Cardiovascular Disease in Obstructive Sleep Apnea: Putative Contributions of Mineralocorticoid Receptors.
Cardiovascular Disease in Obstructive Sleep Apnea: Putative Contributions of Mineralocorticoid Receptors.
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DOI：
10.3390/ijms24032245
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发表时间：
2023-01-23
影响因子：
5.6
通讯作者：
Gozal, David
中科院分区：
文献类型：
--
作者：
Badran, Mohammad;Bender, Shawn B.;Gozal, David
关键词：
阻塞性睡眠呼吸暂停（OSA）是一种慢性且高度流行的病症，其与氧化应激、炎症和纤维化相关，导致内皮功能障碍、动脉僵硬和血管胰岛素抵抗，从而导致心血管疾病和总体死亡率增加。迄今为止，OSA仍然严重诊断不足和治疗不足，常规治疗在改善OSA患者的心血管结局方面产生相对令人沮丧的结果。因此，迫切需要更好地了解OSA相关心血管疾病（CVD）的机制，并开发新的辅助治疗靶点。心血管组织中不适当的盐皮质激素受体（MR）激活在许多CVD状态中起着因果作用，这是公认的。OSA的临床研究和实验模型导致MR配体醛固酮分泌增加和MR过度活化。此外，MR激活与OSA预后恶化相关。尽管有这些记录的关系，但还没有研究探索MR信号在OSA相关CVD中的因果关系。此外，很少有临床研究专门评估了MR拮抗剂治疗通常与OSA相关的全身性高血压的有益作用。在这里，我们提供了一个全面的概述重叠的机械途径招募的背景下，MR激活和OSA诱导的CVD和提出MR靶向治疗作为一个潜在的途径，以消除有害的心血管后果的OSA。
Obstructive sleep apnea (OSA) is a chronic and highly prevalent condition that is associated with oxidative stress, inflammation, and fibrosis, leading to endothelial dysfunction, arterial stiffness, and vascular insulin resistance, resulting in increased cardiovascular disease and overall mortality rates. To date, OSA remains vastly underdiagnosed and undertreated, with conventional treatments yielding relatively discouraging results for improving cardiovascular outcomes in OSA patients. As such, a better mechanistic understanding of OSA-associated cardiovascular disease (CVD) and the development of novel adjuvant therapeutic targets are critically needed. It is well-established that inappropriate mineralocorticoid receptor (MR) activation in cardiovascular tissues plays a causal role in a multitude of CVD states. Clinical studies and experimental models of OSA lead to increased secretion of the MR ligand aldosterone and excessive MR activation. Furthermore, MR activation has been associated with worsened OSA prognosis. Despite these documented relationships, there have been no studies exploring the causal involvement of MR signaling in OSA-associated CVD. Further, scarce clinical studies have exclusively assessed the beneficial role of MR antagonists for the treatment of systemic hypertension commonly associated with OSA. Here, we provide a comprehensive overview of overlapping mechanistic pathways recruited in the context of MR activation- and OSA-induced CVD and propose MR-targeted therapy as a potential avenue to abrogate the deleterious cardiovascular consequences of OSA.
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DOI：
10.1186/1476-5926-10-1
发表时间：
2011-07-05
期刊：
Comparative hepatology
影响因子：
--
作者：
Rosa DP;Martinez D;Picada JN;Semedo JG;Marroni NP
通讯作者：
Marroni NP
影响因子：
--
作者：
Badran M;Ayas N;Laher I
通讯作者：
Laher I
影响因子：
3.7
作者：
Abuyassin B;Badran M;Ayas NT;Laher I
通讯作者：
Laher I
影响因子：
76.2
作者：
Benjafield, Adam V.;Ayas, Najib T.;Malhotra, Atul
通讯作者：
Malhotra, Atul
影响因子：
13
作者：
Arzt, Michael;Woehrle, Holger;Wegscheider, Karl
通讯作者：
Wegscheider, Karl