Aldosterone receptor antagonists: current perspectives and therapies.
Aldosterone receptor antagonists: current perspectives and therapies.
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DOI：
10.2147/vhrm.s33759
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发表时间：
2013
影响因子：
2.9
通讯作者：
Ahmed MI
中科院分区：
文献类型：
--
作者：
Guichard JL;Clark D 3rd;Calhoun DA;Ahmed MI
醛固酮是肾素-血管紧张素-醛固酮系统中血管紧张素II的下游效应物，并与矿皮质激素受体结合。醛固酮主要作用于肾脏水平调节血浆钾和血管内容积状态的传统观点正被醛固酮在其他器官系统中新的“脱靶”效应的证据所补充。醛固酮的基因组效应是众所周知的，但也有非基因组效应的证据，这些最近确定的醛固酮效应需要对醛固酮在人类健康和疾病中的作用的传统观点进行修订。本文的目的是回顾醛固酮和矿物皮质激素受体的生物作用，导致随后的生理和病理生理影响，涉及血管系统，中枢神经系统，心脏和肾脏。此外，我们概述了目前评估矿皮质激素受体拮抗剂在治疗原发性醛固酮增多症、原发性高血压、顽固性高血压、阻塞性睡眠呼吸暂停、心力衰竭和慢性肾病中的应用的证据。
Aldosterone is a downstream effector of angiotensin II in the renin–angiotensin–aldosterone system and binds to the mineralocorticoid receptor. The classical view of aldosterone primarily acting at the level of the kidneys to regulate plasma potassium and intravascular volume status is being supplemented by evidence of new “off-target” effects of aldosterone in other organ systems. The genomic effects of aldosterone are well known, but there is also evidence for non-genomic effects and these recently identified effects of aldosterone have required a revision in the traditional view of aldosterone’s role in human health and disease. The aim of this article is to review the biological action of aldosterone and the mineralocorticoid receptor leading to subsequent physiologic and pathophysiologic effects involving the vasculature, central nervous system, heart, and kidneys. Furthermore, we outline current evidence evaluating the use of mineralocorticoid receptor antagonists in the treatment of primary aldosteronism, primary hypertension, resistant hypertension, obstructive sleep apnea, heart failure, and chronic kidney disease.