Akazawa Hiroshi, Komuro Issei
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine.
Nihon Rinsho. 2012 Sep;70(9):1492-8.
A growing body of evidence indicates that activation of angiotensin II (Ang II) type 1 (AT1) receptor, a seven -transmembrane G protein -coupled receptor, is critically involved in the development of various cardiovascular diseases. Inherently, AT1 receptor is structurally unstable, and shows spontaneous constitutive activity in an Ang II-independent manner. The constitutive activity of AT1 receptor under basal conditions contributes to the cardiac remodeling even in the absence of Ang II, when AT1 receptor is up-regulated in the heart. Furthermore, mechanical stress can activate AT1 receptor by inducing conformational switch without the involvement of Ang II, and induce cardiac hypertrophy in vivo. These agonist-independent activities of AT1 receptor can be inhibited by inverse agonists, but not by neutral antagonists. Therefore, inverse agonism of AT1 receptor blockers provides therapeutic benefits in the prevention of cardiac remodeling, and thus has potential impact on long-term outcomes in patients with cardiovascular diseases.
越来越多的证据表明,血管紧张素II(Ang II)1型(AT1)受体(一种七跨膜G蛋白偶联受体)的激活在各种心血管疾病的发展中起关键作用。本质上,AT1受体在结构上不稳定,并以不依赖Ang II的方式表现出自发组成性活性。即使在没有Ang II的情况下,当心脏中AT1受体上调时,基础条件下AT1受体的组成性活性也会导致心脏重塑。此外,机械应力可通过诱导构象转换激活AT1受体而不涉及Ang II,并在体内诱导心脏肥大。AT1受体的这些非激动剂依赖性活性可被反向激动剂抑制,但不能被中性拮抗剂抑制。因此,AT1受体阻滞剂的反向激动作用在预防心脏重塑方面具有治疗益处,从而对心血管疾病患者的长期预后具有潜在影响。