Importance of rostral ventrolateral medulla neurons in determining efferent sympathetic nerve activity and blood pressure.
Importance of rostral ventrolateral medulla neurons in determining efferent sympathetic nerve activity and blood pressure.
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DOI：
10.1038/hr.2011.208
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发表时间：
2012-02
影响因子：
5.4
通讯作者：
Saruta, Takao
中科院分区：
文献类型：
--
作者：
Kumagai, Hiroo;Oshima, Naoki;Matsuura, Tomokazu;Iigaya, Kamon;Imai, Masaki;Onimaru, Hiroshi;Sakata, Katsufumi;Osaka, Motohisa;Onami, Toshiko;Takimoto, Chie;Kamayachi, Tadashi;Itoh, Hiroshi;Saruta, Takao
交感神经活动（SNA）增强是心血管事件的危险因素。在这篇综述中，我们调查我们的工作假设，加强活动的头端腹外侧延髓（RVLM）的神经元是实验性和原发性高血压的主要原因。在过去的十年中，我们已经研究了RVLM神经元如何调节外周SNA，交感神经系统和肾素-血管紧张素系统如何相互关联，以及如何抑制交感神经系统以预防患者的心血管事件。基于全细胞膜片钳研究的结果，我们报告说，血管紧张素II（Ang II）增强活动的RVLM神经元，交感神经中枢，而血管紧张素II受体阻滞剂（ARB）减少RVLM活动。我们的光学影像显示，包括RVLM和延髓腹外侧尾端在内的纵向喙尾柱起交感神经中枢的作用。通过组织和分析这些数据，我们希望开发出减少患者SNA的疗法。最近，原发性高血压患者通过单次肾神经消融术获得了2年的降压效果。消融不仅损伤了传出肾交感神经，也损伤了传入肾神经，并导致下丘脑、RVLM神经元和传出全身交感神经的活动降低。这些临床结果强调了RVLM神经元在血压调节中的重要性。我们期望肾神经消融术能有效治疗充血性心力衰竭和慢性肾脏疾病，如糖尿病肾病。
Accentuated sympathetic nerve activity (SNA) is a risk factor for cardiovascular events. In this review, we investigate our working hypothesis that potentiated activity of neurons in the rostral ventrolateral medulla (RVLM) is the primary cause of experimental and essential hypertension. Over the past decade, we have examined how RVLM neurons regulate peripheral SNA, how the sympathetic and renin-angiotensin systems are correlated and how the sympathetic system can be suppressed to prevent cardiovascular events in patients. Based on results of whole-cell patch-clamp studies, we report that angiotensin II (Ang II) potentiated the activity of RVLM neurons, a sympathetic nervous center, whereas Ang II receptor blocker (ARB) reduced RVLM activities. Our optical imaging demonstrated that a longitudinal rostrocaudal column, including the RVLM and the caudal end of ventrolateral medulla, acts as a sympathetic center. By organizing and analyzing these data, we hope to develop therapies for reducing SNA in our patients. Recently, 2-year depressor effects were obtained by a single procedure of renal nerve ablation in patients with essential hypertension. The ablation injured not only the efferent renal sympathetic nerves but also the afferent renal nerves and led to reduced activities of the hypothalamus, RVLM neurons and efferent systemic sympathetic nerves. These clinical results stress the importance of the RVLM neurons in blood pressure regulation. We expect renal nerve ablation to be an effective treatment for congestive heart failure and chronic kidney disease, such as diabetic nephropathy.
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DOI：
10.1111/j.1440-1681.2005.04206.x
发表时间：
2005-05-01
影响因子：
2.9
作者：
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通讯作者：
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DOI：
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影响因子：
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作者：
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作者：
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影响因子：
4.9
作者：
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DOI：
10.1152/ajpregu.2001.281.1.r206
发表时间：
2001-07-01
影响因子：
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作者：
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