Circulation. 1997;95:240-244
(Circulation. 1997;95:240-244.)
© 1997 American Heart Association, Inc.
Vascular Endothelin-1 Gene Expression and Effect on Blood Pressure of Chronic ETA Endothelin Receptor Antagonism After Nitric Oxide Synthase Inhibition With L-NAME in Normal Rats
Pavol Sventek, MD;
Andre Turgeon;
Ernesto L. Schiffrin, MD, PhD
the MRC Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal (Quebec), Canada.
Correspondence to Ernesto L. Schiffrin, MD, PhD, Clinical Research Institute of Montreal, 110 Pine Ave W, Montreal, Quebec, Canada H2W 1R7.
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Abstract
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Background Vascular expression of the endothelin-1 gene may
be associated with severe vascular hypertrophy. Because in rats,
inhibition of NO synthase with the
L-arginine analogue
N
-nitro-
L-arginine
methyl ester (L-NAME) induces blood pressure elevation associated
with little cardiovascular hypertrophy, we studied vascular
endothelin-1 gene expression in L-NAMEtreated rats and
the effects of chronic endothelin antagonism.
Methods and Results Sprague-Dawley rats received 100 mg·kg-1·d-1 L-NAME in their drinking water for 3 weeks. Systolic blood pressure rose to 189±3 mm Hg (P<.001 versus control rats). By Northern blot analysis, endothelin-1 mRNA levels were similar in aortas and mesenteric arteries of control and L-NAMEtreated rats. The blood pressure of L-NAME hypertensive rats treated with the ETA-selective endothelin receptor antagonist A-127722 for 3 weeks at a low dose (10 mg·kg-1·d-1) and a high dose (30 mg·kg-1·d-1) was not different from that of rats receiving L-NAME but not the endothelin antagonist. Treatment with the ACE inhibitor cilazapril lowered the blood pressure of L-NAMEtreated rats equally whether or not they were receiving the ETA antagonist.
Conclusions These results indicate that the endothelin system does not participate to an important degree in the mechanisms leading to elevated blood pressure after chronic NO synthase inhibition with L-NAME in normal rats. In the chronic model of L-NAMEinduced hypertension, blockade of the renin-angiotensin system does not unmask an endothelin-dependent vasopressor tone. In addition, either NO does not regulate vascular endothelin-1 gene expression or L-NAME exerts an inhibitory effect on endothelin expression in blood vessels.
Key Words: hypertension arteries hypertrophy angiotensin
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Introduction
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Acute or chronic administration of NOS inhibitors induces blood
pressure elevation in normal rats.
1 2 3 4 5 This may be the
result of inhibition of generation of vascular
1 and renal NO
basal production.
6 7 In the vasculature, the balance between
vasoconstrictor and vasodilator inputs is then altered as tonic
inhibition of vascular tone by NO is reduced.
4 5 In the kidney,
the disappearance of the natriuretic influence of NO may contribute
to sodium retention and blood pressure elevation.
6 7 NO may
exert part of its vascular effects via inhibition of smooth
muscle cell growth.
8 Thus, inhibition of NOS should result
in enhanced cardiovascular hypertrophy. However, it is surprising
that despite the elevation of blood pressure, in the hypertensive
model induced by inhibition of NOS with the
L-arginine analogue
L-NAME, there was little cardiac hypertrophy.
4 5 9 In addition,
there was little or no detectable vascular hypertrophy, particularly
of small, resistance-size arteries.
4 5 10 We recently suggested
that this finding could be the result of an inhibitory effect
of L-NAME on growth
11 independent of the opposing action expected
from the inhibition of generation of NO,
8 which should in fact
stimulate cell proliferation.
