Paradoxical Behaviors of Prostaglandins and of Renin-Angiotensin-Aldosterone Systems in Sodium Regulation of the Body

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There appears to be a complex relationship between the renin-angiotensin system and pro- staglandin generating systems. Recently, it has been reported that the use of inhibitors of pro- staglandin (PG) synthesis in Butter's syndrome resulted in correction of hypersecretion of rien, angiotensin and aldosterone as well as hypokalemia seen in this syndrome. This strongly suggested that PGs play a primary role in sodium regulation of the body, secondarily influencing renin-angiotensin-aldosterone system.<BR>The present study was undertaken critically to examine these points.<BR>Indomethacin suppressed PGs and the body weight increased due to the retention of sodium. Renin-angiotensin-aldosterone system was also suppressed at the same time. However, when the body fluid increased to a certain level, sodium excretion from the kidney began to rise in spite of the sustained suppression of PGs. This sequence of events is analogous to the escape phenomenon seen in mineralocorticoid excess syndrome. However, an interesting thing was that indomethacin seemed to inhibit the increase of potassium excretion accompanying the rise of sodium excretion at that time. In contrast, another inhibitor of PGs, ibuprofen, though simulating mostly the action of indomethacin, did not reveal the inhibition of potassium excretion. Thus, it did not seem that the effect of indomethacin was directly related to its effects as a PG inhibitor. Rather, indometha- cin may primarily cause an intrarenal circulatory change, which in turn causes various changes in all the parameters including PGs, renin-angiotensin-aldosterone system. It is not clear whether the effect of indomethacin to suppress sodium potassium exchange in the renal tubules is related to the intrarenal circulatory changes.<BR>Furthermore, during the prolonged treatment with indomethacin, PGs as well as renin-angiotensin-aldosterone systems tended to return to and even to surpass the initial levels. Similar perplexing results were also seen during the treatment of essential hypertension with diuretics. Once elevated PGs and renin-angiotensin-aldosterone systems all tended to return to the initial state under the sustained influence of diuretics. The behavior of these parameters in congestive heart failure was also to be noted because of their peculiar movements. PG generation system and renin-angiotensin-systems dissociated from each other in this pathological condition. This may be due to the abnormal distribution of intra-renal blood flow. These observations when taken altogether, request us to return to the primitive question; What are the role of renin-angiotensin- aldosterone systems and that of PGs in the sodium regulation of the body?
Japan Society of Clinical Chemistryの論文

Paradoxical Behaviors of Prostaglandins and of Renin-Angiotensin-Aldosterone Systems in Sodium Regulation of the Body

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