Matsuki Kota, Hathaway Catherine K, Chang Albert S, Smithies Oliver, Kakoki Masao
Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Curr Opin Nephrol Hypertens. 2015 Mar;24(2):139-44. doi: 10.1097/MNH.0000000000000100.
It is well established that blocking the renin-angiotensin-aldosterone system (RAAS) is effective for the treatment of cardiovascular and renal complications in hypertension and diabetes mellitus. Although the induction of transforming growth factor beta1 (TGFbeta1) by components of the RAAS mediates the hypertrophic and fibrogenic changes in cardiovascular-renal complications, it is still controversial as to whether TGFbeta1 can be a target to prevent such complications. Here, we review recent findings on the role of TGFbeta1 in fluid homeostasis, focusing on the relationship with aldosterone.
TGFbeta1 suppresses the adrenal production of aldosterone and renal tubular sodium reabsorption. We have generated mice with TGFbeta1 mRNA expression graded in five steps, from 10 to 300% of normal, and found that blood pressure and plasma volume are negatively regulated by TGFbeta1. Notably, the 10% hypomorph exhibits primary aldosteronism and sodium and water retention due to markedly impaired urinary excretion of water and electrolytes.
These results identify TGFbeta signalling as an important counterregulatory system against aldosterone. Understanding the molecular mechanisms for the suppressive effects of TGFbeta1 on adrenocortical and renal function may further our understanding of primary aldosteronism, as well as assist in the development of novel therapeutic strategies for hypertension.
阻断肾素 - 血管紧张素 - 醛固酮系统(RAAS)对治疗高血压和糖尿病的心血管及肾脏并发症有效,这一点已得到充分证实。尽管RAAS的成分诱导转化生长因子β1(TGFβ1)介导了心血管 - 肾脏并发症中的肥厚和纤维化改变,但TGFβ1是否可作为预防此类并发症的靶点仍存在争议。在此,我们综述了TGFβ1在液体平衡中的作用的最新研究结果,重点关注其与醛固酮的关系。
TGFβ1抑制肾上腺醛固酮的产生和肾小管钠重吸收。我们构建了TGFβ1 mRNA表达呈五级梯度变化(从正常水平的10%到300%)的小鼠,并发现血压和血浆容量受TGFβ1负调控。值得注意的是,10%低表达型小鼠由于水和电解质的尿排泄明显受损而表现为原发性醛固酮增多症以及钠和水潴留。
这些结果表明TGFβ信号传导是对抗醛固酮的重要负调节系统。了解TGFβ1对肾上腺皮质和肾功能的抑制作用的分子机制,可能会增进我们对原发性醛固酮增多症的理解,并有助于开发高血压的新型治疗策略。