[Arguments for the existence of an endogenous inhibitor of renal Na-K ATPase with steroid structure and natriuretic action]. / Arguments en faveur de l'existence d'un inhibiteur endogène de la Na-K ATPase rénale, de nature stéroïdienne et à vertu natriurétique.

In order to explain the opposite effect of 6,7-dihydroxylated isomers of 6, 7 - dihydrocanrenone on the urinary sodium and potassium excretion, we have tested the effect of these substances isolated from human urine on the Na(+)-K+ pump from different tissue preparation: rabbit kidney slices as well as NA-K ATPase purified from the kidney. Our results show an inhibition of pump as well as enzyme activity by the 6 beta 7 alpha isomer while the 2 other isomers are either uneffective or slightly stimulating. The 6 beta 7 alpha dihydroxy-6, 7-dihydrocanrenone could be one of the plasma ouabain-like substance incriminated in the pathogenesis of volume-expanded hypertension.

Effect of various 6-dehydro-corticosteroids, 9, 11-dehydro-DOCA and 9 alpha-fluoro-DOCA on the fluxes of sodium and potassium.

The introduction of a double bond at carbons 6 and 7 (6-dehydro-derivatives) of deoxycorticosterone acetate (DOCA), cortisol-21-acetate, 9 alpha-fluorocortisol-21-acetate (9 alpha-F-C-ac) and aldosterone-21-acetate substantially reduces affinity for Type II receptors but not for Type I receptors. Such a modification changes the effect of these steroids on urinary excretion of Na+ and K+. 6-Dehydro-derivatives will thus bind preferentially to receptor Type I inducing the retention of sodium and compete with mineralocorticoids for such receptors. The increase in both natriuresis and kaliuresis when corticosteroids and their 6-dehydro-derivatives are administered together may be interpreted as evidence for a Type II receptor mediation of those ion fluxes. The ionic changes are not mediated by the (Na+ + K+)-ATPase system. The fluoration at 9 and the dehydrogenation at C9C11 of DOCA result in a strong increase of binding to Type I receptor and of sodium retention.

Identification of biologically active natural spirolactone derivatives in man and animal.

For the first time, the presence of three natural spirolactones hydroxylated at C6C7 (6 alpha, 7 alpha-, 6 beta, 7 alpha- and 6 beta, 7 beta-dihydroxy-6,7-dihydrocanrenone (DHC) is demonstrated in man and in animal urine (rat, dog, sheep), and possibly in the blood. The existence of the fourth isomer 6 alpha, 7 beta- is also possible. Salt-loading in man and the rat results in a decrease in urinary 6 alpha, 7 alpha- and 6 beta, 7 beta-DHC. Salt-depletion increases their urinary concentration in the rat. DHC isomers are not found in the urine of adrenalectomized rats. Injected into the caudal vein of the rat, both 6 alpha, 7 alpha- and 6 beta, 7 beta-DHC induce a significant retention of Na+. On the other hand, 6 beta, 7 alpha-DHC significantly increases Na+ and K+ excretion. The biological activities of these natural compounds seem to be different from those of synthetic spirolactonic drugs.

Discovery of a natural spirolactone derivative in man and animal.

The presence of 6,7-dihydroxy-6,7-dihydrocanrenone (DHC) in man and in animal has been shown. Sodium loading results in a decrease of urinary DHC. On the contrary, sodium depletion increases its concentration.