Neues vom Salz-Wasserhaushalt ŒChronische Volumenüberladung › app › download... · Fluid...
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Neues vom Salz-Wasserhaushalt � Chronische Volumenüberladung:Was können wir vom Astronauten lernen?
6.-7.12.2013
R. GerzerDLR-Institut für Luft- und RaumfahrtmedizinKöln
From cyclic GMP to Space Medicine
Puffy Face
Spider Legs
Fluidshift Orthostatic
Intolerance
CVPDiuresis
Natriuresis
Weight Loss
?
Drummer et al. Amer J Physiol. 262:F744-F754(1992)
Drummer et al. Amer J Physiol. 262:F744-F754(1992)
Fluid excretion does not increasein microgravity
MIR 92D-2
Clin. Invest. 30:678-686 (1993) J. Appl. Physiol. 78:2253-2259(1995)
T im e (d a y s )5 6 7 8 9 1 0 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 8
Cum
ulat
ive
Sodi
um B
alan
ce (m
mol
)
0
2 0 0
4 0 0
6 0 0
8 0 0 B D CF lig h t
MIR 97
-1000
-500
0
500
1000
ml
SodiumWater
Unexpected ResultSodium Retention
Drummer et al. Eur. J. Clin. Invest. 30:1066-1075 (2000)
Is sodium also stored non osmotically on earth?- SALTY LIFE STUDIES -
sodium ECV sodium ECVC
um. S
odiu
m B
alan
ce (m
Eq/p
hase
)
-200
0
200
400
600
20050
Day
1-6
Day
7-1
2
***
50 200
200 550
Day
7-1
2
Day
7-1
2D
ay 1
3-22
**
200 550
NaCl Intake (mEq/day)
***: p<0.001 **: p<0.01
50 200
ECV
(Lite
r)
010
12
14
16**
50 200ns
200 550
200 550
e.g., Amer J Physiol. 278:F585-F595 (2000)
Na+ ingestion Na+ excretionextra-cellular volume
Na+
Storage???
Sodium balance
Sodium binds to
glycosaminoglycans in the skin
S o d iu m In ta k e
Hya
luro
nida
se (r
el. c
opie
s)
0
1 0 0 0
2 0 0 0
3 0 0 0
4 0 0 0
5 0 0 0
5 0 m E q /d 5 5 0 m E q /d
*
Cooperation with J. Titze, Erlangen
S o d iu m In ta k e
EXTL
2 (r
elat
ive
copi
es)
0
2 0 0
4 0 0
6 0 0
8 0 0
1 0 0 0
1 2 0 0
1 4 0 0
5 0 m E q /d 5 5 0 m E q /d
*
*: p<0.05
mRNA Expression of Enzymes for Glycosaminoglycan (GAG) Polymerisation in Skin
NaCl Intake NaCl Intake
pH
GlycosaminoglycanH+
Glucuronate GalNAc-4-sulfate
CH2ONa+H+ H+
H+
H+ H+H+ H+
H+ H+H+ H+H+
H+H+
H
Bone and Muscle?
High NaCl Intake induces bone resorption
Frings-Meuthen et al, JBMR 2008
Sodium binds to
glycosaminoglycanes in the skin
bonemuscle
blood pressureimmune system
aging SOLO
�Novel salt storage mechanism
From cyclic GMP to Space Medicine