Reversal by verapamil of defect in sodium transport in leucocytes in essential hypertension

Erythrocyte sodium transport in malignant hypertension

Twenty-three patients with treated malignant hypertension (MH), 23 patients with treated non-malignant hypertension (NMH) and 46 normotensive control subjects were investigated with regard to intraerythrocyte sodium (Na) and potassium (K) levels, as well as transmembrane fluxes of sodium (Na-influx and Na-efflux rate constant). Intraerythrocyte Na and K concentrations were determined by flame photometry. The Na-influx and Na-efflux rate constant were calculated from uptake values for 22Na in vitro. In NMH the Na-influx and Na-efflux rate constant were significantly higher while intraerythrocyte Na and K levels did not differ from the controls. Patients with MH tended to have an elevated intraerythrocyte Na concentration, but an unchanged Na-influx and Na-efflux rate constant relative to controls. The increased rate of erythrocyte membrane transport of Na in treated NMH could be due to a stimulatory effect of antihypertensive treatment on cellular Na transport. Patients with treated MH do not show this effect, and in addition, tend to have an elevated intraerythrocyte Na concentration, which is compatible with the existence of a more pronounced abnormality of cellular ion transport in MH.

Influence of magnesium on blood pressure and the effect of nifedipine in rats

The influence of long-term alterations in dietary magnesium intake on blood pressure and on the antihypertensive effect of the calcium antagonist nifedipine was investigated in normotensive Wistar-Kyoto (WKY) and in spontaneously hypertensive rats (SHR). The rats were fed a diet either high (1%), normal (0.1%), or low (0.01%) in magnesium for 12 weeks (WKY) and 20 weeks (SHR), respectively. Nifedipine was added to the diet for 4 weeks in concentrations of 300 and 1000 ppm. Each dose was given for 2 weeks. Plasma and intraerythrocytic concentrations of sodium, potassium, and magnesium were measured before and at the end of nifedipine treatment. Blood was obtained by cardiac puncture. In the WKY and SHR, blood pressure was not influenced by magnesium intake. The blood pressure-lowering effect of nifedipine was most pronounced on normal dietary magnesium and was significantly suppressed in the magnesium-deficient rats. Plasma and intracellular total magnesium concentrations were consistently increased during high and reduced during low dietary intake of the ion. Intracellular sodium concentration increased during magnesium deficiency and was normalized by nifedipine. The marked and long-term alterations in plasma and intracellular concentrations of magnesium did not influence arterial blood pressure levels in either the normotensive WKY or the SHR. Therefore, dietary magnesium intake does not appear to play an important role in long-term regulation of blood pressure in rats. However, magnesium depletion attenuates the blood pressure-lowering effect of nifedipine.

Reversible inhibition of leucocyte sodium pumps by a circulating serum factor in essential hypertension

To test whether leucocyte sodium pumps function abnormally in patients with essential hypertension specific tritium-ouabain binding (number of pumps) and ouabain sensitive uptake of rubidium-86 (86Rb+) (transport activity) were measured in mononuclear leucocytes from 37 untreated hypertensive patients and 85 normotensive subjects. Ouabain binding was lower and transport activity per binding site higher in the hypertensive patients before incubation (p less than 0.001), but both variables were normal after incubation for 72 hours with fetal calf serum. To determine whether a circulating inhibitor of sodium pumps was present in patients with hypertension ouabain binding and 86Rb+ uptake were measured in normal leucocytes before and after incubation for 72 hours with serum from 13 untreated hypertensive patients and 18 normotensive subjects. Ouabain binding was lower after incubation of cells with serum from hypertensive patients than after incubation with normal serum both before (p less than 0.01) and after (p less than 0.001) dialysis of the serum. The results suggest that in hypertension a circulating serum inhibitor of the sodium pump causes a chronic but reversible reduction in the number of pumps.

The neurochemistry of mania. The effect of lithium on catecholamines, indoleamines and calcium mobilization

In an attempt to elucidate the chemical pathology of mania one has to consider the pharmacology of the two most effective treatments for this illness: lithium and the neuroleptics. Some of the possible mechanisms of action of these drugs on catecholamine and indoleamine mechanisms are discussed. The majority of this article is based on my and my colleagues' work which has been carried out in this MRC Laboratory on the effect of lithium on biological variates in bipolar patients and the effects of the administration of antidepressant treatments in these patients. It is concluded that lithium has a similar action on these mechanisms in both unipolar and bipolar patients which might suggest a common pathology in both unipolar and bipolar illness. It is suggested that in order to maintain an euthymic state in a bipolar patient one should maintain a certain degree of sensitivity of 5-HT2 receptors. This sensitivity may be related to the activity of calcium channels and to the polyphosphoinositide system. The former system can be regulated by the administration of calcium channel antagonists which have been shown to be effective in the treatment of mania. The polyphosphoinositide system is one that can be regulated by therapeutic concentrations of lithium. It is concluded that co-administration of a calcium channel antagonist and lithium may be a very effective treatment for mania.

Erythrocyte phosphate release in essential hypertension

In this study erythrocyte phosphate release depended on the intracellular hydrolysis of organic phosphate esters. Total phosphate release was increased in essential hypertension, which suggests an elevated phosphate ester metabolism. Ouabain-sensitive phosphate release was decreased, and the ratio of intracellular Na+/K+ concentrations was increased, a finding consistent with a diminished Na-K-ATPase activity. Furosemide in a concentration of 1.0 mmol/L inhibited erythrocyte phosphate release by half, probably owing to nonspecific membrane effects. The combination of ouabain and furosemide reduced phosphate transfer to a higher degree than did each substance individually. Because of the nonspecific alteration of erythrocyte membrane permeability by furosemide in a concentration of 1.0 mmol/L, ouabain-insensitive, furosemide-sensitive phosphate release and ouabain-insensitive, furosemide-sensitive Na+ efflux (Na-K cotransport) must not be regarded uncritically as specific transport systems.

Noradrenaline: a circulating inhibitor of sodium transport

Leucocytes were isolated from venous blood of 11 normotensive volunteers with no family history of hypertension and the sodium efflux rate constants determined both alone and in the presence of increasing physiological concentrations of noradrenaline. There was a significant dose dependent reduction of total sodium efflux rate constant due to a reduction in ouabain sensitive sodium pump activity, glycoside insensitive efflux rate constants being unaffected. The magnitude of this effect was similar to the reduction in leucocyte sodium efflux rate constants observed in hypertensive patients (and their normotensive relatives). The noradrenaline induced depression of sodium pump activity was prevented by propranolol in a further seven experiments, suggesting that the effect was mediated by beta adrenoceptors. Catecholamines possibly functioning as circulating inhibitors of sodium transport may contribute to some of the disturbances in membrane electrolyte handling both in essential hypertension in man and in some experimental models of hypertension.