The role of endothelins in hypertension is not well understood.12 13 14 Endothelins may participate in smooth muscle cell growth.15 The endothelin-1 gene is overexpressed in blood vessels from different vascular beds of DOCA-salt hypertensive rats16 17 18 19 as well as in malignant DOCA-salttreated SHR,20 and this is associated with severe vascular hypertrophy. These experimental hypertensive models respond with a slight but significant reduction in the elevation of blood pressure during acute or chronic treatment with endothelin receptor antagonists.21 22 23 24 This has suggested that enhanced vascular expression of the endothelin-1 gene may play a role in blood pressure elevation, not only through vasoconstriction but also via induction of vascular hypertrophy.14 21 Since NO may inhibit endothelin-1 gene expression,25 L-NAME treatment could result in enhanced expression of endothelin-1. Indeed, in SHR, it was recently found that chronic administration of L-NAME induces enhanced vascular endothelin-1 gene expression in large conduit arteries.26 There is also in vivo evidence that in anesthetized rats, an endothelin-induced vasopressor tone after inhibition of NO synthesis in rats may be unmasked by interruption of the renin-angiotensin system with ACE inhibitors in acute experiments.27
We therefore decided to examine vascular endothelin-1 gene expression in rats made hypertensive by administration of the NOS inhibitor L-NAME. It was hypothesized that since these rats present little cardiovascular hypertrophy even though their blood pressure is very high,5 6 7 8 9 10 vascular endothelin-1 gene expression might not be enhanced, because if endothelin-1 were overexpressed, this could have contributed to accentuation of vascular hypertrophy.14 To complete the evaluation of a potential endothelin-dependent component in L-NAMEinduced hypertension, chronic treatment of these rats with an ETA-selective endothelin receptor antagonist using the new, potent orally active agent A-12772228 was investigated to determine whether it was able to affect blood pressure elevation in this hypertensive model. Finally, we asked whether it would be possible to unmask an endothelin-dependent vasopressor tone by administration of an ACE inhibitor if endothelin antagonism should fail to lower blood pressure, which would be demonstrated by a greater lowering of blood pressure in response to the interruption of the renin-angiotensin system in L-NAMEtreated rats receiving the endothelin receptor antagonist, as previously suggested in short-term experiments by other investigators.27
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Methods
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Animal Experiments
The protocol was approved by the Animal Care Committee of the
Clinical Research Institute of Montreal and followed the recommendations
of the Canadian Council for Animal Care. Sprague-Dawley rats
were bought from Charles River (St Constant, Quebec). They were
exposed to a 12-hour light/dark cycle, an ambient temperature
of 22°C, and humidity of 60%. They were offered tap water
or water containing L-NAME at a concentration adjusted daily
such that rats received 100 mg·kg
-1·d
-1, as previously
described.
4 5 Sixteen L-NAMEtreated rats were also treated
for 6 weeks with 10 or 30 mg·kg
-1·d
-1 of the ET
A endothelin receptor antagonist A-127722 (kindly provided by
Dr T.J. Opgenorth, Abbott Laboratories, Abbott Park, Ill) dissolved
in their drinking water. The lower dose of A-127722 chosen is
the one that, when administered by gavage, was effective in
blocking, for >24 hours, the response to endothelin-1 injected
intravenously
28 (see below for inhibitory efficacy of these
doses). During the last 2 weeks of ET
A antagonist treatment,
half the rats also received cilazapril, an ACE inhibitor (kindly
provided by Dr J.P. Clozel, F. Hoffmann-La Roche Ltd, Basel,
Switzerland), 10 mg·kg
-1·d
-1 in their drinking
water, a dose that effectively lowers blood pressure in spontaneously
hypertensive rats.
29 Systolic blood pressure was measured weekly
in prewarmed, slightly restrained rats by the tail-cuff method
and recorded on a Grass model 7 polygraph fitted with a 7P8
preamplifier and a model PCPB photoelectric pulse sensor (all
from Grass Medical Instruments). The average of three pressure
readings was recorded. We previously demonstrated that these
systolic blood pressure measurements are identical to intravascular
systolic blood pressures of hypertensive L-NAMEtreated
rats implanted with telemetric transmitters (TA11PA-C40) and
a catheter placed into the distal portion of the descending
aorta for recording of arterial pressure.
