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N G Levinsky

Publications and source records attributed to N G Levinsky.

At least 37 records · Page 2Linked to original sources

Rat aortic smooth muscle cells in culture express kallikrein, kininogen, and bradykininase activity.

We have studied rat vascular smooth muscle (VSM) cells in culture for the presence of key elements of the glandular kallikrein-kinin system. Direct radioimmunoassay (RIA) using antiserum against rat urinary kallikrein detected a glandular kallikrein-like enzyme (GKLE) in VSM cells and in media. VSM homogenates and culture media had kininogenase activity, generating kinins from dog kininogen. About half of the GKLE was enzymatically inactive which could be activated with trypsin. Kininogenase activity was inhibited completely by aprotinin but only 20% by soybean trypsin inhibitor (SBTI). Trypsin liberated kinins from homogenates and media, demonstrating that VSM cells contain kininogen. Homogenates and media rapidly degrade bradykinin. GKLE, kininogen, and bradykininase activity were all present in VSM cells grown in defined media that contain no serum, thus eliminating any contamination or artefacts from fetal calf serum in standard culture media. Blood vessels of the rat have been reported to contain GKLE. Our observations indicate that GKLE is synthesized by VSM cells, not deposited from plasma. Furthermore, VSM cells synthesize kininogen and bradykininase(s), the other key elements of the glandular kallikrein-kinin system. Thus it is possible that the system functions as an autocoid mechanism that regulates local vascular tone.

Animals↗

A micro-kininogenase assay for studies of kallikrein in renal micropuncture/microperfusion.

We report the development of a micro-kininogenase assay suitable in studying the dynamics of kallikrein at intranephron segmental level. The detection limit is 119 fg or 2.6 attomoles of kallikrein. Activation of microquantities of kallikrein is possible with the use of Triton X-100. Because of its extremely high sensitivity and reproducibility the assay is likely to also prove useful in physiological studies in which only very small amounts of kallikrein containing samples can be obtained.

Animals↗

Renal ischemia and reperfusion impair endothelium-dependent vascular relaxation.

We studied the hemodynamic response of the isolated erythrocyte-perfused kidney to 25 min of ischemia and found that renal vascular resistance (RVR) was increased in the reflow period (16.7 +/- 1.4 mmHg.ml-1.min.g following ischemia vs. 10.2 +/- 0.8 mmHg.ml-1.min.g in control kidneys). Endothelial independent vasodilators [atrial natriuretic factor (ANF) and sodium nitroprusside] prevented the increase in RVR that occurred after ischemia. In contrast, acetylcholine and the calcium ionophore A23187, two vasodilators that act by releasing endothelium-derived relaxing factor (EDRF), had no effect on the increased RVR that occurs on reflow. Two inhibitors of EDRF, methylene blue and gossypol, increased RVR in nonischemic kidneys by 45 +/- 6 and 46 +/- 11%, respectively, an increase that was comparable to that found with ischemia alone (55 +/- 7%). The increase in RVR found with the combination of EDRF inhibition and ischemia (59 +/- 5%) was the same as that found with ischemia alone. We conclude that EDRF activity is impaired following ischemia and reperfusion. This abnormality in EDRF may be an important mechanism contributing to postischemic vasoconstriction in the renal vasculature.

Animals↗

Interleukin 1 inhibits contraction of vascular smooth muscle.

Interleukin 1 has been implicated as a mediator of both systemic and local responses to infection and injury. Since systemic and local vasodilatation are hallmarks of sepsis and infection, we studied the direct effect of IL-1 on vascular contractility. We report here that human recombinant IL-1-beta potently inhibits the response of rat thoracic aorta to vasoconstrictor agents. Exposure of isolated rat aortic rings to IL-1 (20 ng/ml) for 1 h did not affect phenylephrine-induced contractions during the exposure period. However, when rings were retested 150-200 min after initiation of IL-1 exposure, contractions were markedly decreased. The cytokine had a similar effect in rings from which the endothelium was removed. Contractions caused by potassium depolarization also were depressed, indicating the effect of IL-1 is not specific to the alpha-adrenoceptor agonist. The inhibitory effect of IL-1 was concentration-dependent (0.2 to 20 ng/ml), and eliminated by pretreatment with cycloheximide (20 micrograms/ml). Indomethacin (10(-5) M) did not prevent the inhibition caused by IL-1. These studies identify IL-1 as a potent inhibitor of vascular contraction, via an endothelium-independent mechanism. Studies with inhibitors suggest that the action of IL-1 is independent of prostanoid synthesis, and may involve synthesis of protein.

