The acute blood pressure-lowering effect of amiloride is independent of endothelial ENaC and eNOS in humans and mice

Acta Physiol (Oxf). 2019 Jan;225(1):e13189. doi: 10.1111/apha.13189. Epub 2018 Oct 11.

Abstract

Aims: The epithelial sodium channel (ENaC) is expressed in cultured endothelial cells and inhibitory coupling to eNOS activity has been proposed. The present study tested the hypothesis that ENaC blockers increase systemic NO-products and lower blood pressure in patients and mice, depending on eNOS.

Methods: NO-products and cGMP were measured in diabetes patient urine and plasma samples before and after amiloride treatment (20-40 mg for two days, plasma n = 22, urine n = 12 and 5-10 mg for eight weeks, plasma n = 52, urine n = 55). Indwelling catheters were implanted in the femoral artery and vein in mice for continuous arterial blood pressure and heart rate recordings and infusion.

Results: Treatment with amiloride for two days increased plasma and urine NO-products, while plasma cGMP decreased and urinary cGMP was unchanged in patient samples. Eight weeks of treatment with amiloride did not alter NO-products and cGMP. In mice, amiloride boli of 5, 50, and 500 µg/kg lowered heart rate and arterial blood pressure significantly and acutely. Benzamil had no effect on pressure and raised heart rate. In hypertensive eNOS-/- and L-NAME-treated mice, amiloride lowered blood pressure significantly. L-NAME infusion significantly decreased NO-products in plasma; amiloride and eNOS-deletion had no effect. An acetylcholine bolus resulted in acute blood pressure drop that was attenuated in eNOS-/- and L-NAME mice. ENaC subunit expressions were not detected consistently in human and mouse arteries and endothelial cells.

Conclusion: Amiloride has an acute hypotensive action not dependent on ENaC and eNOS and likely related to the heart.

Keywords: EnNaC; Hypertension; L-NAME; Nitric oxide; benzamil; diabetes.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid Sensing Ion Channel Blockers / pharmacology
  • Amiloride / analogs & derivatives
  • Amiloride / pharmacology*
  • Animals
  • Blood Pressure / drug effects
  • Diabetes Mellitus, Type 1
  • Diabetes Mellitus, Type 2
  • Endothelial Cells / drug effects*
  • Endothelial Cells / metabolism
  • Epithelial Sodium Channels / metabolism*
  • Gene Expression Regulation / drug effects
  • Humans
  • Hypertension / drug therapy
  • Mice
  • Mice, Knockout
  • Nitric Oxide Synthase Type III / genetics
  • Nitric Oxide Synthase Type III / metabolism*

Substances

  • Acid Sensing Ion Channel Blockers
  • Epithelial Sodium Channels
  • benzamil
  • Amiloride
  • NOS3 protein, human
  • Nitric Oxide Synthase Type III
  • Nos3 protein, mouse