26 To determine the
efficacy of the doses of A-127722 used, in preliminary experiments
Sprague-Dawley rats received 10 or 30 mg·kg
-1·d
-1 A-127722 in their drinking water for 6 days. They were then
anesthetized with ketamine/xylazine 90/12 mg/kg IP, and heparinized
normal salinefilled PE-50 polyethylene catheters (Intramedic,
Clay Adams) were introduced into a carotid artery and jugular
vein. Blood pressure was monitored with a Gould P23ID pressure
transducer on a Grass polygraph. Bolus intravenous injections
of 50 ng angiotensin II and of 0.3 nmol/kg endothelin-1 in 0.1
mL normal saline were successively administered, and the pressor
response to endothelin-1 was calculated as a percentage of the
pressor response to angiotensin II in the same rat in relation
to responses in parallel control rats that had not received
the ET
A endothelin receptor antagonist. Endothelin-1 responses
were inhibited by 24% in the rats that had received the antagonist
A-127722 at the low dose and by 35% in the rats that had received
A-127722 at the high dose. This degree of inhibition of pressor
responses to endothelin-1 intravenous bolus injections is similar
to that found in the past with the combined ET
A/ET
B endothelin
receptor antagonist bosentan at doses that effectively lowered
blood pressure in endothelin-dependent hypertensive models such
as DOCA-salt hypertensive rats.
21
Northern Blot Analysis
Rats were killed by decapitation. A 1.5-cm-long segment of thoracic aorta and the complete mesenteric arterial tree were removed and dissected free of fat. Tissues were snap-frozen in liquid nitrogen and stored at -70°C until extraction of total RNA was performed. RNA was extracted from frozen tissues by a guanidine isothiocyanatephenol-chloroform method.30 Total RNA samples (20 µg) were denatured in 1xrunning buffer (20 mmol/L MOPS [pH 7.0], 6 mmol/L sodium acetate, 1 mmol/L EDTA), 6% formaldehyde, and 50% formamide for 15 minutes at 65°C. RNA samples were run on a 1.0% agarose gel containing 1xrunning buffer for 4 to 5 hours. The samples were transferred from the gel to a nylon membrane, Hybond-N (Amersham), by capillary action with 3 mol/L NaCl/0.3 mol/L sodium citrate (20xSSC). After blotting, the membranes were dried by baking at 80°C for 2 hours. The locations of the 18S and 28S rRNA species were revealed by staining with 0.02% methylene blue in 0.3 mol/L sodium acetate (pH 5.5). Membranes were prehybridized at 60°C for 2 hours (42°C for the 32P-labeled oligonucleotide probe for the 18S rRNA) in 400 mmol/L sodium phosphate buffer (pH 7.2) containing 5% SDS, 1 mmol/L EDTA, 0.1% BSA, and 50% formamide. Hybridization with the 32P-labeled probe was carried out for 18 to 20 hours at 60°C. The membranes were washed in 12.5 mmol/L NaCl/0.1% SDS three times at 72°C for 20 minutes. They were exposed to Reflection films (Dupont) with intensifying screens at -70°C for 6 days (2 to 4 hours for the 18S rRNA). The autoradiograms were analyzed with a Bio-Rad imaging densitometer and Molecular Analyst software version 1.1 (Bio-Rad Laboratories).
