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Proximal tubule ACE2 mediates early responses to hypertension by regulating intrarenal RAS and sodium homeostasis
Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley
Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley
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Research Article Cardiology Nephrology

Proximal tubule ACE2 mediates early responses to hypertension by regulating intrarenal RAS and sodium homeostasis

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Abstract

ACE2 is a membrane-bound monocarboxypeptidase strongly expressed in the renal proximal tubule (PT) with high affinity to degrade the vasopressor angiotensin II (AngII). We employed a mouse model of PT-specific ACE2 deletion (PT ACE2–KO) to demonstrate that the renal PT is a critical site for ACE2 regulation of blood pressure (BP) via modulation of the intrarenal renin-angiotensin system (RAS). While deletion of ACE2 from the PT had a minimal effect on baseline physiology, PT ACE2–KO mice were more susceptible to AngII hypertension than control mice. At day 5 of AngII infusion, the enhanced BP response was associated with cardiac hypertrophy, increased renal AngII levels, failure to suppress epithelial sodium channel (ENaC) γ cleavage, and increased sodium pump activity in PT ACE2–KO mice. Control mice instead increased renal ACE2 expression to reduce renal AngII accumulation and suppress intrarenal RAS activation, which offered protection from hypertension and complications. Transcriptional analysis corroborated changes in intrarenal RAS components and revealed alterations in distinct physiological pathways during AngII hypertension in PT ACE2–KO mice. Our studies provide evidence for alterations in ENaC regulation to contribute to the development of AngII hypertension and support PT-derived ACE2 as an integral member of the intrarenal RAS.

Authors

Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley

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Figure 3

Proximal tubule ACE2 stabilizes response to AngII by mitigating increases in intrarenal RAS activity.

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Proximal tubule ACE2 stabilizes response to AngII by mitigating increase...
(A) Mean arterial pressure (MAP) curve at baseline and with continuous AngII infusion (1,000 ng/kg/min) for 15 days. Day 5 MAP values are also presented in Figure 2A. (B) Renal AngII levels from Control and PT ACE2–KO mice. (C) Urinary ACE2 activity. (D) Immunoblots of angiotensinogen (n = 5), ACE1 (n = 6), and ACE2 (n = 6) protein abundance at baseline and with 5 days of AngII infusion. All lanes of the angiotensinogen immunoblot were run on the same gel but were noncontiguous. (E–G) Quantification of renal angiotensinogen, ACE1, and ACE2 abundance. (H and I) Immunoblots depicting urinary abundance of full-length ACE2 (FL-ACE2) and soluble ACE2 (sACE2) at day 6 and 14 days of AngII treatment. Coomassie brilliant blue stain was used to demonstrate similar loading for urine blots (56, 62). Data expressed as mean ± SEM. MAP (n = 16) was analyzed by mixed-effects analysis with Fisher’s LSD pairwise comparison post hoc analysis. Renal AngII (n = 3–10), urinary ACE2 activity (n = 6), and renal protein abundance were analyzed using a 2-way ANOVA with Tukey’s post hoc multiple comparison. Urinary ACE2 levels were analyzed by an unpaired 2-tailed t test with Welch’s correction (H and I). *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001.

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