensive response to insulin excess in spontaneously hypertensive rats

Our previous studies demonstrate that chronic insulin administration exacerbates hypertension in spontaneously hypertensive rats (SHR). In the present study, we tested the hypothesis that the pressor effect of insulin in SHR is medicated by sympathetic nervous system overactivity. Male SHR (7 weeks old) were given daily subcutaneous injection of insulin or vehicle for 3 days, after which each rat received an intravenous infusion of the peripheral ganglionic blocker hexamethonium. Two days later, in a second experiment, the infusion protocol was repeated with the alpha 2-adrenoceptor agonist clonidine, which more selectively inhibits sympathetic (as compared with parasympathetic) nervous system activity. Insulin treatment for 3 days caused a significant increase in mean arterial pressure (MAP; 164 +/- 2 mm Hg vs. saline control 148 +/- 3 mm Hg), but ganglionic blockade with hexamethonium eliminated the difference in blood pressure (BP) between the insulin-treated and control SHR. Infusion of clonidine significantly reduced MAP in the insulin-treated group to the level of the untreated control SHR, but the infusion did not reduce MAP in the latter group. In a second group of rats, acute administration of prazosin also eliminated the difference in MAP between insulin-treated and control SHR. We conclude that in SHR the sympathetic nervous system contributes importantly to the pressor effect of insulin administration and that this effect may be mediated by the central nervous system.

Attenuation of insulin-induced drinking by beta-adrenoceptor antagonists

Insulin-induced drinking (IID) in male Wistar rats, evoked by administering 5 U/kg of crystalline porcine insulin i.p., was significantly decreased by propranolol (0.1 and 0.5 mg/kg s.c.) after 1 and 2 h. The blood glucose of rats treated with a much higher dose of propranolol (10 mg/kg body weight) and insulin did not differ from that of rats treated solely with insulin after 30 and 120 min. Atenolol (0.5 mg/kg s.c.) caused a reduction in IID after 1 and 2h. Butoxamine (1 mg/kg s.c.) also reduced IID after 1 and 2h, and at 0.5 mg/kg after 1h. The alpha-blocker, phenoxybenzamine (10 mg/kg s.c.), had the opposite effect, stimulating IID after 2h. There is no direct evidence that insulin activated the sympathetic system at the doses used in these experiments. Nevertheless, the results reported here seem to be compatible with the involvement of the sympathetic system in IID, possible through the renin-angiotensin system.

Insulin stimulation of water intake in humans

Drinking response to the intravenous administration of insulin (0.1 U/kg) was studied in 15 volunteers (eight males and seven females). Water intake was significantly higher after insulin than after saline administration during the 90-min period studied. Plasma glucose decreased significantly in individuals receiving insulin and the time of the maximum decrease (30 min) was concurrent with the beginning of water intake. Haematocrit values in the insulin-treated group were also significantly higher at that time. Plasma renin activity (PRA) after insulin administration was higher than under basal conditions or after saline injection. On the other hand, psychological responses indicated that insulin probably elicits thirst prior to the hunger which appears with hypoglycaemia. A possible role of endogenous insulin in meal-related thirst is hypothesized.

Effects of inhibitors of the renin-angiotensin system on water intake after insulin administration

Male wistar rats drank in a dose-related manner, in response to 1 to 40 U/kg of i.p. insulin. Maximum intakes took place during the first 30 min after i.p. insulin administration, coinciding with the period of maximal drop of blood glucose. Plasma renin activity (PRA) in rats treated with i.p. insulin was higher than in basal conditions or after saline injection. Nephrectomy and adrenalectomy did not abolish insulin-induced drinking. A low dose of captopril (0.1 mg/kg s.c.) did not modify insulin-induced drinking, but a higher dose (10 mg/kg s.c.), or enalapril (0.5 mg/microgram s.c.), significantly increased insulin-induced drinking. Enhancement of insulin-induced drinking by s.c. captopril was not secondary to an increased diuresis. Captopril (50 micrograms i.c.v.) significantly reduced the cumulative water intake after i.p. insulin (20 U/kg i.p.) plus s.c. captopril (10 mg/kg). The blockade of central receptors for angiotensin II with sarile-AII (5 micrograms) significantly diminished insulin-induced drinking. It appears that the peripheral renin angiotensin system is not necessary for insulin-induced drinking but central angiotensin II plays an important role.

