Pharmacological Reviews, Vol 44, 81-102, Copyright © 1992 by American Society for Pharmacology and Experimental Therapeutics

Actions of adrenergic and cholinergic drugs on renal tubular cells

LC Garg
Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville.

There is convincing evidence to suggest that there are direct effects of adrenergic agents on renal tubules. During the last several years, considerable progress has been made in determining the type of adrenoceptors present in renal tubular cells through the use of radioligand binding and signal transduction methods. The receptor data are summarized in table 6. Almost all major nephron segments seem to have alpha 1- and alpha 2-adrenoceptors. However, there are few data describing the subtypes of alpha 1- or alpha 2-adrenoceptors in these segments. beta-Adrenoceptors are present in the CNT and collecting ducts of almost all species and in the thick ascending limbs of rats and mice. Adrenergic mediated signal transduction has been examined in some nephron segments, but virtually nothing is known about the relationship between the generation of adrenoceptor-mediated second messengers and changes in phosphorylation/activity of transport proteins (ion channels, ion pumps) in different types of renal tubular cells. There is general agreement that gluconeogenesis in the PCT is mediated by alpha 1-adrenoceptors through the PI and Ca2+ messenger system. Evidence also indicates that the increase in Na+ transport associated with renal nerve stimulation or adrenergic agonists in the PCT or the loop of Henle is mediated by alpha 1-adrenoceptors. Adrenergic agents modulate the effect of other hormones, such as PTH and vasopressin, on renal tubule transport by a decrease in cAMP, and this effect is mediated by alpha 2-adrenoceptors. There may be some interaction between the two alpha subtype-mediated effects in some nephron segments. beta-Adrenergic agonists stimulate cAMP formation in the PST, thick ascending limb (rat and mouse), CNT, and collecting duct segments. The physiological role of the beta-adrenoceptors in the PST is not known. beta-Adrenergic agonists stimulate sodium reabsorption by activation of the basolateral Cl- channel in the thick ascending limbs of rat and mice. The activation of beta-adrenoceptors in the CNT and CCD increases Cl- reabsorption and HCO3- secretion by stimulation of Cl/HCO3 exchange in the apical membrane of type B intercalated cell. The antikaliuretic effect of beta-adrenergic agonists is probably due to the stimulation of K+ reabsorption in type A intercalated cells in the CCD and OMCD. In the case of cholinergic drugs, the data in the literature are consistent with a model in which cholinergic agents increase papillary blood flow, resulting in the washout of the hypertonic medullary interstitium. This leads to a decrease in water abstraction out of the descending limb of Henle's loop.(ABSTRACT TRUNCATED AT 400 WORDS)

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