Nishiyama Akira, Kiyomoto Hideyasu, Kohno Masakazu
Department of Pharmacology, Kagawa University Medical School.
Nihon Rinsho. 2009 Apr;67(4):695-700.
Recent clinical trials have indicated the utility of mineralocorticoid receptor (MR) antagonists in patients with cardiovascular and renal diseases. Experiments studies have shown that chronic treatment with aldosterone resulted in severe cardiac and renal injuries, which were ameliorated by MR antagonists. In vitro studies also showed that MR is highly expressed in cultured vascular endothelial cells, vascular smooth muscle cells, cardiomyocytes, mesangial cells, glomerular epithelial cells, renal fibroblasts and proximal tubular cells. In these cells, aldosterone-induced cell injuries were prevented by MR antagonists. These accumulating data support the notion that aldosterone is involved in the pathogenesis of cardiovascular and renal injuries through local MR activation.
近期临床试验表明,盐皮质激素受体(MR)拮抗剂对患有心血管疾病和肾脏疾病的患者有用。实验研究表明,长期使用醛固酮会导致严重的心脏和肾脏损伤,而MR拮抗剂可改善这些损伤。体外研究还表明,MR在培养的血管内皮细胞、血管平滑肌细胞、心肌细胞、系膜细胞、肾小球上皮细胞、肾成纤维细胞和近端肾小管细胞中高度表达。在这些细胞中,MR拮抗剂可预防醛固酮诱导的细胞损伤。这些越来越多的数据支持了这样一种观点,即醛固酮通过局部MR激活参与心血管和肾脏损伤的发病机制。