Aldosterone: Essential for Life but Damaging to the Vascular Endothelium.
Aldosterone: Essential for Life but Damaging to the Vascular Endothelium.
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DOI：
10.3390/biom13061004
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发表时间：
2023-06-17
期刊：
影响因子：
5.5
通讯作者：
中科院分区：
文献类型：
--
作者：
肾素血管紧张素醛固酮系统是血压的关键调节器。醛固酮是该途径的最终效应物，主要通过盐皮质激素受体起作用。醛固酮促进钠和水的保存，并作为钾排泄的有力刺激。然而，盐皮质激素受体过度刺激的病理影响的证据正在增加。在这里，我们讨论了在心脏，醛固酮增多症是如何与纤维化，心功能不全，适应不良肥大。在肾脏中，醛固酮被证明会导致蛋白尿和纤维化，并可能导致肾脏疾病的进展。最近，研究表明，醛固酮过量损伤内皮细胞。在这里，我们综述了如何损害内皮糖萼可能有助于这一进程。内皮糖萼是细胞管腔表面的异质性负电荷层。醛固酮暴露改变了这一层。由此产生的结构变化降低了内皮细胞对保护性剪切应力的反应性，改变了渗透性，并增加了免疫细胞的运输。最后，我们回顾了目前限制内皮损伤的治疗策略，并建议预防醛固酮暴露引起的糖萼重塑可能提供一种新的策略，避免盐皮质激素阻断引起的高钾血症的严重不良反应。
The renin angiotensin aldosterone system is a key regulator of blood pressure. Aldosterone is the final effector of this pathway, acting predominantly via mineralocorticoid receptors. Aldosterone facilitates the conservation of sodium and, with it, water and acts as a powerful stimulus for potassium excretion. However, evidence for the pathological impact of excess mineralocorticoid receptor stimulation is increasing. Here, we discussed how in the heart, hyperaldosteronism is associated with fibrosis, cardiac dysfunction, and maladaptive hypertrophy. In the kidney, aldosterone was shown to cause proteinuria and fibrosis and may contribute to the progression of kidney disease. More recently, studies suggested that aldosterone excess damaged endothelial cells. Here, we reviewed how damage to the endothelial glycocalyx may contribute to this process. The endothelial glycocalyx is a heterogenous, negatively charged layer on the luminal surface of cells. Aldosterone exposure alters this layer. The resulting structural changes reduced endothelial reactivity in response to protective shear stress, altered permeability, and increased immune cell trafficking. Finally, we reviewed current therapeutic strategies for limiting endothelial damage and suggested that preventing glycocalyx remodelling in response to aldosterone exposure may provide a novel strategy, free from the serious adverse effect of hyperkalaemia seen in response to mineralocorticoid blockade.
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影响因子：
5.8
作者：
McGraw AP;McCurley A;Preston IR;Jaffe IZ
通讯作者：
Jaffe IZ
影响因子：
2.9
作者：
Barrett KV;McCurley AT;Jaffe IZ
通讯作者：
Jaffe IZ
醛固酮通过基质金属蛋白酶依赖性糖蛋白糖脂诱导蛋白尿。
影响因子：
19.6
作者：
Butler MJ;Ramnath R;Kadoya H;Desposito D;Riquier-Brison A;Ferguson JK;Onions KL;Ogier AS;ElHegni H;Coward RJ;Welsh GI;Foster RR;Peti-Peterdi J;Satchell SC
通讯作者：
Satchell SC
DOI：
10.1161/atvbaha.114.303424
发表时间：
2014-10-01
影响因子：
8.7
作者：
Bryan, Matthew T.;Duckles, Hayley;Evans, Paul C.
通讯作者：
Evans, Paul C.
影响因子：
5.8
作者：
Caroccia, Brasilina;Seccia, Teresa Maria;Rossi, Gian Paolo
通讯作者：
Rossi, Gian Paolo