肾素 - 血管紧张素 - 醛固酮系统阻滞的研究进展

肾素-血管紧张素-醛固酮系统起初被认为是较简单的神经体液调节机制之一。但是,这一想法随着RAAS阻滞剂:肾素阻滞剂、血管紧张素转换酶抑制剂(ACEI)、AT1受体拮抗剂及盐皮质激素受体拮抗剂的深入研究而受到挑战。因此,RAAS的组成、以上药物发挥作用的具体通路及副作用均得到重新定义。在RAAS阻滞剂的应用过程中,机体肾素水平升高,并刺激肾素原受体(即无活性的肾素前体,PRR),进而对机体造成不良影响。同理,在AT1受体拮抗剂的应用过程中,血浆血管紧张素II的水平升高,并与2型血管紧张素II(AT2)受体结合,进而对机体产生有利作用。此外,随着ACEI及ARB的应用,血管紧张素1-7水平升高,其与Mas受体结合,发挥心脏及肾脏保护的作用,还可通过刺激干细胞发挥组织修复作用。     

肾素- 血管紧张素- 醛固酮系统与原发性高血压病的关系

目的:探讨血浆肾素-血管紧张素系统与原发性高血压病的关系。方法:采用病例-对照研究设计,入选125例原发性高血压病患者与60例血压正常健康体检者为对照组。采用放射免疫方法测定立位、卧位血浆肾素活性(PRA),醛固酮(ALD)浓度及血管紧张素Ⅱ(AngⅡ)浓度。结果:原发性高血压患者,立位、卧位血浆PRA均低于正常对照组(P<0.05),而ALD浓度及AngⅡ浓度均高于正常对照组(P<0.05)。根据高血压病1级、2级、3级分组,立位、卧位血浆PRA均依次降低(P<0.05);而ALD浓度及AngⅡ浓度依次升高(P<0.05)。结论:肾素-血管紧张素-醛固酮系统与原发性高血压病的发病关系密切,血浆PRA水平、AngⅡ及ALD浓度有望成为原发性高血压病分级的有效指标;降低原发性高血压患者AngⅡ及ALD量是治疗高血压病的关键,血浆AngII、ALD也有望成为评价原发性高血压病疗效的指标。     

急性高原病患者血浆肾素—血管紧张素—醛固酮系统及脑脊液变化

急性高原病通常分为急性高原反应(HAAR)、高原肺水肿(HAPE)和高原昏迷(HACC)三型。对其发病机理目前还存在着争议,为进一步探讨其发病机理,采用自身对比实验,观察了HAAR、HAPE各20名患者发病时及治愈后的血浆肾素(PRA)-血管紧张素(AⅡ)-醛固酮(ALD)系统及脑脊液变化。     

肾素-血管紧张素系统通过氧化应激机制参与血管反应性的调节

肾素-血管紧张素系统过度激活导致血管氧化应激损伤,进而影响血管功能.xanthine氧化酶、NAD(P)H氧化酶和脱耦联的NO合酶是血管组织中活性氧的主要来源.超氧化物阴离子和活性氧簇中的其他成分通过多种机制失活NO在心血管疾病的发生和发展中具有重要作用.随着对氧化应激损伤参与血管反应性调节机制的认识逐渐加深,有希望通过抑制氧化应激损伤改善血管内皮功能.     

利钠肽系统与肾素-血管紧张素-醛固酮系统在心力衰竭中交互作用

慢性心力衰竭是以高发病率、高入院率及高死亡率为特征的临床综合征,也是各种心血管疾病发展的终末阶段。神经激素系统的激活在心力衰竭病理生理中起着关键作用,其以肾素-血管紧张素-醛固酮系统(RAAS)、交感神经系统(SNS)及利钠肽系统(NPs)为主要组成部分。在心衰的病理生理中,NPs与RAAS存在交互作用,其对于与心功能不全相关的血液动力学改变与组织重塑起重要的作用,并且最终可导致心衰的恶化。因此,能够同时作用于RAAS与NPs,并且能够纠正两者间调节紊乱的干预措施,对于慢性心衰的治疗将具有良好的疗效。本文将主要对RAAS、NPs及NPs与RAAS的交互作用在心衰中的病理生理作用进行综述,并展望针对NPs与RAAS的交互作用的临床应用前景。     

