Kinsman Brian J, Nation Haley N, Stocker Sean D
Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh Hypertension Center, University of Pittsburgh, 3550 Terrace Ave S976, Pittsburgh, PA, 15261, USA.
Curr Hypertens Rep. 2017 Jun;19(6):50. doi: 10.1007/s11906-017-0749-7.
The central nervous system plays a pivotal role in the regulation of extracellular fluid volume and consequently arterial blood pressure. Key hypothalamic regions sense and integrate neurohumoral signals to subsequently alter intake (thirst and salt appetite) and output (renal excretion via neuroendocrine and autonomic function). Here, we review recent findings that provide new insight into such mechanisms that may represent new therapeutic targets.
Implementation of cutting edge neuroscience approaches such as opto- and chemogenetics highlight pivotal roles of circumventricular organs to impact body fluid homeostasis. Key signaling mechanisms within these areas include the N-terminal variant of transient receptor potential vannilloid type-1, NaX, epithelial sodium channel, brain electroneutral transporters, and non-classical actions of vasopressin. Despite the identification of several new mechanisms, future studies need to better define the neurochemical phenotype and molecular profiles of neurons within circumventricular organs for future therapeutic potential.
中枢神经系统在细胞外液量的调节以及动脉血压的调节中起着关键作用。下丘脑的关键区域感知并整合神经体液信号,进而改变摄入量(口渴和盐欲)和排出量(通过神经内分泌和自主功能进行肾脏排泄)。在此,我们综述近期的研究发现,这些发现为可能代表新治疗靶点的此类机制提供了新的见解。
光遗传学和化学遗传学等前沿神经科学方法的应用突显了室周器官在影响体液平衡方面的关键作用。这些区域内的关键信号机制包括瞬时受体电位香草酸亚型1的N端变体、钠氢交换体、上皮钠通道、脑电中性转运体以及血管加压素的非经典作用。尽管已确定了几种新机制,但未来的研究需要更好地明确室周器官内神经元的神经化学表型和分子特征,以挖掘其未来的治疗潜力。