Frame Alissa A, Carmichael Casey Y, Wainford Richard D
Department of Pharmacology & Experimental Therapeutics and The Whitaker Cardiovascular Institute Boston University School of Medicine, 72 East Concord St, Boston, 02118, MA, USA.
Curr Hypertens Rep. 2016 Sep;18(9):69. doi: 10.1007/s11906-016-0676-z.
The etiology of hypertension, a critical public health issue affecting one in three US adults, involves the integration of the actions of multiple organ systems, including the renal sympathetic nerves. The renal sympathetic nerves, which are comprised of both afferent (sensory input) and efferent (sympathetic outflow) arms, have emerged as a major potential therapeutic target to treat hypertension and disease states exhibiting excess renal sympathetic activity.
This review highlights recent advances in both clinical and basic science that have provided new insight into the distribution, function, and reinnervation of the renal sympathetic nerves, with a focus on the renal afferent nerves, in hypertension and hypertension-evoked disease states including salt-sensitive hypertension, obesity-induced hypertension, and chronic kidney disease. Increased understanding of the differential role of the renal afferent versus efferent nerves in the pathophysiology of hypertension has the potential to identify novel targets and refine therapeutic interventions designed to treat hypertension.
高血压是一个影响三分之一美国成年人的关键公共卫生问题,其病因涉及多个器官系统的协同作用,包括肾交感神经。肾交感神经由传入(感觉输入)和传出(交感神经输出)两部分组成,已成为治疗高血压及表现出肾交感神经活动亢进的疾病状态的主要潜在治疗靶点。
本综述重点介绍了临床和基础科学方面的最新进展,这些进展为肾交感神经的分布、功能和再支配提供了新的见解,尤其关注高血压以及由高血压引发的疾病状态(包括盐敏感性高血压、肥胖性高血压和慢性肾病)中的肾传入神经。对肾传入神经与传出神经在高血压病理生理学中不同作用的深入理解,有可能确定新的靶点并优化旨在治疗高血压的治疗干预措施。