In vitro evidence for a blood-borne renin-releasing factor

The present studies using kidney slices were designed to test whether serotonergic stimulation of renin secretion is mediated via an endocrine signal. Previous in vivo studies have indicated that central serotonergic neurons regulate renin secretion. Administration of the serotonin releaser dl-p-chloroamphetamine-HCl (PCA) to rats causes dose-dependent increases in renin secretion that can be blocked by serotonin depletion with p-chlorophenylalanine (PCPA), injections of 5,7-dihydroxytryptamine into the dorsal raphe nucleus or ablation of the mediobasal hypothalamus. The renin-releasing substance was obtained from nephrectomized male donor rats which were sacrificed 1 hour after receiving an injection of PCA intraperitoneally. Plasma from rats that received saline injections was used as control. The plasma was collected and separated by ultrafiltration into fractions containing solutes with molecular weights between 500-10,000 daltons. The renin-releasing ability of this substance was studied in vitro using rat renal cortical slices. The plasma fraction (M.W. = 500 - 10,000) from rats treated with PCA caused dose-dependent increases in renin release from the kidney slices. Heating of the plasma factor at 100 degrees C for 30 minutes did not reduce the ability of this substance to release renin from the kidney slices. PCA alone (66 X 10(-6)M) did not increase renin release from the kidney slices. These data suggest that stimulation of serotonergic receptors in the brain triggers the release of an endocrine factor that is capable of directly stimulating renin release from the kidneys.

Relationship between PG and beta-adrenergic pathways to renin release in rat renal cortical slices

The precise importance of prostaglandin (PG) in the beta-adrenergic pathway to renin release is unresolved. Thus, we examined this question using renal cortical slices from Sprague-Dawley rats incubated in Krebs-Ringer bicarbonate mixture (KRB), KRB + isoproterenol (10(-5) M, ISO), or a solution containing KRB + ISO + either propranolol (PRO, 10(-5) M) or indomethacin (IN, 10(-5) M). Media samples were assayed for renin activity, 6-keto-PGF1 alpha (the stable metabolite of PGI2), and PGE2. ISO only increased renin release 1.96-fold; modest increments in 6-keto-PGF1 alpha and PGE2 also occurred. The addition of PRO prevented these increases. In the next series of studies, ISO again increased renin, but the addition of IN failed to modify this increase in renin release. However, IN did prevent any increase in 6-keto-PGF1 alpha or PGE2. Meclofenemate (10(-5) M) provided results similar to those of IN. PGI2 was found to stimulate the release of renin in concentrations of 10(-7) M. The combination of submaximal stimulatory concentrations of PGI2 (10(-6) M, a 1.6-fold increment) and ISO (10(-6) M, a 1.7-fold increment) produced a synergistic increase in renin release (2.84-fold). These results demonstrate that renal prostaglandins do not function as essential mediators of the beta-adrenergic pathway to renin release. Rather, high concentrations of prostaglandins may increase the renin-releasing action of beta-agonists, thereby modulating the release of renin.

The effect of prostaglandin synthesis inhibition on the direct stimulation of renin release from rabbit renal cortical slices

Prostaglandins have been hypothesized to have several mechanistic functions in sympathetically mediated release of renin. The rabbit renal cortical slice system was chosen to examine the prostaglandin dependency of renin release directly stimulated by either a direct adenylate cyclase activator, forskolin, or a beta-agonist, isoproterenol. In this study, we demonstrate that with forskolin (1 X 10(-5) M) or isoproterenol (1 X 10(-6) M), renin release was elevated 2-3 fold above control, and that this increase was shown to accompany a substantial increase in the tissue levels of cAMP (19.5 fold and 3.5 fold respectively). We also demonstrate that the increase in renin release produced by these compounds was not inhibited by cyclooxygenase inhibitors, indomethacin (25 microM) or eicosatetraynoic acid (30 micrograms/ml), nor was it inhibited by the selective prostacyclin synthesis inhibitor, U-51605 (30 micrograms/ml). Each of these inhibitors was demonstrated to block the synthesis of prostaglandins in the cortical slices at the concentrations used. Thus we propose that prostaglandins do not play a role in the induction of renin release resulting from elevated cyclic nucleotide levels or beta-adrenergic stimulation.

Dissociation of beta-adrenergic stimulation of renin secretion and prostacyclin synthesis in the rabbit kidney

The effect of inhibition of prostaglandin (PG) synthesis with indomethacin on basal and isoproterenol-stimulated renin secretion was examined in the isolated perfused rabbit kidney. 6-keto PGF1 alpha' the stable metabolite of prostacyclin, was measured in urine by radioimmunoassay using 125I labelled histamine coupled to 6-keto PGF1 alpha as ligand. The level in urine, prior to isolation and perfusion of the kidney, was 10.7 +/- 5.6 ng/min, and this was reduced to 0.32 +/- 0.25 ng/min (P less than 0.05) in rabbits treated with 2.0 mg/kg of indomethacin. Renin release was markedly stimulated by intrarenal infusion of isoproterenol (0.1 microgram/min) but urinary 6-keto PGF1 alpha did not change. These responses were not affected by indomethacin treatment. Renal perfusion pressure, perfusate flow rate and consequently renal vascular resistance, remained relatively constant during the course of perfusion and were unaltered by indomethacin treatment. These results therefore do not support a role for PGs, and in particular prostacyclin, in the renin response to beta-adrenergic stimulation with isoproterenol.