Purinergic inhibition of ENaC produces aldosterone escape

J Am Soc Nephrol. 2010 Nov;21(11):1903-11. doi: 10.1681/ASN.2010040377. Epub 2010 Sep 2.

Abstract

The mechanisms underlying "aldosterone escape," which refers to the excretion of sodium (Na(+)) during high Na(+) intake despite inappropriately increased levels of mineralocorticoids, are incompletely understood. Because local purinergic tone in the aldosterone-sensitive distal nephron downregulates epithelial Na(+) channel (ENaC) activity, we tested whether this mechanism mediates aldosterone escape. Here, urinary ATP concentration increased with dietary Na(+) intake in mice. Physiologic concentrations of ATP decreased ENaC activity in a dosage-dependent manner. P2Y(2)(-/-) mice, which lack the purinergic receptor, had significantly less increased Na(+) excretion than wild-type mice in response to high-Na(+) intake. Exogenous deoxycorticosterone acetate and deletion of the P2Y(2) receptor each modestly increased the resistance of ENaC to changes in Na(+) intake; together, they markedly increased resistance. Under the latter condition, ENaC could not respond to changes in Na(+) intake. In contrast, as a result of aldosterone escape, wild-type mice had increased Na(+) excretion in response to high-Na(+) intake regardless of the presence of high deoxycorticosterone acetate. These data suggest that control of ENaC by purinergic signaling is necessary for aldosterone escape.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adenosine Triphosphate / urine
  • Aldosterone / metabolism*
  • Animals
  • Desoxycorticosterone / analogs & derivatives
  • Desoxycorticosterone / pharmacology
  • Down-Regulation / physiology*
  • Epithelial Sodium Channels / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Models, Animal
  • Nephrons / drug effects
  • Nephrons / metabolism*
  • Receptors, Purinergic P2Y2 / deficiency*
  • Receptors, Purinergic P2Y2 / genetics
  • Receptors, Purinergic P2Y2 / metabolism
  • Sodium / urine
  • Sodium, Dietary / pharmacology

Substances

  • Epithelial Sodium Channels
  • Receptors, Purinergic P2Y2
  • Sodium, Dietary
  • Desoxycorticosterone
  • Aldosterone
  • Adenosine Triphosphate
  • Sodium