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Adenosine stimulates NA/K ATPase and prolongs survival in hemorrhagic shock
Daniel N Darlington1, Donald S Gann
1Department of Surgery, and The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. ddarlington@smail.umaryland.edu
Background:
Hemorrhagic shock leads to the appearance of substances in plasma that can change Na/K ATPase activity. Our laboratory has reported the existence of a plasma inhibitor of Na/K ATPase that appears during shock. Recently, we have isolated a substance in plasma that stimulates Na/K ATPase.
Methods:
Using liquid chromatography, we found a fraction of plasma that simulated Na/K ATPase. The purified substance was identified as adenosine by its UV spectrum. Na/K ATPase activity was assessed using 86Rb uptake in erythrocytes.
Results:
Plasma from rat, dog, and calf stimulated Na/K ATPase activity in a dose-dependent manner and this stimulation was inhibited by ouabain. Commercial adenosine also stimulated Na/K ATPase in a dose-dependent manner and was inhibited by ouabain. Na/K ATPase was not stimulated by ATP, ADP, AMP adenine, hypoxanthine, xanthine or uric acid. Stimulation by adenosine (1 mmol/L) was not affected by adenosine receptor antagonists, caffeine (1 mmol/L) or aminophylline (1 mmol/L). However, the stimulation was inhibited by the nucleoside transport blocker, dipyridamole, suggesting that adenosine acts inside the cell. Adenosine (0.5 mmol/L) given to rats in hemorrhagic shock survived longer suggesting that stimulation of Na/K ATPase prolongs survival during hemorrhagic shock.
Conclusion:
Adenosine stimulates Na/K ATPase and prolongs survival in hemorrhagic shock, possible by reversing or overcoming the effects of an endogenous inhibitor of Na/K ATPase, as it does for ouabain. The effect of adenosine on Na/K ATPase is not mediated through adenosine receptors and probably results from an intracellular process.
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