Review: the central role of calcium in the pathogenesis of cardiovascular disease.
Review: the central role of calcium in the pathogenesis of cardiovascular disease.
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综述：钙在心血管疾病发病机制中的核心作用。
DOI：
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发表时间：
1996
影响因子：
2.7
通讯作者：
H. Elliott
中科院分区：
文献类型：
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作者：
H. Haller;H. Elliott
钙依赖过程在心血管系统的几种不同细胞中发挥核心作用，包括血管平滑肌细胞和内皮细胞，以及单核细胞、巨噬细胞和血小板。响应细胞外刺激，胞质钙浓度增加。增长由两个不同的阶段组成。首先，钙通过IP3从细胞内储存中释放出来。在第二阶段，钙通过细胞膜流入是导致细胞内钙浓度持续升高的主要原因。这一阶段细胞质钙的峰值增加是细胞持续激活和血管平滑肌收缩过程以及激活蛋白质生物合成的核转录因子的先决条件。在缺血条件下，控制细胞内游离钙浓度的调节系统消耗了细胞生理能量供应的大部分（90%），缺血条件下氧气供应的减少迅速降低了细胞内钙储存或细胞膜外运输的能力。钙拮抗剂主要作用于l型钙通道，以减少钙流入体内细胞。由于钙拮抗剂药物能够影响与动脉粥样硬化、肾小球硬化、左心室肥厚和胰岛素抵抗有关的广泛的细胞过程，因此有充分的理由将其用于一系列临床疾病状态。
Calcium-dependent processes play a central role in several different cells of the cardiovascular system including vascular smooth muscle and endothelial cells and also in monocytes, macrophages and platelets. In response to extracellular stimuli cytosolic calcium concentration increases. The increase is composed of two distinct phases. Firstly, calcium is released from intracellular stores via IP3. In the second phase calcium influx across the cell membrane is mostly responsible for the sustained rise in intracellular calcium concentration. This phase of the peak increase in cytosolic calcium is a prerequisite for sustained activation of the cell and the processes of vascular smooth muscle contraction and the activation of nuclear transcription factors for protein biosynthesis. Under ischemic conditions the regulatory systems which control the intracellular free calcium concentration consume a major portion of the cell's physiological energy supply (90%) and a decreased oxygen supply under ischemic conditions rapidly reduces the cell's capacity for intracellular calcium storage or outward transport across its membrane. Calcium antagonist drugs principally act on L-type calcium channels to reduce the influx of calcium into the the cells of the body. Since calcium antagonist drugs are able to influence a wide range of cellular processes which have been implicated in atherosclerosis, glomeruloscierosis, left ventricular hypertrophy and insulin resistance there are strong grounds for their use in a range of clinical disease states.