The rat endothelin-1 probe was prepared from rat lung RNA by reverse transcriptasePCR.17 18 19 20 A 319-bp rat preproET-1 PCR product was obtained with a 5' forward primer, 5'-CTAGGTCTAAGCGATCCTTG-3', and a 3' reverse primer, 5'-TTCTGGTCTCTGTAGAGTTC-3', located at nucleotides 266 to 285 and 565 to 584 of the coding sequence of the rat endothelin-1 cDNA, respectively.31 This PCR product was then cloned into pGEM-7zf(+) plasmid (Promega). The radiolabeled antisense riboprobe was prepared as previously described17 18 19 20 with [
-32P]UTP (800 Ci/mmol; Dupont). 18S rRNA was analyzed by use of a specific oligonucleotide probe (5'-CTTCCTCTAGATAGTCAAGTTCGACCGTCT-3')32 labeled with T4 polynucleotide kinase (Pharmacia) and [
-32P]ATP (3000 Ci/mmol, Dupont). The 32P-labeled probes were purified by chromatography in a Sephadex G-50 column (Pharmacia) or NACS cartridges (Gibco-BRL) for the riboprobe and the oligonucleotide probe, respectively.
Measurement of Plasma Endothelin and Plasma Renin Activity
Blood was obtained from the rat's neck during the first few seconds after decapitation and collected in tubes containing potassium EDTA for measurement of plasma endothelin-1 and plasma renin activity. Immunoreactive endothelin-1 was extracted from plasma by passage through C18 Sep-Pak cartridges (Waters Associates) and measured by radioimmunoassay as previously described.33 The antibody against endothelin-1 was from Peninsula. The minimal detectable concentration of endothelin was 0.4 pmol/L, and recovery of 5 pmol/L endothelin-1 added to plasma was 75%. The cross-reactivity of the antibody was 10% with big endothelin and 7% with endothelin-3. Plasma renin activity was measured by radioimmunoassay of angiotensin I generated during a 2-hour incubation in the presence of 8-hydroxyquinoline and sodium edetate as angiotensinase inhibitors at pH 6.5 and at 37°C as previously described.16
Analysis of Data
Values are given as mean±SEM unless otherwise stated. Statistical differences were evaluated by two-tailed Student's t test for comparison of two means or, when multiple groups were examined, by ANOVA followed by a Bonferroni post hoc test. Results were considered significantly different at values of P<.05.
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Results
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L-NAME treatment induced a rapid rise in blood pressure (Fig
1

and Table). Body weight, plasma immunoreactive endothelin,
and plasma renin activity were similar in L-NAMEtreated
and untreated rats (Table

).

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Figure 1. Time course of systolic blood pressure in response to treatment with L-NAME 100 mg·kg-1·d-1 in drinking water. Control rats received tap water. n=18 to 20 rats per group. Values are mean±SD. *P<.01.
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Northern blot analyses of RNA extracted from aortic segments and the complete mesenteric arterial tree did not show significant differences in the abundance of endothelin-1 mRNA transcripts between L-NAMEtreated and untreated rats (Figs 2
and 3).

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Figure 2. Representative Northern blot of total RNA (20 µg per lane) extracted from the aorta and mesenteric arterial tree (mesenteric arteries) of control rats and rats treated with L-NAME. Top, A single band of 2.3 kb corresponding to the rat endothelin-1 mRNA transcript. The analysis was done with a specific 32P-labeled complementary RNA probe for rat preproendothelin-1. Bottom, Band of the 18S ribosomal RNA on the same blots, obtained by hybridizing with a specific 32P-labeled oligonucleotide probe and used to normalize the abundance of endothelin-1 mRNA (see Fig 3 ). Similar results were obtained in at least two different membranes with material from different rats.
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Figure 3. Endothelin-1 mRNA content expressed as the ratio of the optical density of the endothelin-1 mRNA to the 18S rRNA bands (mean±SEM) from samples of RNA extracted from the aorta and the mesenteric arterial tree (mesenteric arteries) of 18 control and 20 L-NAMEtreated rats and examined by Northern blot analysis.
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Chronic treatment of L-NAME hypertensive rats with the ETA-selective endothelin receptor antagonist A-127722 at either the low or high dose was not associated with a significant difference in systolic blood pressure relative to L-NAMEtreated rats not receiving the antagonist (Fig 4
). Administration of the ACE inhibitor cilazapril lowered blood pressure significantly in L-NAMEtreated rats, as expected, to the same degree whether or not they received the ETA-selective endothelin receptor antagonist at the low or high dose.

