Department of Medical Oncology, University Hospital of Salamanca, 37007 Salamanca, Spain.
Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
Biomolecules. 2021 Feb 10;11(2):254. doi: 10.3390/biom11020254.
The dopaminergic system can adapt to the different physiological or pathological situations to which the kidneys are subjected throughout life, maintaining homeostasis of natriuresis, extracellular volume, and blood pressure levels. The role of renal dopamine receptor dysfunction is clearly established in the pathogenesis of essential hypertension. Its associations with other pathological states such as insulin resistance and redox balance have also been associated with dysfunction of the dopaminergic system. The different dopamine receptors (D1-D5) show a protective effect against hypertension and kidney disorders. It is essential to take into account the various interactions of the dopaminergic system with other elements, such as adrenergic receptors. The approach to therapeutic strategies for essential hypertension must go through the blocking of those elements that lead to renal vasoconstriction or the restoration of the normal functioning of dopamine receptors. D1-like receptors are fundamental in this role, and new therapeutic efforts should be directed to the restoration of their functioning in many patients. More studies will be needed to allow the development of drugs that can be targeted to renal dopamine receptors in the treatment of hypertension.
多巴胺能系统可以适应肾脏在整个生命周期中所面临的不同生理或病理情况,维持钠排泄、细胞外液体积和血压水平的动态平衡。肾多巴胺受体功能障碍在原发性高血压的发病机制中作用明确。其与其他病理状态(如胰岛素抵抗和氧化还原平衡)的关联也与多巴胺能系统功能障碍有关。不同的多巴胺受体(D1-D5)对高血压和肾脏疾病具有保护作用。必须考虑到多巴胺能系统与其他元素(如肾上腺素能受体)的各种相互作用。治疗原发性高血压的策略方法必须通过阻断导致肾血管收缩或恢复多巴胺受体正常功能的那些元素来实现。D1 样受体在这方面起着基础性作用,新的治疗方法应致力于恢复许多患者的受体功能。还需要更多的研究来开发可以针对高血压治疗中的肾脏多巴胺受体的药物。