Cutaneous control of blood pressure.
Cutaneous control of blood pressure.
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DOI：
10.1097/mnh.0000000000000188
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发表时间：
2016-01
影响因子：
3.2
通讯作者：
Weller R
中科院分区：
文献类型：
--
作者：
Johnson RS;Titze J;Weller R
教科书理论认为血压是由大脑、血管或肾脏调节的。最近的证据表明，血压可以在皮肤中调节。皮肤具有复杂的毛细血管逆流系统，其控制体温、皮肤灌注和明显的全身血压。流行病学数据表明，阳光照射在控制血压方面起着重要作用。UVA辐射产生血管扩张和血压下降。角质形成细胞和免疫细胞通过产生NO控制皮肤广泛逆流环路系统中的血流，NO是血管张力的关键调节剂。角质形成细胞中HIF-1α和HIF-2α活性之间的平衡通过NO依赖性机制控制皮肤灌注、全身温度调节和全身血压。此外，皮肤积累Na+，其产生屏障以促进免疫宿主防御。免疫细胞控制皮肤Na+代谢和Na+通过淋巴系统的清除。淋巴清除减少会增加血压。除了众所周知的脑、血管和肾脏的作用外，皮肤对于人类和实验动物的全身血压控制也很重要。
Textbook theory holds that blood pressure is regulated by the brain, by blood vessels, or by the kidney. Recent evidence suggests that blood pressure could be regulated in the skin. The skin holds a complex capillary counter current system which controls body temperature, skin perfusion, and apparently systemic blood pressure. Epidemiological data suggest that sunlight exposure plays a role in controlling blood pressure. UVA radiation produces vasodilation and a fall in blood pressure. Keratinocytes and immune cells control blood flow in the extensive countercurrent loop system of the skin by producing NO, a key regulator of vascular tone. The balance between HIF-1α and HIF-2α activity in keratinocytes controls skin perfusion, systemic thermoregulation, and systemic blood pressure by NO-dependent mechanisms. Furthermore, the skin accumulates Na+ which generates a barrier to promote immunological host defense. Immune cells control skin Na+ metabolism and the clearance of Na+ via the lymphatic system. Reduced lymphatic clearance increases blood pressure. Besides the well-known role of the brain, blood vessels, and the kidney, the skin is important for systemic blood pressure control in humans and in experimental animals.