Liu Limei, Liu Jian, Huang Yu
*Department of Physiology and Pathophysiology, Peking University Health Science Center, Peking, China; and †Institute of Vascular Medicine and Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, China.
J Cardiovasc Pharmacol. 2015 May;65(5):399-405. doi: 10.1097/FJC.0000000000000176.
Vascular endothelial cells play a major role in maintaining cardiovascular homeostasis. Endothelial dysfunction, characterized by reduced endothelium-dependent relaxations or accompanied by enhanced endothelium-dependent contractions, is a hallmark of and plays a pivotal role in the pathogenesis of hypertension. Endothelial dysfunction in hypertension has been linked to decreases in nitric oxide (NO) bioavailability, reflecting the impaired generation of NO and/or the enhanced inactivation of NO by reactive oxygen species. Many of these conditions can be improved by glucagon-like peptide 1 (GLP-1), a proglucagon-derived hormone secreted by intestinal endocrine L-type cells, which is rapidly inactivated by an enzyme dipeptidyl peptidase 4 in circulation. On one hand, GLP-1 analogues or dipeptidyl peptidase 4 inhibitors upregulate endothelial nitric oxide synthase expression and increase endothelial nitric oxide synthase phosphorylation, resulting in improved production of NO and thus endothelium-dependent relaxations. On the other hand, GLP-1 and related agents attenuate endothelium-dependent contractions by reducing reactive oxygen species generation and cyclooxygenase-2 expression. GLP-1 elevating agents and GLP-1 receptor agonists improve endothelial function in hypertension, suggesting that GLP-1 signaling could be a therapeutic target in hypertension-related vascular events.
血管内皮细胞在维持心血管稳态中起主要作用。内皮功能障碍的特征是内皮依赖性舒张减弱或伴有内皮依赖性收缩增强,是高血压发病机制的标志并在其中起关键作用。高血压中的内皮功能障碍与一氧化氮(NO)生物利用度降低有关,这反映了NO生成受损和/或活性氧对NO的灭活增强。这些情况中的许多都可以通过胰高血糖素样肽1(GLP-1)得到改善,GLP-1是一种由肠道内分泌L型细胞分泌的胰高血糖素衍生激素,在循环中会被二肽基肽酶4迅速灭活。一方面,GLP-1类似物或二肽基肽酶4抑制剂上调内皮型一氧化氮合酶表达并增加内皮型一氧化氮合酶磷酸化,从而改善NO的生成并进而改善内皮依赖性舒张。另一方面,GLP-1及相关药物通过减少活性氧生成和环氧合酶-2表达来减弱内皮依赖性收缩。GLP-1升高剂和GLP-1受体激动剂可改善高血压患者的内皮功能,这表明GLP-1信号传导可能是高血压相关血管事件的治疗靶点。