Risler Norma R, Cruzado Montserrat C, Miatello Roberto M
Department of Pathology, School of Medical Sciences, National University of Cuyo, Centro Universitario, (5500) Mendoza, Argentina.
ScientificWorldJournal. 2005 Dec 12;5:959-71. doi: 10.1100/tsw.2005.122.
The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole) vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts) and noncellular (extracellular matrix) components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.
高血压的基本血流动力学异常是外周阻力增加,这主要归因于小动脉壁结构变化导致的血管腔减小,整体上称为血管重塑。血管壁是一个由细胞成分(内皮细胞、平滑肌细胞、外膜细胞和成纤维细胞)和非细胞成分(细胞外基质)组成的活跃、灵活且整合的器官,其会根据生理和病理刺激动态地改变形状或数量,或进行重新组织,在生理条件下维持血管壁的完整性,或参与高血压等心血管疾病中的血管变化。针对可参与血管重塑机制的新信号通路和分子的研究已提供证据表明,血管结构不仅受血压影响,还受与压力升高无关的机制影响。本综述将概述相关证据,解释在高血压实验模型中参与血管重塑发展的一些病理生理机制,特别提及作为原发性高血压模型的自发性高血压大鼠以及作为继发性高血压模型的果糖喂养大鼠在代谢综合征背景下的研究结果。对产生血管改变机制的理解将有助于开发用于高血压疾病血管保护的新型药物工具。