Tissue sodium excess is not hypertonic and reflects extracellular volume expansion
Tissue sodium excess is not hypertonic and reflects extracellular volume expansion
复制标题
DOI：
10.1038/s41467-020-17820-2
复制
发表时间：
2020-08-24
影响因子：
16.6
通讯作者：
Delles, Christian
中科院分区：
文献类型：
--
作者：
Rossitto, Giacomo;Mary, Sheon;Delles, Christian
我们对Na+稳态的理解最近被皮肤作为多种心血管疾病和危险因素中Na+积累的仓库的概念所重塑。提出的组织Na+的非水依赖性可诱导局部致病性变化，但缺乏可靠的证据。在这里，我们表明，组织Na+过量高Na+摄入量是一个系统性的，而不是皮肤特异性的，反映建筑的变化，即在细胞外到细胞内的隔间的转变，由于减少细胞内或积累的水溶性Na+在细胞外空间的现象。我们还表明，这种积累是不可能证明所观察到的发展实验性高血压，如果它是水独立的。最后，我们表明，这种等渗皮肤Na+过剩，反映亚临床水肿，发生在高血压患者和与老化。我们的研究结果的影响，质疑以前的假设，但也加强了组织Na+过剩的重要性，是机械和临床。Na+被认为以高渗的方式在组织中积累，特别是在皮肤中，并产生局部致病作用。在这里，我们重新评估这种现象，它是系统性的，反映了组织中相对细胞外体积的等渗变化，例如亚临床水肿;因此，它发生在人类高血压和衰老中。
Our understanding of Na+ homeostasis has recently been reshaped by the notion of skin as a depot for Na+ accumulation in multiple cardiovascular diseases and risk factors. The proposed water-independent nature of tissue Na+ could induce local pathogenic changes, but lacks firm demonstration. Here, we show that tissue Na+ excess upon high Na+ intake is a systemic, rather than skin-specific, phenomenon reflecting architectural changes, i.e. a shift in the extracellular-to-intracellular compartments, due to a reduction of the intracellular or accumulation of water-paralleled Na+ in the extracellular space. We also demonstrate that this accumulation is unlikely to justify the observed development of experimental hypertension if it were water-independent. Finally, we show that this isotonic skin Na+ excess, reflecting subclinical oedema, occurs in hypertensive patients and in association with aging. The implications of our findings, questioning previous assumptions but also reinforcing the importance of tissue Na+ excess, are both mechanistic and clinical. Na+ has been suggested to accumulate in tissues, particularly skin, in a hypertonic manner and to exert local pathogenic effects. Here, we reappraise this phenomenon which is systemic in nature and reflects isotonic changes in the relative extracellular volume in tissues, e.g. subclinical oedema; as such, it occurs in human hypertension and aging.