Luther James M
aDivision of Clinical Pharmacology bDivision of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Curr Opin Nephrol Hypertens. 2016 Jan;25(1):16-21. doi: 10.1097/MNH.0000000000000189.
This review will highlight recent developments in mineralocorticoid receptor research which impact aldosterone-associated vascular and cardiometabolic dysfunction.
The mineralocorticoid receptor is also expressed in vascular smooth muscle and vascular endothelium, and contributes to vascular function and remodeling. Adipocyte-derived leptin stimulates aldosterone secretion, which may explain the observed link between obesity and hyperaldosteronism. Adipocyte mineralocorticoid receptor overexpression produces systemic changes consistent with metabolic syndrome. Ongoing studies with novel nonsteroidal mineralocorticoid receptor antagonists may provide a novel treatment for diabetic nephropathy and heart failure in patients with chronic kidney disease, with reduced risk of hyperkalemia.
Ongoing research continues to demonstrate novel roles of the vascular and adipocyte mineralocorticoid receptor function, which may explain the beneficial metabolic and vascular benefits of mineralocorticoid receptor antagonists.
本综述将重点介绍盐皮质激素受体研究的最新进展，这些进展影响与醛固酮相关的血管和心脏代谢功能障碍。
盐皮质激素受体也在血管平滑肌和血管内皮中表达，并有助于血管功能和重塑。脂肪细胞衍生的瘦素刺激醛固酮分泌，这可能解释了肥胖与醛固酮增多症之间观察到的联系。脂肪细胞盐皮质激素受体过表达会产生与代谢综合征一致的全身变化。正在进行的新型非甾体盐皮质激素受体拮抗剂研究可能为慢性肾脏病患者的糖尿病肾病和心力衰竭提供一种新的治疗方法，同时降低高钾血症风险。
正在进行的研究继续证明血管和脂肪细胞盐皮质激素受体功能的新作用，这可能解释盐皮质激素受体拮抗剂有益的代谢和血管益处。
