血管紧张素转换酶2-血管紧张素1-7-Mas轴对血管作用的研究进展

血管紧张素转换酶2（ACE2）和Mas受体的发现使人们对肾素-血管紧张素（RAS）有了更全面的认识。ACE2可水解血管紧张素Ⅰ和血管紧张素Ⅱ直接或间接生成血管紧张素1-7（Ang 1-7）,并与高血压的形成密切相关。Ang 1-7主要通过Mas受体引起血管舒张、抑制细胞增殖。ACE2-Ang1-7-Mas轴的发现为RAS的研究、高血压等心血管疾病的防治和新药开发提供了新的思路和方向。     

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。     

慢性阻断血管紧张素Ⅱ1型受体不能完全防止模拟失重大鼠血管的适应性结构变化

我们以前的工作提示,在模拟失重所引起的血管区域特异性适应变化中,局部肾素．血管紧张素系统（local reninangiotensin system,L-RAS）可能发挥关键调控作用。本文以losartan慢性阻断血管紧张素Ⅱ1型受体（angiotensin Ⅱtypelreceptor,AT1R）,观察模拟失重是否仍能引起血管的这种适应性改变,并检测大血管管壁L-RAS主要成分的表达是否也发生相应变化。以尾部悬吊大鼠模型模拟失重的生理影响。制作基底动脉、胫前动脉、颈总动脉和腹主动脉的HE染色切片,在光学显微镜下进行形态观测：用免疫组织化学技米测量颈总动脉和腹主动脉壁的血管紧张素原（angiotensinogen,AGT）及AT-R的表达变化。结果表明：4周模拟失重引起大鼠基底动脉中膜和颈总动脉管壁各平滑肌肌层肥厚,而胫前动脉和腹主动脉则发生萎缩性改变;给予losartan4周引起上述4种血管皆发生萎缩性变化;阻断AT1R,模拟失重仍然能引起基底动脉、颈总动脉发生相对肥厚性改变和腹主动脉萎缩加重。4周模拟失重还引起颈总动脉壁中AGT和AT1R表达上调,而腹主动脉壁及血管周围组织中AGT和AT1R表达下调;给予losartan4周仅引起腹主动脉壁中AGT和AT1R表达减少;阻断AT1R,模拟失重使腹主动脉壁AT1R表达进一步减少。结果提示,4周模拟失重引起大鼠脑、颈部与后身大、中动脉血管的形态结构改变和L-RAS主要成分表达发生上调或下调,血管L-RAS在其中可能发挥关键性调控作用;但在慢性阻断AT1R的条件下,其它调控机制仍可能在脑血管适应性调节中发挥一定作用。     

不同年龄白发性高血压大鼠肾脏AT1R和AT2R的表达

目的本研究观察不同月龄自发性高血压大鼠（SHR）肾脏ALR和ALR表达,初步探讨AT1R和AT2R在高血压发生、发展过程中的可能作用。方法1月龄组（S1）、2月龄组（S2）、3月龄组（S3）、6月龄组（S6）和9月龄组（墨）雄性SHR共5组,每组各6只,各组均有相应月龄匹配的Wistar-Kyoto大鼠（WKY）作对照。采用RBP-I型大鼠血压心率测定仪测量大鼠尾动脉收缩压（SBP）;放免法测定血浆血管紧张素Ⅱ（AngⅡ）;免疫组化染色结合计算机图像分析方法测定肾脏AT1R和ALR表达水平。结果（1）SHR SBP随着月龄的增加而上升,S6后趋于稳定。（2）1个月后SHR血浆AngⅡ浓度均高于S1（P〈0.05）,而S2、S3、S6和S9之间无明显差别（P〉0.05）;1个月后SHR血浆AngⅡ浓度均高于相应配对的WKY组（P〈0.05）;而WKY各月龄组均无明显差别（P〉0.05）。（3）SHR肾脏AT1R随着月份的增加而增加（P〈0.05）,且高于相应配对的WKY组（P〈0.05）。SHR肾脏ABR随着月份的增加而降低,S6明显降低（P〈0.05）,S6和S9比较无明显差别（P〉0.05）;且均低于相应配对的WKY组（P〈0.05）。WKY各月龄组AT1R和AT2R无明显差别（P〉0.05）。结论SHR肾脏AT1R表达水平比WKY高,并随着年龄的增加而递增;AT2R表达水平比WKY低,并随着年龄的增加而降低。     

