Department of Renal and Body Fluid Physiology, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland.
Department of Clinical Neuroendocrinology, Centre of Postgraduate Medical Education, Warsaw, Poland.
Clin Exp Hypertens. 2021 Jul 4;43(5):392-401. doi: 10.1080/10641963.2021.1890762. Epub 2021 Mar 9.
Chymase generates angiotensin II (ANG II) independently of angiotensin-converting enzyme in tissues and it contributes to vascular remodeling and development of hypertension, however the exact mechanism of its action is unclear. Hence, the effects of chymase inhibition were examined in anesthetized spontaneously hypertensive rats (SHR) in two stages of the disease development, . pre-hypertensive (SHR7) and with established hypertension (SHR16). Chymostatin, a commercial chymase inhibitor, was infused intravenously alone or in subsequent groups co-infused with captopril. Mean blood pressure (MBP), total renal blood flow (RBF) and ANG II content (plasma and tissues) were measured. In SHR16 chymase blockade significantly decreased MBP (-6%) and plasma (-38%), kidney (-71%) and heart (-52%) ANG II levels. In SHR7 chymostatin did not influence MBP or RBF, but significantly decreased heart ANG II level. Jointly, functional studies and ANG II determinations support the evidence that in SHR chymase can raise plasma ANG II and contribute to blood pressure elevation. We propose that addition of chymase blockade to ACE inhibition could be a promising approach in the treatment of hypertensive patients resistant to therapy with ACE-inhibitors alone.
糜酶独立于血管紧张素转换酶在组织中生成血管紧张素 II(ANG II),并有助于血管重塑和高血压的发展,但其确切作用机制尚不清楚。因此,在疾病发展的两个阶段,即在高血压前期(SHR7)和已建立的高血压(SHR16)的麻醉自发性高血压大鼠(SHR)中,研究了糜酶抑制的作用。糜蛋白酶抑制剂 chymostatin 单独或在随后的与卡托普利共同输注的组中静脉内输注。测量平均血压(MBP)、总肾血流量(RBF)和 ANG II 含量(血浆和组织)。在 SHR16 中,糜酶阻断显著降低了 MBP(-6%)和血浆(-38%)、肾脏(-71%)和心脏(-52%)的 ANG II 水平。在 SHR7 中,chymostatin 不影响 MBP 或 RBF,但显著降低了心脏 ANG II 水平。联合功能研究和 ANG II 测定支持以下证据,即在 SHR 中,糜酶可以升高血浆 ANG II 并有助于血压升高。我们提出,将糜酶阻断与 ACE 抑制联合使用可能是治疗对 ACE 抑制剂单独治疗有抵抗的高血压患者的一种有前途的方法。