Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor Enhance Angiotensin II-Induced Renal Vascular Sensitivity and Reduce Renal Function During Pregnancy

作者：Cunningham Mark W Jr; Williams Jan M; Amaral Lorena; Usry Nathan; Wallukat Gerd; Dechend Ralf; LaMarca Babbette^*

来源：Hypertension, 2016, 68(5): 1308-1313.

DOI：10.1161/HYPERTENSIONAHA.116.07971

• angiotensin II
• autoantibodies
• hypertension
• preeclampsia
• pregnancy

Preeclamptic women produce agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA) and exhibit increased blood pressure (mean arterial pressure), vascular sensitivity to angiotensin II (ANG II), and display a decrease in renal function. The objective of this study was to examine the renal hemodynamic changes during pregnancy in the presence of AT1-AAs with or without a slow pressor dose of ANG II. In this study, mean arterial pressure was elevated in all pregnant rats treated with ANG II with or without AT1-AA. Glomerular filtration rate was reduced from 1.90 +/- 0.16 mL/min in normal pregnant (NP) to 1.20 +/- 0.08 in ANG II+AT1-AA rats. Renal blood flow was decreased in ANG II+AT1-AA versus NP rats to 7.4 +/- 1.09 versus 15.4 +/- 1.75 mL/min. Renal vascular resistance was drastically increased between ANG II+AT1-AA versus NP rats (18.4 +/- 2.91 versus 6.4 +/- 0.77 mmHg/mL per minute). Isoprostane excretion was increased by 3.5-fold in ANG II+AT1-AA versus NP (1160 +/- 321 versus 323 +/- 52 pg/mL). In conclusion, ANG II and AT1-AA together significantly decrease glomerular filtration rate by 37% and renal blood flow by 50% and caused a 3-fold increase in renal vascular resistance and isoprostane levels versus NP rats. These data indicate the importance of AT1-AAs to enhance ANG II-induced renal vasoconstriction and reduce renal function as mechanisms to cause hypertension as observed during preeclampsia.