有氧运动改善自发性高血压大鼠肾纤维化的作用*

目的: 研究有氧运动训练对自发性高血压大鼠(SHR)肾脏纤维化影响, 探讨有氧运动对高血压肾损害的保护作用。方法: 8周龄雄性SHR和同龄Wistar京都大鼠(WKY)随机分为4组(n=6):安静WKY对照组(WKY-S)、安静SHR对照组(SHR-S)、低强度运动组(SHR-L)和中强度运动组(SHR-M)。SHR-L组、SHR-M组分别以14 m/min(最大有氧速度的35%)、20 m/min(最大有氧速度的50%)在0°坡度的运动跑步机上跑步,共运动14周,每周5次,每次60 min,WKY-S和SHR-S组安静饲养。14周后,运动训练结束72 h后检测大鼠血压;之后取血和肾脏检测血清肌酐SCr和尿素氮BUN含量,苏木精与伊红(HE)染色观察肾组织形态,Masson染色观察肾组织胶原沉积情况,计算肾脏胶原容积分数(CVF),检测肾脏 AngⅡ、AT1R、TGF-β、α-SMA、CTGF蛋白表达。结果: 与WKY-S组相比,SHR-S组的血压和血清SCr、BUN含量、肾脏CVF水平和AngⅡ、AT1R、TGF-β、α-SMA、CTGF蛋白表达均明显升高(P＜0.05);与SHR-S组相比,SHR-L组和SHR-M组血压和血清SCr、BUN含量、肾脏CVF水平和AngⅡ、AT1R、TGF-β、α-SMA、CTGF蛋白表达均明显下降(P＜0.05)且SHR-M组下降趋势更明显(P＜0.05)。结论: 有氧运动可通过抑制肾脏AngⅡ-AT1R-TGF-β通路,改善自发性高血压大鼠的肾纤维化与肾功能。     

AngⅡ对血管平滑肌细胞PDGF受体表达的影响

目的:研究血管紧张素Ⅱ(AngⅡ)对血管平滑肌细胞血小板源生长因子(PDGF)受体表达的影响.方法:采用大鼠主动脉球囊内皮剥脱术制备主动脉再狭窄模型,观察形态学变化;放免法测定主动脉AngⅡ含量;免疫印迹法测定主动脉PDGF-β受体含量,并与假手术组相比较.培养大鼠主动脉血管平滑肌细胞(VSMC),AngⅡ刺激正常培养的与洛沙坦预处理过的VSMC 6 h,测定PDGF-β受体含量.结果:球囊内皮剥脱术后14 d,主动脉中层VSMC大量增殖,内膜显著增厚,AngⅡ含量显著升高(P＜0.05),PDGF-β受体表达显著增强(P＜0.05).AngⅡ诱导VSMC PDGF-β受体表达显著增强(P＜0.01),AngⅡ受体拮抗剂洛沙坦完全抑制AngⅡ对PDGF-β受体上调的诱导作用.结论:AngⅡ可通过其Ⅰ型受体诱导血管平滑肌细胞PDGF受体上调,这可能是AngⅡ促VSMC发生增殖的一个重要机制.     

新型抗高血压活性肽GAP-A的一级结构及生理活性研究

研究了新型乳酪蛋白源抗高血压活性肽GAP-A的分子量与一级结构,并检测了其对体外血管紧张素转化酶(ACE)的抑制活性及体内降血压效果。结果显示:抗高血压活性肽GAP-A分子量为M2,氨基酸序列为B1-B2-B3;GAP-A在体外对ACE有很强的抑制活性,抑制率为79.6%;GAP-A对自发性高血压大鼠(spontaneously hypertensive rats,SHR)有显著的降血压作用,而对血压正常的SD大鼠的血压没有影响。     

治疗肝纤维化的蛋白质药物研究进展

肝纤维化是肝脏出现瘢痕组织,瘢痕尽管在肝脏的位置有异,但是均一致表现为细胞外基质的增生和性质转变,尤其在疾病的早期。蛋白质药物在治疗疾病方面有许多优势,我们将用于治疗肝纤维化的蛋白质药物做出总结,为新药研究提供思路。     

