Inhibition of the renin-angiotensin system causes concentric hypertrophy of renal arterioles in mice and humans.

Inhibition of the renin-angiotensin system causes concentric hypertrophy of renal arterioles in mice and humans.
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DOI:
10.1172/jci.insight.154337
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发表时间:
2021-12-22
期刊:
影响因子:
8
通讯作者:
Gomez RA
Gomez RA
中科院分区:
医学1区
文献类型:
--
作者:
Watanabe H;Martini AG;Brown RI;Liang X;Medrano S;Goto S;Narita I;Arend LJ;Sequeira-Lopez MLS;Gomez RA

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肾素-血管紧张素系统(RAS)抑制剂广泛用于治疗高血压。使用携带荧光细胞谱系示踪剂的小鼠,单细胞RNA-Seq,以及在小鼠和人类中长期抑制RAS,我们发现删除肾素或抑制RAS导致肾内动脉和小动脉的同心增厚。这种严重的疾病是由多克隆扩增和转化的肾素细胞从一个经典的内分泌表型的基质分泌表型:细胞包围血管壁,并诱导相邻的平滑肌细胞和细胞外基质的积累,导致血流阻塞,局灶性缺血和纤维化。通过β1整合素的条件性缺失来消融肾素细胞防止了小动脉肥大,表明肾素细胞是血管疾病的原因。鉴于这些发现,有必要在人体中进行前瞻性形态学研究,以确定广泛使用RAS抑制剂引起的肾血管损伤的程度。
Inhibitors of the renin-angiotensin system (RAS) are widely used to treat hypertension. Using mice harboring fluorescent cell lineage tracers, single-cell RNA-Seq, and long-term inhibition of RAS in both mice and humans, we found that deletion of renin or inhibition of the RAS leads to concentric thickening of the intrarenal arteries and arterioles. This severe disease was caused by the multiclonal expansion and transformation of renin cells from a classical endocrine phenotype to a matrix-secretory phenotype: the cells surrounded the vessel walls and induced the accumulation of adjacent smooth muscle cells and extracellular matrix, resulting in blood flow obstruction, focal ischemia, and fibrosis. Ablation of the renin cells via conditional deletion of β1 integrin prevented arteriolar hypertrophy, indicating that renin cells are responsible for vascular disease. Given these findings, prospective morphological studies in humans are necessary to determine the extent of renal vascular damage caused by the widespread use of inhibitors of the RAS.
DOI: 10.1042/cs20200184
发表时间: 2020-07-17
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