Impaired Hypothalamic Regulation of Sympathetic Outflow in Primary Hypertension
Impaired Hypothalamic Regulation of Sympathetic Outflow in Primary Hypertension
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DOI：
10.1007/s12264-018-0316-5
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发表时间：
2018-12
影响因子：
5.6
通讯作者：
Jing-Jing Zhou-Jing;Huijie Ma;Jian-ying Shao;H. Pan;De-Pei Li
中科院分区：
文献类型：
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作者：
Jing-Jing Zhou-Jing;Huijie Ma;Jian-ying Shao;H. Pan;De-Pei Li
下丘脑室旁核（PVN）是通过调节心血管、神经内分泌和其他功能来维持体内平衡的关键区域。在高血压中，PVN 通过脑干和脊髓的神经支配为交感神经流出提供兴奋性驱动的主要来源。我们讨论目前关于 PVN 在正常血压和高血压条件下交感神经输出调节中的作用的研究结果。 PVN 似乎在产生交感血管舒缩活动升高方面发挥着重要作用，这是多种形式高血压（包括人类原发性高血压）的特征。最近对自发性高血压大鼠模型的研究表明，PVN 前交感神经元的抑制性和兴奋性突触输入不平衡，高血压时抑制性突触输入受损，兴奋性突触输入增强。 PVN 中抑制性和兴奋性突触输入的这种不平衡构成了高血压患者交感神经流出增加的基础。在这篇综述中，我们讨论了谷氨酸能和 GABA 能输入之间平衡的破坏以及相关的细胞和分子改变，作为高血压中 PVN 前交感神经元过度活跃的机制。
The hypothalamic paraventricular nucleus (PVN) is a crucial region involved in maintaining homeostasis through the regulation of cardiovascular, neuroendocrine, and other functions. The PVN provides a dominant source of excitatory drive to the sympathetic outflow through innervation of the brainstem and spinal cord in hypertension. We discuss current findings on the role of the PVN in the regulation of sympathetic output in both normotensive and hypertensive conditions. The PVN seems to play a major role in generating the elevated sympathetic vasomotor activity that is characteristic of multiple forms of hypertension, including primary hypertension in humans. Recent studies in the spontaneously hypertensive rat model have revealed an imbalance of inhibitory and excitatory synaptic inputs to PVN pre-sympathetic neurons as indicated by impaired inhibitory and enhanced excitatory synaptic inputs in hypertension. This imbalance of inhibitory and excitatory synaptic inputs in the PVN forms the basis for elevated sympathetic outflow in hypertension. In this review, we discuss the disruption of balance between glutamatergic and GABAergic inputs and the associated cellular and molecular alterations as mechanisms underlying the hyperactivity of PVN pre-sympathetic neurons in hypertension.