不同年龄自发性高血压大鼠心脏AT2R的表达与心肌纤维化

目的观察不同年龄自发性高血压大鼠（SHR）心脏AT2R的表达水平及心肌胶原含量,探讨AT2R在高血压发生、发展过程中的作用。方法 1月龄组（S1）、2月龄组（S2）、3月龄组（S3）、6月龄组（S6）和9月龄组（S9）雄性SHR共五组,每组各6只,各组均有相应月龄的Wistar-Kyoto大鼠（WKY）作对照。采用RBP-I型大鼠血压心率测定仪测量大鼠动脉收缩压（SBP）;放免法（RIA）测定血浆血管紧张素Ⅱ（AngⅡ）;免疫组化染色结合计算机图像分析方法测定心脏AT2R的表达水平,天狼星红胶原染色大鼠的心脏切片。结果 1.SHR SBP随着月龄的增加呈持续上升（P〈0.05）,SHR的SBP均高于相应配对的WKY组（P〈0.05）。2.一个月后SHR血浆AngⅡ浓度均高于S1（P〈0.05）,一个月后SHR血浆AngⅡ浓度均高于相应配对的WKY组（P〈0.05）。3.SHR心脏AT2R免疫染色阳性面积比随着月份的增加而降低,SHR心脏AT2R免疫染色阳性面积比均低于相应配对的WKY组（P﹤0.05）4.SHR心肌中的胶原含量随着月龄的增加而增加。结论 SHR心脏AT2R表达水平比WKY低,并随着年龄的增加而降低。SHR心肌中的胶原含量随着月龄的增加而增加,而WKY无类似趋势。     

ACEI及无创呼吸机辅助治疗心衰合并OSAHS的疗效及对血清BNP水平的影响

目的:探讨血管紧张素转换酶抑制剂(Angiotensin-converting enzyme inhibitor,ACEI)联合无创呼吸机辅助治疗心衰合并阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)疗效及对血清脑钠素(Brain natriuretic peptide,BNP)水平的影响。方法:抽取我院自2013年1月到2019年4月收治的98例心衰合并OSAHS患者,根据治疗方法分为对照组(49例,ACEI常规治疗)与实验组(49例,ACEI联合无创呼吸机辅助治疗),比较两组患者治疗前后红细胞生成素(Erythropoietin,EPO)、血红蛋白(hemoglobin,Hb)、红细胞计数(red blood cell,RBC)、平均红细胞蛋白含量(Mean corpuscular protein content,MCH)、血细胞比容(Hematocrit,HCT)、平均红细胞体积(Mean red blood cell volume,MCV)、夜间平均最低血氧合度(Lowest oxygen saturation,LSaO2)、睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、血清脑钠素(Brain natriuretic peptide,BNP)水平、中心收缩压(systolic pressure,SP)及中心舒张压(diastolic pressure,DP)的变化。结果:治疗后,两组患者EPO、Hb、RBC、MCH、HCT、MCV水平均明显低于治疗前,且实验组患者的以上指标水平均显著低于对照组(P<0.05)。两组治疗后LSaO2高于明显高于治疗前,AHI水平低于治疗前,且实验组LSaO2高于对照组,AHI水平低于对照组(均P<0.05)。治疗后两组患者BNP、SP和DP明显低于治疗前(P<0.05),且实验组患者的以上指标水平低于对照组(P<0.05)。实验组患者的术后并发症发生率明显低于对照组(P<0.05)。结论:ACEI及无创呼吸机辅助治疗心衰合并OSAHS可改善患者的睡眠紊乱、睡眠呼吸障碍、心衰及高血压,具有临床推广应用的价值。     

Partial prevention of changes in SR gene expression in congestive heart failure due to myocardial infarction by enalapril or losartan

Although activation of the renin-angiotensin system (RAS) is known to produce ventricular remodeling and congestive heart failure (CHF), its role in inducing changes in the sarcoplasmic reticulum (SR) protein and gene expression in CHF is not fully understood. In this study, CHF was induced in rats by ligation of the left coronary artery for 3 weeks and then the animals were treated orally with or without an angiotensin converting enzyme inhibitor, enalapril (10 mg/kg/day) or an angiotensin II receptor antagonist, losartan (20 mg/kg/day) for 4 weeks. Sham-operated animals were used as control. The animals were hemodynamically assessed and protein content as well as gene expression of SR Ca²⁺-release channel (ryanodine receptor, RYR), Ca²⁺-pump ATPase (SERCA2), phospholamban (PLB) and calsequestrin (CQS) were determined in the left ventricle (LV). The infarcted animals showed cardiac hypertrophy, lung congestion, depression in LV +dP/dt and –dP/dt, as well as increase in LV end diastolic pressure. Both protein content and mRNA levels for RYR, SERCA2 and PLB were decreased without any changes in CQS in the failing heart. These alterations in LV function as well as SR protein and gene expression in CHF were partially prevented by treatment with enalapril or losartan. The results suggest that partial improvement in LV function by enalapril and losartan treatments may be due to partial prevention of changes in SR protein and gene expression in CHF and that these effects may be due to blockade of the RAS.     

