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高血压及相关肾损伤中的氧化应激与抗氧化治疗

Oxidative stress and antioxidant treatment in hypertension and the associated renal damage.

作者信息

Manning R Davis, Tian Niu, Meng Shumei

机构信息

Department of Physiology and Biophysics, University of Mississippi Medical Center Jackson, USA.

出版信息

Am J Nephrol. 2005 Jul-Aug;25(4):311-7. doi: 10.1159/000086411. Epub 2005 Jun 14.

Abstract

Reactive oxygen species (ROS) are elevated in humans with hypertension many of which develop end-stage renal disease (ESRD), and antioxidant capacity is decreased. About one-half of essential hypertensives have a salt-sensitive type of hypertension, and the amount of renal damage that occurs in salt-sensitive hypertensives greatly exceeds that of non-salt-sensitive hypertensives. Antioxidant therapy can improve cardiovascular outcomes in humans but only if sufficient doses are used. Salt-sensitive hypertensive animal models, especially Dahl salt-sensitive rats, have been used to investigate the relationship between hypertension, ROS and end-stage renal damage. In experimental salt-sensitive hypertension, ROS increase and significant renal damage occur. In the Dahl salt-sensitive (S) rat on high Na for 3 weeks, renal damage is mild, renal levels of superoxide dismutase are decreased, and treatment with Tempol reduces arterial pressure. In the Dahl S rat on high Na for 5 weeks, renal damage is severe, GFR and renal plasma flow are decreased, and renal superoxide production is high. Treatment with vitamins C and E decreases renal superoxide production and renal damage and prevents the decrease in renal hemodynamics. Antioxidant treatment reduces arterial pressure, aortic superoxide production and renal inflammation in DOCA-salt rats, and decreases blood pressure and aortic superoxide release and increases bioactive nitric oxide in SHR stroke-prone rats. In conclusion, in both human and experimental salt-sensitive hypertension, superoxide production and renal damage are increased, antioxidant capacity is decreased, and antioxidant therapy can be helpful.

摘要

高血压患者体内的活性氧(ROS)水平升高,其中许多人会发展为终末期肾病(ESRD),且抗氧化能力下降。约一半的原发性高血压患者患有盐敏感性高血压,盐敏感性高血压患者发生的肾损害程度大大超过非盐敏感性高血压患者。抗氧化治疗可改善人类心血管结局,但前提是使用足够的剂量。盐敏感性高血压动物模型,尤其是 Dahl 盐敏感性大鼠,已被用于研究高血压、ROS 与终末期肾损害之间的关系。在实验性盐敏感性高血压中,ROS 增加并发生明显的肾损害。在给予高钠饮食 3 周的 Dahl 盐敏感性(S)大鼠中,肾损害较轻,肾脏超氧化物歧化酶水平降低,用 Tempol 治疗可降低动脉血压。在给予高钠饮食 5 周的 Dahl S 大鼠中,肾损害严重,肾小球滤过率(GFR)和肾血浆流量降低,肾脏超氧化物生成量高。用维生素 C 和 E 治疗可降低肾脏超氧化物生成量和肾损害,并防止肾血流动力学下降。抗氧化治疗可降低 DOCA-盐大鼠的动脉血压、主动脉超氧化物生成量和肾脏炎症,并降低易发生中风的自发性高血压大鼠(SHR)的血压和主动脉超氧化物释放量,增加生物活性一氧化氮。总之,在人类和实验性盐敏感性高血压中,超氧化物生成量和肾损害均增加,抗氧化能力下降,抗氧化治疗可能有益。

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