Animals↗

Hemodynamic effects of different preparations of stroma free hemolysates in the isolated perfused rat kidney.

We have examined the effects of Stroma Free Hemolysate (SFH) solutions in the isolated perfused rat kidney. Three types of SFH, stored for 6 to 8 months at 4 degrees C, were tested: 1) unmodified, 2) glyoxalated and lightly cross linked and 3) pyridoxalated and polymerized. All three SFH solutions, added to the perfusate at a concentration of approximately 420 mg/100ml, increased renal vascular resistance (RVR) and reduced glomerular filtration rate (GFR). Unmodified, glyoxalated and lightly cross linked and pyridoxalated polymerized SFH resulted in a rise in RVR of 55%, 38% and 33% respectively and a fall in GFR of 42%, 57% and 83% respectively. In order to determine whether storage had altered the effect of SFH on renal function, one of the forms of SFH (glyoxalated and lightly cross linked) was studied only 4-6 weeks after preparation. While this preparation caused an increase in RVR of 41% it did not alter GFR; filtration fraction (FF) rose. However, after further storage of this preparation for 6-7 months, the solution resulted in a marked decrease in GFR of 47% as well as a rise in RVR of 23%. We conclude that three different SFH preparations resulted in marked vasoconstriction and reductions in GFR. These deleterious effects on renal hemodynamics were noted at a concentration of hemoglobin well below that necessary to effectively improve oxygen content. Storage of the SFH solutions may cause or contribute to their effects on renal function. SFH solutions intended for use as blood substitutes should be tested for vasoconstrictor activity.

Animals↗

Micropuncture localization of kallikrein secretion in the rat nephron.

We have used free-flow micropuncture to study the tubular locus at which kallikrein enters the urine. Kallikrein was measured by a newly developed, very sensitive assay for kininogenase activity; active kallikrein was measured directly by this assay and total kallikrein after activation of inactive kallikrein. Kallikrein was readily detected in all of 17, late distal tubular fluid-samples. In contrast, kallikrein was too low to detect in 15 of 17 proximal or in 11 of 14 early distal tubular fluid samples. Calculations indicate that less than 10% of urinary kallikrein could have derived from filtration or from proximal secretion of kallikrein. We conclude that urinary kallikrein enters the urine via secretion in the distal tubule. Filtration or proximal secretion of kallikrein does not contribute significantly to urinary kallikrein excretion.

Animals↗

Interactions between ADH and prostaglandins in isolated erythrocyte-perfused rat kidney.

Interactions between antidiuretic hormone (ADH) and renal prostaglandins in the regulation of sodium reabsorption and urinary concentrating ability were studied in isolated erythrocyte-perfused rat kidneys (IEPK). In this model, hemodynamic characteristics are comparable to those found in vivo, and tubular morphology is preserved throughout the period of perfusion. [Deamino]-D-arginine vasopressin (dDAVP) markedly reduced fractional sodium excretion (FE Na) in the IEPK from 3.5 +/- 0.6 to 0.45 +/- 0.14%. After indomethacin, FE Na fell still further to 0.08 +/- 0.02%. In the absence of dDAVP indomethacin had no effect on sodium excretion; FE Na was 2.4 +/- 0.6% in control and 2.0 +/- 0.4% in indomethacin-treated groups. dDAVP increased urine osmolality in the IEPK to 741 +/- 26 mosmol/kg. When prostaglandin synthesis was blocked with indomethacin, urinary osmolality increased further to 1,180 +/- 94 mosmol/kg. In isolated kidneys perfused without erythrocytes (IPK), dDAVP decreased FENa from 14.5 +/- 1.8% to 9.6 +/- 1.2%; addition of indomethacin had no further effect. dDAVP increased urine osmolality only modestly to 350 +/- 12 mosmol/kg in the IPK and indomethacin did not increase concentrating ability further (342 +/- 7 mosmol/kg). Thus the IEPK (unlike the IPK) can excrete a markedly hypertonic urine in response to ADH. ADH also enhances tubular reabsorption of sodium in the IEPK. Prostaglandins inhibit both these actions of ADH but do not directly affect sodium excretion in the absence of the hormone.