Protein kinase C isozymes in hypertension and hypertrophy: Insight from SHHF rat hearts

Chronic hypertension results in cardiac hypertrophy and may lead to congestive heart failure. The protein kinase C (PKC) family has been identified as a signaling component promoting cardiac hypertrophy. We hypothesized that PKC activation may play a role mediating hypertrophy in the spontaneously hypertensive heart failure (SHHF) rat heart. Six-month-old SHHF and normotensive control Wistar Furth (WF) rats were used. Hypertension and cardiac hypertrophy were confirmed in SHHF rats. PKC expression and activation were analyzed by Western blots using isozyme-specific antibodies. Compared to WF, untreated SHHF rats had increased phospho-active (10-fold), (4-fold), and (3-fold) isozyme expression. Furthermore, we analyzed the effect of an angiotensin II type 1 receptor blocker (ARB) and hydralazine (Hy) on PKC regulation in SHHF rat left ventricle (LV). Both the ARB and Hy normalized LV blood pressure, but only the ARB reduced heart mass. Neither treatment affected PKC expression or activity. Our data show differential activation of PKC in the hypertensive, hypertrophic SHHF rat heart. Regression of hypertrophy elicited by an ARB in this model occurred independently of changes in the expression and activity of the PKC isoforms examined. (Mol Cell Biochem 270: 63–69, 2005)     

Comparative effects of a vasopeptidase inhibitor vs. an angiotensin convertin enzyme inhibitor on cardiomyocyte apoptosis in rats with heart failure

Apoptosis is involved in ventricular remodeling after myocardial infarction (MI). We investigated the effects of the vasopeptidase inhibitor (VPI) omapatrilat on cardiomyocyte apoptosis and compared it to the angiotensin converting enzyme inhibitor (ACEI) captopril in the rat post-MI model and in cultured neonatal rat cardiomyocytes. Wistar males rats surviving 4 h post-MI were assigned to omapatrilat (40 or 80 mg/kg/day), captopril (160 mg/kg/day) or no treatment. After 56 days, hemodynamic measurements were performed (n = 96) and rats were sacrificed. One group had assessment of cardiac remodeling and detection of DNA fragments by in situ end labelling method (ISEL), while the other had morphologic measurements and DNA laddering assessed. In addition, cultured neonatal rat cardiomyocytes (n = 6) were treated for 72 h with vehicle, captopril or omapatrilat in the presence or absence of the apoptosis inducing agent H₂O₂. Omapatrilat and captopril resulted in similar improvements of hemodynamic measurements, ventricular weight and dilatation, cardiac fibrosis and myocardial cell cross-section in large MI rats. Omapatrilat increased scar thickness more than did captopril. All sham-operated groups had little evidence of apoptosis. In the large MI group, there was a significant increase in ISEL-positive cells in the control (0.095 ± 0.016%) and captopril (0.124 ± 0.024%) groups in comparison with control sham-operated (0.006 ± 0.006%), but this increase was limited to the peri-MI area. Omapatrilat (0.012 ± 0.012% for both doses) prevented the increase in apoptosis in the peri-MI area. Also, omapatrilat but not captopril reduced DNA laddering in large MI. Moreover, in cultured neonatal rat cardiomyocytes, omapatrilat but not captopril reduced apoptosis as assessed by DNA laddering. The VPI omapatrilat, with its combination of NEP and ACE inhibition, suppresses cardiomyocyte apoptosis post-MI and in neonatal cultured rat cardiomyocytes more than the ACEI captopril, but this does not result in significant hemodynamic or morphologic differences between omapatrilat and captopril.     

