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Institut für Physiologie, 10117 Berlin, Germany
"THE SUN WILL NOT RISE UNTIL after
the first cup of coffee." Who has not once required a mug of coffee
to get going? Among the first things to do after draining the cup is to
rebalance the body fluids. In fact, more volume is excreted than the
amount of coffee consumed. Why is this so? Four members of our
editorial team may have come a bit closer to answering this question
(1, 6). The effects of caffeine may rely on their
capability to inhibit adenosine receptors. Adenosine plays an important
role in kidney function, as has been reported recently in this journal (3, 4, 7). Renin secretion is enhanced by adenosine, leading to larger quantities of ANG II, a potent vasoconstrictor. Moreover, adenosine may play the crucial role in mediating the tubuloglomerular feedback response. The tubuloglomerular feedback is
one of the major mechanisms involved in autoregulating glomerular filtration and renal blood flow. The tubuloglomerular feedback mechanism enables the fine tuning of glomerular filtration. Excessive filtration leads to an increase in the distal tubular sodium chloride load. This is sensed by the macula densa, and then vasoconstriction of
renal afferent arterioles occurs by a hitherto unknown substance. The
enhanced preglomerular vascular resistance brings filtration back to
normal levels. Previously it was held that renin played the decisive
role in mediating the tubuloglomerular feedback. There is a clear
relationship between early distal NaCl concentration and plasma renin
levels (2). Accumulating evidence brought about by
experiments using blockers of adenosine receptors indicates, however,
that adenosine may have a more important role than previously believed.
Indeed, adenosine is required to cause vasoconstriction of the renal
afferent arterioles in the face of the distal tubular sodium chloride
challenge. This has now been shown unequivocally in mice lacking
functional adenosine A1 receptors (1, 6). Microperfusion studies in these animals demonstrated the total absence
of a tubuloglomerular feedback response. Currently, it seems that renin
is only important for determining the pressure range and level of
autoregulation (5). In the study published in this issue
of the American Journal of Physiology-Regulatory, Integrative and
Comparative Physiology (1), sodium excretion was more
than twice as high in the A1 receptor-deficient animals and
mean arterial blood pressure was slightly elevated in the homozygous
knockout mice. In the study by Sun et al. (6), however, the changes in these parameters did not reach statistical significance.
As pointed out by Brown and associates (1), the
modest hypertension and natriuresis resemble the effects of caffeine at levels reached by normal coffee consumption habits. The authors therefore suggest that the A1 receptor-deficient mouse
could serve as a model for coffee drinkers! Because caffeine may block
adenosine receptors unspecifically, it is not fully clear if this is
the optimum model. However, their study has provided a crucial step for
understanding the tubuloglomerular feedback.
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REFERENCES
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FOOTNOTES |
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Address for reprint requests and other correspondence: P. Persson, Institut für Physiologie, Tucholskystr. 2, 10117 Berlin, Germany (E-mail: pontus.persson{at}charite.de).
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REFERENCES |
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1.
Brown, R,
Ollerstam A,
Johansson B,
Skøtt O,
Fredholm B,
and
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Abolished tubuloglomerular feedback and increased plasma renin in adenosine A1 receptor-deficient mice.
Am J Physiol Regulatory Integrative Comp Physiol
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2001
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Leyssac, PP,
Holstein-Rathlou NH,
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Pflueger, AC,
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Silldorff, EP,
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Sorensen, CM,
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Sun, D,
Samuelson LC,
Yang T,
Huang Y,
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Mediation of tubuloglomerular feedback by adenosine: evidence from mice lacking adenosine 1 receptors.
Proc Natl Acad Sci USA
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9983-9988,
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7.
Zou, AP,
Nithipatikom K,
Li PL,
and
Cowley AW, Jr.
Role of renal medullary adenosine in the control of blood flow and sodium excretion.
Am J Physiol Regulatory Integrative Comp Physiol
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