Objectives: Neutral endopeptidase (NEP) inhibition potentiated the renal ac
tion of Atrial Natriuretic Peptide (ANP) and was associated with appearance
of the peptide in the urine, providing evidence of protection of the filtr
ated peptide along the course of the nephron. The macula densa, composed of
epithelial cells, receives ionic information from the urinary compartment
via Na-K-2Cl cotransport and influences renin secretion by the myoepithelio
id cells in the afferent arteriole. bNOS constitutively expressed in the ep
ithelial cells of the macula densa. is involved in this feed-back. NEP inhi
bition was associated with the absence of any increase in renin secretion.
The hypothesis is that potentiation of urinary ANP by NEP inhibition could
limit renin secretion by directly or indirectly targeting the macula densa
in vivo. Methods and results: We tested the interaction between NEP inhibit
ion (candoxatril) and Na-K-2Cl inhibition (bumetanide) on electrolyte and A
NP urinary excretion, renin secretion, macula densa activity (NADPH diaphor
ase activity and bNOS mRNA) and TSC-1 mRNA expression in the renal cortex a
nd BSC-1 in the renal medulla of rats treated for 5 days. Bumetanide increa
sed urinary electrolyte excretion whereas candoxatril did not. Candoxatril
increased urinary ANP and cyclic GMP excretion. Bumetanide increased renin
and aldosterone secretion whereas candoxatril decreased renin secretion. Th
is effect on renin release was associated with an increase in macula densa
NADPH diaphorase activity in the bumetanide-treated group which was blunted
by candoxatril. Lastly, bumetanide increased TSC-1 mRNA expression in the
cortex and this effect was blunted by candoxatril. Conclusion: These result
s suggest that potentiation of ANP by NEP inhibition could interfere with t
ubular function at different levels and limit renin secretion by a urinary
pathway involving macula densa activity. (C) 2001 Elsevier Science BY All r
ights reserved.