Absorption↗

Effect of erythrocytes on the function and morphology of the isolated perfused rat kidney.

We have examined the effects of erythrocytes on the function and morphology of isolated rat kidneys perfused with a physiological concentration of bovine albumin (45 g/l). (1) In kidneys perfused without red cells, renal vascular resistance (RVR) was low (4.2 +/- 0.3 mm Hg/ml/min/g), fractional sodium excretion (FeNa) was high (14.5 +/- 1.8%) and concentrating ability impaired (maximum urine osmolality 343 +/- 4 mmol/kg). The erythrocyte-free kidney also developed necrosis of the cells of the medullary thick ascending limb (mTAL). (2) Erythrocytes at a hematocrit of 4-6% did not alter RVR but prevented ischemic changes in the mTAL and reduced FeNa to 9.4 +/- 0.03%. Concentrating ability was not improved by a hematocrit of 4-6% despite the presence of a morphologically normal mTAL. (3) At a hematocrit of 40-45%, RVR was increased (to 11.2 +/- 0.4 mm Hg/ml/min/g) and FeNa was further lowered to 3.5 +/- 0.6%. Also, urinary concentrating ability was markedly improved (maximum urine osmolality 640 +/- 35 mmol/kg). (4) The isolated perfused kidney (IPK) at a hematocrit of 40-45% was able to autoregulate renal perfusate flow rate of GFR but autoregulation was incomplete. A 50% increase in perfusion pressure from 100 to 150 mm Hg increased renal perfusate flow rate and GFR 27 and 29%, respectively. Thus the IPK is not able to autoregulate as efficiently as the kidney in vivo, even in the presence of red cells at a normal hematocrit.

Animals↗

Health care for veterans: the limits of obligation.

The federal government has a generally unquestioned obligation to provide health care to veterans for diseases or disabilities acquired during military service. Much argued, however, is the government's obligation to offer care for nonservice-connected disorders. The Reagan administration has sharpened the debate recently by attempting to impose a means test on veterans over sixty-five who are seeking such care. But the controversy focuses on the wrong issue. Society has a moral obligation to provide adequate health care to all citizens but has no special obligation to care for nonservice-connected health problems of veterans.

Delivery of Health Care↗

The doctor's master.

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Cost-Benefit Analysis↗

Components of the kallikrein-kinin system in rat urine.

Using a direct radioimmunoassay and a kininogenase assay, we determined that 68% of rat urinary kallikrein was enzymatically active while 32% was in an inactive form which was activated by trypsin. Inorganic cations, at concentrations found in rat urine, were inhibitory in an amidase assay but appeared to potentiate kininogenase activity of pure rat urinary kallikrein. In random urines, kinin concentration was 4.2 +/- 0.7 ng/ml. Trypsinization of the urines generated 52.9 +/- 25.8 ng kinin/ml, indicating that kininogen was present. The rate of kinin formation in vivo may depend on the availability of kininogen and the concentration of inorganic cations in urine, as well as on other well-recognized factors, such as the kallikrein activity of the urine.

Animals↗

Recovery of proximal tubular function from ischemic injury.

