Expression and function of COX isoforms in renal medulla: evidence for regulation of salt sensitivity and blood pressure. Am J Physiol Renal Physiol 290: F542-F549, 2006. First published September 27, 2005; doi:10.1152/ajprenal.00232.2005.-Expression of cyclooxygenase (COX)-2, but not COX-1, in the renal medulla is stimulated by chronic salt loading; yet the functional implication of this phenomenon is incompletely understood. The present study examined the cellular localization and antihypertensive function of high-salt-induced COX-2 expression in the renal medulla, with a parallel assessment of the function of COX-1. COX-2 protein expression in response to high-salt loading, assessed by immunostaining, was found predominantly in inner medullary interstitial cells, whereas COX-1 protein was abundant in collecting duct (CD) and inner medullary interstitial cells and was not affected by high salt. We compared mRNA expressions of COX-1 and COX-2 in CD vs. non-CD cells isolated from aquaporin 2-green fluorescent protein transgenic mice. A low level of COX-2 mRNA, but a high level of COX-1 mRNA, as determined by real-time RT-PCR, was detected in CD compared with non-CD segments. During high-salt intake, chronic infusions of the COX-2 blocker NS-398 and the COX-1 blocker SC-560 into the renal medulla of Sprague-Dawley rats for 5 days induced ϳ30-and 15-mmHg increases in mean arterial pressure, respectively. During similar high-salt intake, COX-1 knockout mice exhibited a gradual, but significant, increase in systolic blood pressure that was associated with a marked suppression of urinary PGE2 excretion. Therefore, we conclude that the two COX isoforms in the renal medulla play a similar role in the stabilization of arterial blood pressure during salt loading.cyclooxygenase-1; cyclooxygenase-2; mean blood pressure; prostaglandins; renal medullary interstitial cells PROSTAGLANDINS (PGs) are important autocrine/paracrine factors that contribute to salt balance and blood pressure (BP) control through mechanisms that primarily involve the regulation of vascular tone and renal excretory function. The vascular endothelium is a rich source of prostacyclin (PGI 2 ) and a potent vasodilator and inhibitor of platelet aggregation (5), whereas platelets produce thromboxane A 2 , a potent vasoconstrictor (9). The PGI 2 -thromboxane A 2 balance is considered to play an important role in the maintenance of normal vascular tone. The kidney is capable of synthesizing all types of PGs, especially PGE 2 and PGI 2 , which influence urinary sodium excretion directly through inhibition of tubular transport function and indirectly through regulation of activity of the reninangiotensin system (4). Within the kidney, the inner medulla has the greatest capacity for PG synthesis. In vitro studies have demonstrated that PGs, such as PGE 2 , can directly inhibit NaCl transport in isolated thick ascending limbs (30) and collecting ducts (CDs) (11, 31). In addition, PGE 1 augments renal medullary blood flow and attenuates the hydroosmotic effect o...