Tulane Hypertension and Renal Center of Excellence, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
Department of Physiology, Tulane University School of Medicine, New Orleans, LA 70112, USA.
Int J Mol Sci. 2022 Feb 22;23(5):2402. doi: 10.3390/ijms23052402.
Contrary to public perception, hypertension remains one of the most important public health problems in the United States, affecting 46% of adults with increased risk for heart attack, stroke, and kidney diseases. The mechanisms underlying poorly controlled hypertension remain incompletely understood. Recent development in the approach to study gain or loss of function of a particular gene has significantly helped advance our new insights into the role of proximal tubule angiotensin II (Ang II) and its AT (AT) receptors in basal blood pressure control and the development of Ang II-induced hypertension. This novel approach has provided us and others with an important tool to generate novel mouse models with proximal tubule-specific loss (deletion) or gain of the function (overexpression). The objective of this invited review article is to review and discuss recent findings using novel genetically modifying proximal tubule-specific mouse models. These new studies have consistently demonstrated that deletion of AT (AT) receptors or its direct downstream target Na/H exchanger 3 (NHE3) selectively in the proximal tubules of the kidney lowers basal blood pressure, increases the pressure-natriuresis response, and induces natriuretic responses, whereas overexpression of an intracellular Ang II fusion protein or AT (AT) receptors selectively in the proximal tubules increases proximal tubule Na reabsorption, impairs the pressure-natriuresis response, and elevates blood pressure. Furthermore, the development of Ang II-induced hypertension by systemic Ang II infusion or by proximal tubule-specific overexpression of an intracellular Ang II fusion protein was attenuated in mutant mice with proximal tubule-specific deletion of AT (AT) receptors or NHE3. Thus, these recent studies provide evidence for and new insights into the important roles of intratubular Ang II via AT (AT) receptors and NHE3 in the proximal tubules in maintaining basal blood pressure homeostasis and the development of Ang II-induced hypertension.
与公众的认知相反,高血压仍然是美国最重要的公共卫生问题之一,影响了 46%的成年人,使他们面临心脏病发作、中风和肾脏疾病的风险增加。高血压控制不佳的机制仍不完全清楚。最近在研究特定基因功能获得或丧失的方法方面的进展,极大地帮助我们深入了解了近端小管血管紧张素 II (Ang II)及其 AT (AT) 受体在基础血压控制和 Ang II 诱导的高血压发展中的作用。这种新方法为我们和其他人提供了一个重要的工具,可以生成具有近端小管特异性缺失(缺失)或功能获得(过表达)的新型小鼠模型。本文的目的是回顾和讨论最近使用新型基因修饰的近端小管特异性小鼠模型的研究结果。这些新的研究一致表明,在肾脏的近端小管中特异性缺失 AT (AT) 受体或其直接下游靶标 Na/H 交换器 3 (NHE3) 可降低基础血压,增加压力-排钠反应,并诱导排钠反应,而在近端小管中特异性过表达细胞内 Ang II 融合蛋白或 AT (AT) 受体可增加近端小管 Na 重吸收,损害压力-排钠反应,并升高血压。此外,通过全身 Ang II 输注或通过近端小管特异性过表达细胞内 Ang II 融合蛋白诱导的 Ang II 诱导的高血压在近端小管特异性缺失 AT (AT) 受体或 NHE3 的突变小鼠中减弱。因此,这些最近的研究为 Ang II 通过 AT (AT) 受体和 NHE3 在维持基础血压稳态和 Ang II 诱导的高血压发展中的近端小管内重要作用提供了证据和新的见解。