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肾内肾素-血管紧张素系统。

The intrarenal renin-angiotensin system.

作者信息

Burns K D, Homma T, Harris R C

机构信息

Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232.

出版信息

Semin Nephrol. 1993 Jan;13(1):13-30.

PMID:8434183
Abstract

In this article, we have discussed the localization of components of the renal renin-angiotensin system, as well as the existing information on the regulation of this axis and the effects of Ang II on renal function. All the components of the renin-angiotensin system are present in both fetal and adult kidney. In the adult kidney, renin is principally localized to jg cells of the distal afferent arteriole, where release is stimulated by increases in intracellular cAMP and inhibited by increases in cytosolic calcium. Four distinct stimuli mediating renin release are (1) NaCl sensed at the macula densa, (2) the sympathetic nervous system, (3) humoral factors, with Ang II, vasopressin, endothelin, and adenosine inhibiting renin release, and (4) changes in intrarenal blood pressure. Alterations in renal renin gene expression have been reported in pathophysiological states, such as salt depletion, diabetes mellitus, ureteral obstruction, Bartter's syndrome, and with high protein feeding. The highest renal concentrations of mRNA for the renin substrate angiotensinogen are found in the PT, where the protein is localized to subapical granules. Both salt depletion and androgens upregulate renal angiotensinogen mRNA. Of interest, renal angiotensinogen mRNA levels are lower in SHR than in normotensive WKY rats. As with angiotensinogen, renal ACE is mainly localized to the PT, with highest concentration on the brush border. The mechanisms of regulation of both renal angiotensinogen and ACE require further study. Using recently developed specific nonpeptide Ang II receptor antagonists, it appears that adult renal Ang II receptors are principally of the AT1 class, whereas fetal kidney Ang II receptors are of the AT2 subtype. By binding to AT1 receptors, Ang II exerts constrictive effects on both afferent and efferent arterioles, with increased effect reported on efferent arterioles. Glomerular Ang II receptors are localized to mesangial cells, mediating contractile responses resulting in changes in glomerular surface area and Kf, and potentially regulating mesangial sieving and phagocytosis. These receptors are reduced with salt restriction or in experimental diabetes. The highest concentrations of tubular Ang II receptors are found in PT, on both brush border and basolateral membranes.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在本文中,我们讨论了肾素 - 血管紧张素系统各组分的定位,以及关于该轴调节的现有信息和血管紧张素II对肾功能的影响。肾素 - 血管紧张素系统的所有组分在胎儿和成年肾脏中均有存在。在成年肾脏中,肾素主要定位于远端入球小动脉的球旁细胞,细胞内cAMP增加会刺激其释放,而胞质钙增加则会抑制其释放。介导肾素释放的四种不同刺激因素为:(1)致密斑处感知的NaCl;(2)交感神经系统;(3)体液因子,其中血管紧张素II、血管加压素、内皮素和腺苷会抑制肾素释放;(4)肾内血压变化。在诸如盐耗竭、糖尿病、输尿管梗阻、巴特综合征以及高蛋白喂养等病理生理状态下,已报道肾素基因表达会发生改变。肾素底物血管紧张素原的mRNA在近端小管中的肾内浓度最高,该蛋白定位于顶端下颗粒。盐耗竭和雄激素均可上调肾血管紧张素原mRNA。有趣的是,自发性高血压大鼠(SHR)的肾血管紧张素原mRNA水平低于正常血压的WKY大鼠。与血管紧张素原一样,肾血管紧张素转换酶(ACE)主要定位于近端小管,在刷状缘浓度最高。肾血管紧张素原和ACE的调节机制仍需进一步研究。使用最近开发的特异性非肽类血管紧张素II受体拮抗剂,似乎成年肾脏中的血管紧张素II受体主要为AT1类,而胎儿肾脏中的血管紧张素II受体为AT2亚型。通过与AT1受体结合,血管紧张素II对入球小动脉和出球小动脉均产生收缩作用,据报道对出球小动脉的作用更强。肾小球血管紧张素II受体定位于系膜细胞,介导收缩反应,导致肾小球表面积和滤过系数(Kf)发生变化,并可能调节系膜滤过和吞噬作用。这些受体在盐限制或实验性糖尿病状态下会减少。肾小管血管紧张素II受体的最高浓度出现在近端小管的刷状缘和基底外侧膜上。(摘要截选至400字)

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