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Figure 4. Time course of systolic blood pressure in response to treatment with L-NAME 100 mg·kg-1·d-1 (all groups) and the ETA-selective endothelin receptor antagonist A-127722 (ETAA) at 10 mg·kg-1·d-1 (low dose) or 30 mg·kg-1·d-1 (high dose) in drinking water. Rats received or did not receive the ACE inhibitor cilazapril for 2 weeks concurrently with the endothelin antagonist at the end of 4 weeks as indicated, at a dose of 10 mg·kg-1·d-1 in drinking water (solid symbols). L-NAMEtreated rats receiving or not receiving the endothelin antagonist and not receiving cilazapril are represented with open symbols. n=4 to 8 rats per group. Note that results are presented here as mean±SD. ANOVA for the first 4 weeks and the last 2 weeks of treatment was performed separately, because the hypotheses for the two periods were different. *P<.05, any group not receiving cilazapril (open symbols) during weeks 5 and 6 vs any group treated with cilazapril (solid symbols).
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Discussion
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The present study demonstrates the absence of enhancement of
expression of the endothelin-1 gene in blood vessels in the
model of hypertension induced in normal rats by administration
of the NOS inhibitor L-NAME. This suggests that endothelin-1
may play little role in blood pressure elevation in L-NAMEinduced
hypertension, since previous evidence has suggested that enhanced
vascular expression of the endothelin-1 gene could be a marker
of endothelin involvement in elevated blood pressure.
14 This
hypothesis is strengthened by the finding that blood pressure
was practically unaffected when L-NAMEtreated rats received
the ET
A-selective endothelin receptor antagonist A-127722 for
4 weeks in this study, whereas ACE inhibition significantly
lowers blood pressure in this model (Reference 7 and this study).
The doses of A-127722 used in the study were shown in preliminary
experiments to inhibit by 24% (low dose) and by 35% (high dose)
the response to a bolus intravenous injection of a large pharmacological
dose of endothelin-1 (0.3 nmol/kg) in the afternoon (rats drink
at night and had received the drug for 6 days); therefore, either
dose would be expected to effectively inhibit presumably much
lower amounts of endogenously generated endothelin-1. The degree
of inhibition of pressor responses to intravenous endothelin-1
bolus injections was similar to that found in the past with
the combined ET
A/ET
B endothelin receptor antagonist bosentan
at doses that effectively lowered blood pressure in endothelin-dependent
hypertensive models such as DOCA-salt hypertensive rats.
21 Thus, the doses of the ET
A-selective endothelin receptor antagonist
were probably effective in blocking endogenous endothelin but
failed to affect blood pressure elevation in L-NAMEtreated
rats. It has been suggested that in the L-NAME model of hypertension,
it is possible to unmask an endothelin-dependent vasopressor
tone with ACE inhibitors in short-term experiments.
27 However,
our data suggest that in the long-term experimental paradigm
of L-NAMEinduced hypertension, this does not occur.