Bradykinin (B2 independent effect of captopril on the development of pressure overload cardiac hypertrophy

Besides the reduction of angiotensin II formation, locally increased kinins may play a role in the cardiovascular action of angiotensin converting enzyme (ACE) inhibitors.To characterize the contribution of bradykinin to the effects of ACE inhibition by captopril on the development of pressure overload hypertrophy, sham-operated rats and rats with ascending aortic constriction were treated with captopril (80 mg/kg/day) or captopril and B₂-kinin receptor antagonist HOE 140 (0.5 mg/kg/day) for 7 weeks. Left ventricular mass and geometry, hydroxyproline concentration and myosin isozymes (marker of a fetal phenotype) were assessed. Rats with aortic constriction exhibited a marked increase in left ventricular weight and diastolic pressure-volume relationship was shifted to smaller volumes. Signs of congestive heart failure were not apparent. The hydroxyproline concentration remained unaltered. However, the proportion of isomyosin V3 was increased (p < 0.05). Administration of captopril reduced (p < 0.05) systolic blood pressure, body and cardiac weight in all treated rats. The reduction of left ventricular weight was disproportionally higher in pressure overloaded rats, thus the relative left ventricular weight decreased by 15% (p < 0.05). Captopril augmented the isomyosin V1 expression (p < 0.05) in sham operated as well as pressure overloaded rats. The isomyosin V1 percentage was inversely related to the relative left ventricular weight. Two different (p < 0.05) correlation lines were detected for untreated and captopril treated rats. None of captopril associated effects were removed by simultaneously administered B₂ kinin receptor antagonist HOE 140.Thus, stimulation of bradykinin B2 receptor appears not to mediate the effects of captopril on cardiac growth and contractile proteins during the development of pressure overload hypertrophy.     

Finerenone Impedes Aldosterone-dependent Nuclear Import of the Mineralocorticoid Receptor and Prevents Genomic Recruitment of Steroid Receptor Coactivator-1

Aldosterone regulates sodium homeostasis by activating the mineralocorticoid receptor (MR), a member of the nuclear receptor superfamily. Hyperaldosteronism leads todeleterious effects on the kidney, blood vessels, and heart. Although steroidal antagonists such as spironolactone and eplerenone are clinically useful for the treatment of cardiovascular diseases, they are associated with several side effects. Finerenone, a novel nonsteroidal MR antagonist, is presently being evaluated in two clinical phase IIb trials. Here, we characterized the molecular mechanisms of action of finerenone and spironolactone at several key steps of the MR signaling pathway. Molecular modeling and mutagenesis approaches allowed identification of Ser-810 and Ala-773 as key residues for the high MR selectivity of finerenone. Moreover, we showed that, in contrast to spironolactone, which activates the S810L mutant MR responsible for a severe form of early onset hypertension, finerenone displays strict antagonistic properties. Aldosterone-dependent phosphorylation and degradation of MR are inhibited by both finerenone and spironolactone. However, automated quantification of MR subcellular distribution demonstrated that finerenone delays aldosterone-induced nuclear accumulation of MR more efficiently than spironolactone. Finally, chromatin immunoprecipitation assays revealed that, as opposed to spironolactone, finerenone inhibits MR, steroid receptor coactivator-1, and RNA polymerase II binding at the regulatory sequence of the SCNN1A gene and also remarkably reduces basal MR and steroid receptor coactivator-1 recruitment, unraveling a specific and unrecognized inactivating mechanism on MR signaling. Overall, our data demonstrate that the highly potent and selective MR antagonist finerenone specifically impairs several critical steps of the MR signaling pathway and therefore represents a promising new generation MR antagonist.     

Control of cardiomyocyte gene expression as drug target

Pressure overload of the heart is associated with a perturbed gene expression of the cardiomyocyte leading to an impaired pump function. The ensuing neuro-endocrine activation results in disordered influences of angiotensin II and catecholamines on gene expression. To assess whether angiotensin II type 1 receptor inhibition can also counteract a raised sympathetic nervous system activity, spontaneously hypertensive rats fed a hypercaloric diet were treated with eprosartan (daily 90 mg/kg body wt) and cardiovascular parameters were monitored with implanted radiotelemetry pressure transducers. Both, blood pressure and heart rate were increased (p < 0.05) by the hypercaloric diet. Although eprosartan reduced (p < 0.05) the raised systolic and diastolic blood pressure, the diet-induced rise in heart rate was blunted only partially. In addition to drugs interfering with the enhanced catecholamine influence, compounds should be considered that selectively affect cardiomyocyte gene expression via 'metabolic' signals.