The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
Department of Nephrology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital, Taiyuan, China.
Neuroendocrinology. 2024;114(1):1-13. doi: 10.1159/000533691. Epub 2023 Aug 19.
Hypertension is among the most harmful factors of cardiovascular and cerebrovascular diseases and poses an urgent problem for the development of human society. In addition to previous studies on its pathogenesis focusing on the peripheral sympathetic nervous system, investigating the central causes of high blood pressure involving the neuroendocrine and neuroinflammatory mechanisms of the hypothalamic paraventricular nucleus (PVN) is paramount. This nucleus is considered to regulate the output of neurohormones and sympathetic nerve activity. In this article, we focussed on the neuroendocrine mechanism, primarily exploring the specific contributions and interactions of various neurons and neuroendocrine hormones, including GABAergic and glutamatergic neurons, nitric oxide, arginine vasopressin, oxytocin, and the renin-angiotensin system. Additionally, the neuroinflammatory mechanism in the PVN was discussed, encompassing microglia, reactive oxygen species, inflammatory factors, and pathways, as well as immune connections between the brain and extracerebral organs. Notably, the two central mechanisms involved in the PVN not only exist independently but also communicate with each other, jointly maintaining the hypertensive state of the body. Furthermore, we introduce well-known molecules and signal transduction pathways within the PVN that can play a regulatory role in the two mechanisms to provide a basis and inspire ideas for further research.
高血压是心血管和脑血管疾病最危险的因素之一，对人类社会的发展构成了紧迫的问题。除了以前对其发病机制的研究主要集中在外周交感神经系统之外，研究涉及下丘脑室旁核（PVN）的神经内分泌和神经炎症机制的高血压的中枢原因至关重要。这个核被认为调节神经激素和交感神经活动的输出。在本文中，我们专注于神经内分泌机制，主要探讨各种神经元和神经内分泌激素的特定贡献和相互作用，包括 GABA 能和谷氨酸能神经元、一氧化氮、精氨酸加压素、催产素和肾素-血管紧张素系统。此外，还讨论了 PVN 中的神经炎症机制，包括小胶质细胞、活性氧、炎症因子和途径，以及大脑和脑外器官之间的免疫联系。值得注意的是，PVN 中涉及的两个中枢机制不仅独立存在，而且相互交流，共同维持身体的高血压状态。此外，我们介绍了 PVN 内可以在两个机制中发挥调节作用的知名分子和信号转导途径，为进一步研究提供了依据和启示。
