Rosenthal Talma, Younis Firas, Alter Ariela
Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Israel.
Pharmaceuticals (Basel). 2010 Mar 26;3(4):916-939. doi: 10.3390/ph3040916.
Rat experimental models are used extensively for studying physiological mechanisms and treatments of hypertension and diabetes co-existence. Each one of these conditions is a major risk factor for cardiovascular disease (CVD), and the combination of the two conditions is a potent enhancer of CVD. Five major animal models that advanced our understanding of the mechanisms and therapeutic approaches in humans are discussed in this review: Zucker, Goto-Kakizaki, SHROB, SHR/NDmcr-cp and Cohen Rosenthal diabetic hypertensive (CRDH) rats. The use of various drugs, such as angiotensin-converting enzyme (ACE) inhibitors (ACEIs), various angiotensin receptor blockers (ARBs), and calcium channel blockers (CCBs), to combat the effects of concomitant pathologies on the combination of diabetes and hypertension, as well as the non-pharmacological approach are reviewed in detail for each rat model. Results from experiments on these models indicate that classical factors contributing to the pathology of hypertension and diabetes combination-Including hypertension, hyperglycemia, hyperinsulinemia and hyperlipidemia-can now be treated, although these treatments do not completely prevent renal complications. Animal studies have focused on several mechanisms involved in hypertension/diabetes that remain to be translated into clinical medicine, including hypoxia, oxidative stress, and advanced glycation. Several target molecules have been identified that need to be incorporated into a treatment modality. The challenge continues to be the identification and interpretation of the clinical evidence from the animal models and their application to human treatment.
大鼠实验模型被广泛用于研究高血压与糖尿病并存的生理机制及治疗方法。这两种病症中的每一种都是心血管疾病(CVD)的主要危险因素,而这两种病症并存会有力地加剧心血管疾病。本文综述了五种推进我们对人类相关机制及治疗方法理解的主要动物模型:Zucker大鼠、Goto-Kakizaki大鼠、SHROB大鼠、SHR/NDmcr-cp大鼠和科恩·罗森塔尔糖尿病高血压(CRDH)大鼠。针对每种大鼠模型,详细综述了使用各种药物(如血管紧张素转换酶(ACE)抑制剂(ACEI)、各种血管紧张素受体阻滞剂(ARB)和钙通道阻滞剂(CCB))来对抗伴随病症对糖尿病和高血压并存情况的影响,以及非药物治疗方法。对这些模型进行实验的结果表明,导致高血压与糖尿病并存病症的经典因素——包括高血压、高血糖、高胰岛素血症和高脂血症——现在可以得到治疗,尽管这些治疗并不能完全预防肾脏并发症。动物研究聚焦于高血压/糖尿病中涉及的几种尚未转化为临床医学的机制,包括缺氧、氧化应激和晚期糖基化。已经确定了几种需要纳入治疗模式的靶分子。挑战仍然在于识别和解读来自动物模型的临床证据及其在人类治疗中的应用。