Fluid (sodium) reabsorption, total glucose efflux, and reabsorption of angiotensin II and insulin from the proximal convoluted tubule were studied in rats by in vivo microperfusion. After 35 min of total renal artery occlusion, function was assessed at two intervals, 0-1 h (early recovery, ER) and 2-4 h (late recovery, LR). Light and electron microscopic evaluation showed 60-75% loss of proximal convoluted tubule brush border membrane in ER and nearly complete restoration of brush border in LR. No other structural abnormalities were evident. Renal blood flow was unchanged from control during both ER and LR. During ER, fluid reabsorption was reduced to 29.8 +/- 5.2%, and total glucose efflux, at normal tubule loads, to 73.9 +/- 5.5% of control. However, angiotensin II and insulin reabsorption were unchanged. In LR, fluid reabsorption remained significantly reduced at 54.3 +/- 8.1% of control. Total glucose efflux from the proximal tubule was normal in LR at glucose loads of up to 400 pmol X min-1, but was significantly reduced at higher loads. Passive glucose efflux, measured in the presence of 10(-4)M phloridzin, was not altered by ischemia. Brief ischemia results in significant alterations in proximal tubular reabsorption of sodium and glucose, which correlate with a substantial loss of brush border during ER. However, despite restoration of cell morphology to normal in LR, transport defects for both sodium and glucose persist.

Absorption↗

Effects of alterations in sodium and water metabolism on urinary excretion of active and inactive kallikrein in man.

Renal kallikrein is present in human urine in both an active and an inactive form. Several previous studies have examined the response of active kallikrein excretion to alterations in sodium and water metabolism, but the response of inactive kallikrein has not been evaluated systematically. We have developed a method for determining inactive kallikrein in urine using two assays. Active kallikrein is measured using a kininogenase assay. Total (active plus inactive) kallikrein is measured using a direct RIA. Inactive kallikrein is calculated from the difference between active and total kallikrein excretion. We have used this technique to study the effect of alterations in sodium and water metabolism on kallikrein excretion. Acute volume expansion with saline and moderate acute or chronic increases in water intake did not alter the excretion of either active or inactive kallikrein. Dietary sodium restriction increased the excretion of total kallikrein by 30%; active kallikrein increased 82%, while inactive kallikrein excretion was found to be unchanged. Spironolactone reduced total kallikrein excretion in subjects on a low salt diet. Again, the change in excretion was entirely attributable to the active form of the enzyme. Total kallikrein excretion increased during the first 3 days of fludrocortisone administration in subjects on a high salt intake and then plateaued. Active kallikrein increased progressively throughout the 7-day study period. Inactive kallikrein increased during the first 4 days, then fell to control levels. Thus, mineralocorticoid initially stimulates the formation and/or release into urine of both active and inactive kallikrein. Later, reciprocal changes in active and inactive enzymes occur.

Body Water↗

The effect of cations on the activity of human urinary kallikrein.

We studied the effect of ions on the ability of purified human urinary kallikrein to cleave its natural substrate (kininogen) as well as two synthetic substrates, tosylarginine [3H]methyl ester and Pro-Phe-Arg-[3H]benzylamide. The kininogenase activity of kallikrein is markedly dependent upon the concentration of cations in vitro. Kininogenase activity is very low when measured in a low electrolyte buffer. The addition of cations to the reaction mixture increases activity by up to 27-fold. Maximum activity is achieved with 100 mM sodium, 100 mM potassium, or 20 mM magnesium. The activity is stable at higher concentrations of cation. Renal kallikrein is believed to act within distal tubular fluid in vivo. The concentration of cations in this fluid varies widely in response to alterations in salt and water metabolism. Thus, the relationship of kininogenase activity to the concentration of cations demonstrated in vitro may be relevant to the activity of kallikrein at its presumed site of action in the kidney. In separate experiments, we evaluated the effect of ions on the amidase and esterase activities of kallikrein which are the basis of several assays in routine use for physiological studies. In contrast to their stimulatory effect on kininogenase activity, cations inhibit amidase and to a lesser extent esterase activity. Additional studies indicate that urinary cations probably account entirely for the well known ability of normal urine to inhibit the amidase and esterase activities of kallikrein.

Anions↗