肾素—血管紧张素系统——应激激素反应系统

各种急性与慢性庆激时,循环血中及脑、心血管、肾上腺等组织中血管紧张素Ⅱ（ＡⅡ）显著增多;人剧烈运动后血浆ＡⅡ与皮质醇一样均剧烈增加,在慢性应激性高血压动物循环及组织中,ＡⅡ含量持续地增高。还发现高浓度ＡⅡ对肾上腺糖皮质激素的分泌有直接的刺激作用,而组织ＡⅡ含量增多又受肾上腺素能β受体的激发。根据近年来的系列工作,并结合文献,我们认为ＡⅡ是一种重要的应激激素;肾素－血管紧张素系统是一个应激激素反应系     

肾素-血管紧张素系统的新调节分子:ACE2

血管紧张素转化酶（angiotensin—converting enzyme,ACE）为含锌的金属蛋白酶,是肾素-血管紧张素系统（renin—angiotensin system,RAS）重要的调节分子。血管紧张素转化酶2（angiotensin—con—verting enzyme2,ACE2）是迄今发现的唯一的ACE同系物（homologue）,它主要分布于睾丸、肾脏和心脏。ACE2可水解血管紧张素Ⅰ（angiotensinⅠ,AngⅠ）和血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）羧基端的1个氨基酸残基,分别形成Ang1-9和有血管舒张作用的Ang1-7。ACE2的生理病理作用还不甚明了,传统的ACE抑制剂不能抑制ACE2的活性。ACE2在心血管、肾脏系统的作用可能与ACE相反．与ACE共同调节心脏、肾脏等脏器的正常功能。     

血管紧张素—（1—7）——肾素血管紧张素系统的新激素

长期以来,血管紧张素－（１－７）「Ａｎｇ－（１－７））」－直被认为是血管紧张素Ⅱ的无生物活性代谢产物。近年的研究证明Ａｎｇ－（１－７）在神经系统和心血管功能调节中起有作用,是血管紧张素系统中一种新的重要激素。     

雌激素在中枢肾素-血管紧张素系统功能异常诱导的高血压中的保护作用

雌激素主要由卵巢分泌,是一种类固醇激素。流行病学研究显示,绝经前女性的高血压发病率明显低于同龄男性。研究表明,雌激素可通过影响中枢肾素-血管紧张素系统(RAS)组分的功能发挥其在中枢血压调控中的保护作用。雌激素作用于雌激素受体可抑制RAS增压信号通路或/和激活其减压信号通路,衰减中枢核团内自主神经元兴奋性进而延缓外界刺激诱导的高血压的发生。本文通过对雌激素在中枢RAS活动增强诱导的高血压发生中心血管保护作用及作用机制等方面进行综述,为临床开展性别差异性的高血压防治提供新思路。     

咸味觉在钠平衡行为调节中的作用

钠缺乏动物对NaCl溶液显示出强烈嗜好。NaCl的识别依赖于味细胞上的氨氯吡脒敏感性钠通道,舌下腺和颌下腺分泌物对钠通道活性调节有重要作用。鼓索神经是咸味信息的主要传入途径,但可能还存在其他传入通路,钠缺乏动物和正常动物对NaCl刺激可能具有不同的应答和传导机制。孤束核和臂旁核参与钠缺乏时的NaCl嗜好性改变,但调节钠食欲的高级中枢位于前脑。血管加压素、一氧化氮、多巴胺、速激肽、组织胺等体液因素和神经递质与钠平衡的行为调节有关。     

Activation of brain renin-angiotensin-aldosterone system by central sodium in Wistar rats

