α2A-Adrenoceptors modulate renal sympathetic neurotransmission and protect against hypertensive kidney disease

Lydia Hering, Masudur Rahman, Henning Hoch, Lajos Markó, Guang Yang, Annika Reil, Mina Yakoub, Vikram Gupta, Sebastian A. Potthoff, Oliver Vonend, Donna L. Ralph, Susan B. Gurley, Alicia A. McDonough, Lars C. Rump, Johannes Stegbauer

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Increased nerve activity causes hypertension and kidney disease. Recent studies suggest that renal denervation reduces BP in patients with hypertension. Renal NE release is regulated by prejunctional α2A-adrenoceptors on sympathetic nerves, and α2A-adrenoceptors act as autoreceptors by binding endogenous NE to inhibit its own release. However, the role of α2A-adrenoceptors in the pathogenesis of hypertensive kidney disease is unknown. Methods: We investigated effects of α2A-adrenoceptor-regulated renal NE release on the development of angiotensin II-dependent hypertension and kidney disease. In uninephrectomized wild-type and α2Aadrenoceptor- knockout mice, we induced hypertensive kidney disease by infusing AngII for 28 days. Results: Urinary NE excretion and BP did not differ between normotensive α2A-adrenoceptor-knockout mice and wild-type mice at baseline. However, NE excretion increased during AngII treatment, with the knockout mice displaying NE levels that were significantly higher than those of wild-type mice. Accordingly, the α2A-adrenoceptor-knockout mice exhibited a systolic BP increase, which was about 40 mm Hg higher than that found in wild-type mice, and more extensive kidney damage. In isolated kidneys, AngIIenhanced renal nerve stimulation induced NE release and pressor responses to a greater extent in kidneys from α2A-adrenoceptor-knockout mice. Activation of specific sodium transporters accompanied the exaggerated hypertensive BP response in α2A-adrenoceptor-deficient kidneys. These effects depend on renal nerves, as demonstrated by reduced severity of AngII-mediated hypertension and improved kidney function observed in α2A-adrenoceptor-knockout mice after renal denervation. Conclusions: Our findings reveal a protective role of prejunctional inhibitory α2A-adrenoceptors in pathophysiologic conditions with an activated renin-angiotensin system, such as hypertensive kidney disease, and support the concept of sympatholytic therapy as a treatment.

Original languageEnglish (US)
Pages (from-to)783-798
Number of pages16
JournalJournal of the American Society of Nephrology
Volume31
Issue number4
DOIs
StatePublished - Apr 2020

ASJC Scopus subject areas

  • Nephrology

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