Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA, USA.
Curr Atheroscler Rep. 2013 Jul;15(7):340. doi: 10.1007/s11883-013-0340-x.
The mineralocorticoid receptor (MR), a steroid-hormone-activated transcription factor, plays a substantial role in cardiovascular diseases. MR antagonists (MRAs) have long been appreciated as effective treatments for heart failure and hypertension; however, recent research suggests that additional patient populations may also benefit from MRA therapy. Experimental evidence demonstrates that in addition to its classic role in the regulating sodium handling in the kidney, functional MR is expressed in the blood vessels and contributes to hypertension, vascular inflammation and remodeling, and atherogenesis. MR activation drives pathological phenotypes in smooth muscle cells, endothelial cells, and inflammatory cells, whereas MRAs inhibit these effects. Collectively, these studies demonstrate a new role for extrarenal MR in cardiovascular disease. This review summarizes these new lines of evidence and how they contribute to the mechanisms of atherosclerosis, pulmonary and systemic hypertension, and vein graft failure, and describes new patient populations that may benefit from MRA therapy.
醛固酮受体（MR）是一种类固醇激素激活的转录因子，在心血管疾病中发挥重要作用。MR 拮抗剂（MRA）长期以来一直被认为是心力衰竭和高血压的有效治疗方法；然而，最近的研究表明，其他患者群体也可能从 MRA 治疗中受益。实验证据表明，除了在调节肾脏钠处理中的经典作用外，功能性 MR 还在血管中表达，并有助于高血压、血管炎症和重塑以及动脉粥样硬化形成。MR 激活可导致平滑肌细胞、内皮细胞和炎症细胞发生病理性表型，而 MRA 则抑制这些作用。总的来说，这些研究表明肾脏外的 MR 在心血管疾病中具有新的作用。本文综述了这些新的证据及其在动脉粥样硬化、肺动脉高压和系统性高血压以及静脉移植物失败的机制中的作用，并描述了可能从 MRA 治疗中受益的新的患者群体。