Functional studies indicate that the sympathoexcitatory and pressor responses to an increase in cerebrospinal fluid (CSF) [Na+] by central infusion of Na+-rich artificial cerebrospinal fluid (aCSF) in Wistar rats are mediated in the brain by mineralocorticoid receptor (MR) activation, ouabain-like compounds (OLC), and AT1-receptor stimulation. In the present study, we examined whether increasing CSF [Na+] by intracerebroventricular infusion of Na+-rich aCSF activates MR and thereby increases OLC and components of the renin-angiotensin system in the brain. Male Wistar rats received via osmotic minipump an intracerebroventricular infusion of aCSF or Na+-rich aCSF, in some groups combined with intracerebroventricular infusion of spironolactone (100 ng/h), antibody Fab fragments (to bind OLC), or as control gamma-globulins. After 2 wk of infusion, resting blood pressure and heart rate were recorded, OLC and aldosterone content in the hypothalamus were assessed by a specific ELISA or radioimmunoassay, and angiotensin-converting enzyme (ACE) and AT1-receptor binding densities in various brain nuclei were measured by autoradiography using 125I-labeled 351 A and 125I-labeled ANG II. When compared with intracerebroventricular aCSF, intracerebroventricular Na+-rich aCSF increased CSF [Na+] by approximately 5 mmol/l, mean arterial pressure by approximately 20 mmHg, heart rate by approximately 65 beats/min, and hypothalamic content of OLC by 50% and of aldosterone by 33%. Intracerebroventricular spironolactone did not affect CSF [Na+] but blocked the Na+-rich aCSF-induced increases in blood pressure and heart rate and OLC content. Intracerebroventricular Na+-rich aCSF increased ACE and AT1-receptor-binding densities in several brain nuclei, and Fab fragments blocked these increases. These data indicate that in Wistar rats, a chronic increase in CSF [Na+] may increase hypothalamic aldosterone and activate CNS pathways involving MR, and OLC, leading to increases in AT1-receptor and ACE densities in brain areas involved in cardiovascular regulation and hypertension.     

The role of sodium and potassium transport pathways in taste transduction: an overview

Recent studies have shown that taste sensations are mediatedby a multiplicity of transduction mechanisms. The taste of saltis produced in part by the entry of Na⁺ through channels inthe apical taste cell membrane. Na⁺ transport also mediatessweet perception in some species. The taste of KCI requiresentry of K⁺ through apical potassium channels. The productionof second messengers such as cAMP by taste stimuli or tastemodifiers can depolarize taste cells by inducing an enzymaticcascade that alters K⁺ permeability.     

The renin-angiotensin-aldosterone system in Cushing's syndrome and pheochromocytoma

We investigated the status of the renin-angiotensin-aldosterone axis in 5 patients with Cushing's syndrome and 7 patients with pheochromocytoma. In most of the patients with Cushing's syndrome no significant abnormalities of the renin-angiotensin-aldosterone system could be detected. In 4 out of 7 patients with pheochromocytoma, plasma renin activity remained high after saline suppression and decreased into the normal range in all 4 patients after removal of pheochromocytoma. These results imply that the postulated mineralocorticoid excess was not present in the patients with Cushing's syndrome studied. In pheochromocytoma, high levels of plasma catecholamines contribute to a high renin state which may have pathophysiologic implications.     

Endocannabinoid system in food intake and metabolic regulation

PURPOSE OF REVIEW: As the incidence of obesity and the metabolic syndrome has increased, research has focused on the importance of the endocannabinoid system in the brain and peripheral tissues. Rimonabant, an inverse agonist of the CB1 receptor is being used therapeutically. This review presents recent advances in endocannabinoid physiology. RECENT FINDINGS: The endocannabinoid system interacts with other anorexigenic and orexigenic pathways to regulate food intake in the hypothalamus, and the hedonistic value of food in the mesolimbic system. Endocannabinoid system overactivity contributes to hepatic steatosis, increased adipose tissue inflammation, dysregulated insulin signalling in the pancreas and disturbed oxidative pathways in skeletal muscle. The breakdown pathways for anandamide and 2-arachidonoylglycerol, the endocannabinoid receptor ligands, are reviewed, and the recent discoveries of endocannabinoid receptor polymorphisms and their relationship to obesity and metabolic disease noted. The favourable effect of rimonabant on fat mass glycaemic control, lipid metabolism and overall cardiovascular risk must be tempered by adverse effects on mood. SUMMARY: The ubiquitous role of the endocannabinoid system in food intake and energy metabolism is now established. Drugs that manipulate different aspects of this system may benefit subjects with the metabolic and cachectic syndromes.