11 beta-Hydroxsteroid dehydrogenase 2 (11 beta-OHSD2) protects the non
selective renal mineralocorticoid receptor from the endogenous glucoco
rticoid cortisol. Thus, drugs inhibiting 11 beta-OHSD2 might enhance u
rinary loss of potassium. As diuretics influence the renal handling of
potassium, we analyzed the impact of 13 commonly used diuretics on 11
beta-OHSD2. Furosemide was the only inhibitor. Its inhibition constan
t (K-i) was 30 mu mol when extracts from COS-1 cells transfected with
human 11 beta-OHSD2 were used as an enzyme source. The type of inhibit
ion was competitive. To establish whether furosemide inhibits 11 beta-
OHSD2 and 11 beta-OHSD1 in the renal target tissue, isolated tubular
segments from rats were analyzed. Furosemide decreased the oxidative a
ctivity of 11 beta-OHSD2 in intact distal tubules and 11 beta-OHSD1 in
proximal convoluted tubules. For the assessment of furosemide on the
excretion of corticosterone metabolites in vivo, rats were given furos
emide ip, and the ratio of tetrahydrocorticosterone plus 5 alpha-tetra
hydrocorticosterone to 11-dehydrotetrahydrocorticosterone was determin
ed in urine. This ratio increased after the administration of furosemi
de in all animals, indicating inhibition of the oxidative activity of
11 beta-OHSD. Thus, furosemide inhibits the 11 beta-OHSD2 enzyme in th
e target tissue and might by that mechanism enhance the mineralocortic
oid effect of 11 beta-hydroxyglucocorticoids.