In contrast to DOCA-salt hypertension and DOCA-salttreated SHR, in which the endothelin system appears to play a role14 16 17 18 19 20 21 22 23 24 in agreement with the presence of severe vascular hypertrophy,20 34 which may be endothelin-dependent, L-NAMEinduced hypertension is a model of experimental hypertension that could be predicted to have little or no dependence on the vasoconstrictor and hypertrophic action of endothelins, in view of the absence of important vascular hypertrophy.4 5 10 11 This resembles the spontaneously hypertensive rat, which has little vascular hypertrophy and exhibits predominantly eutrophic vascular remodeling.35 Indeed, SHR do not present enhanced vascular endothelin-1 gene expression20 36 or respond to endothelin antagonism with blood pressure lowering.22 37 38 However, Richard et al27 showed that L-NAMEinduced hypertension in rats may respond to endothelin antagonism with bosentan, a combined ETA/ETB endothelin receptor antagonist, when rats had been treated previously with an ACE inhibitor, apparently unmasking an endothelin-dependent vasopressor action. L-NAMEtreated rats exhibit evidence of renin dependency,7 although they do not always have increased plasma renin activity (References 4 and 5 and this study) but do respond to ACE inhibitors with lowering of blood pressure (Reference 7 and this study). It is possible that if the activity of the renin system is significantly enhanced, increased angiotensin II may stimulate endothelin-1 expression by the endothelium.39 40 Thus, under some circumstances a certain degree of activation of the endothelin system may be found after treatment with L-NAME. Alternatively, the data of Richard et al27 may indicate that anesthetized L-NAMEtreated rats may exhibit a short-term increase in plasma endothelin, perhaps of pituitary origin,41 and under these circumstances an endothelin-dependent pressor tone contributes to the maintenance of blood pressure after interruption of the renin-angiotensin system with ACE inhibitors.27 In addition, we have found that SHR treated with L-NAME develop a form of malignant hypertension associated with enhanced expression of endothelin-1 in blood vessels.26 These rats present severe elevations of plasma renin activity and respond with lowering of blood pressure to ACE inhibitors.42 The overexpression of endothelin-1 in blood vessels of L-NAMEtreated SHR is limited to the conduit arteries, which exhibit an accentuation of the severity of vascular hypertrophy, but was not found in small arteries, in which vascular hypertrophy is not more severe than in untreated SHR, even though blood pressure elevation achieves malignant levels.26 Thus, it appears that if the renin system is activated in L-NAMEtreated rats, such as in SHR treated with L-NAME,26 endothelin expression may be enhanced in some vessels. However, L-NAME appears to exert a growth-inhibitory effect in some vascular beds,11 which in small arteries may be mediated in part by inhibition of endothelin-1 expression.26 L-NAMEtreated SHR, which develop malignant hypertension and overexpress endothelin-1 gene limited to large vessels,26 are also unresponsive to administration of the combined endothelin antagonist bosentan.42 Thus, it appears that to obtain a sustained blood pressurelowering effect with either a combined ETA and ETB endothelin receptor antagonist such as bosentan or an ETA-selective endothelin receptor antagonist such as A-127722, enhanced expression of the endothelin-1 gene in small arteries18 and severe vascular hypertrophy at this same level,20 as found in DOCA-salt hypertensive rats, may be necessary conditions.
In conclusion, in hypertension induced by administration of L-NAME to normal Sprague-Dawley rats, the vascular expression of endothelin-1 was not enhanced. Chronic administration of an ETA-selective endothelin receptor antagonist did not induce any significant lowering of blood pressure in the hypertensive model induced in rats by chronic NOS inhibition by L-NAME. These results suggest that the endothelin system does not appear to participate to an important degree in the mechanisms leading to elevated blood pressure after NO synthesis inhibition with L-NAME in normal rats. In the chronic unanesthetized experimental paradigm, an endothelin-dependent vasopressor tone is not unmasked by ACE inhibition. In addition, these data suggest that either NO does not regulate vascular endothelin-1 gene expression or L-NAME exerts an inhibitory effect on endothelin expression in blood vessels.
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Selected Abbreviations and Acronyms
|
|---|
| DOCA |
= |
deoxycorticosterone acetate |
| L-NAME |
= |
N -nitro-L-arginine methyl ester |
| NOS |
= |
nitric oxide synthase |
| PCR |
= |
polymerase chain reaction |
| SHR |
= |
spontaneously hypertensive rats |
|
 |
Acknowledgments
|
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This work was supported by a group grant from the Medical Research
Council of Canada to the Multidisciplinary Research Group on
Hypertension and by grants from the Fondation des maladies du
coeur du Quebec.
Received May 20, 1996;
revision received August 9, 1996;
accepted August 24, 1996.
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