The Role of Cardiovascular Mineralocorticoid Receptors in Health and Disease

心血管盐皮质激素受体在健康和疾病中的作用

• 批准号: 7575668
• 负责人: GEZA FEJES-TOTH
• 金额: $ 39.98万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7575668
• 关键词: Adrenal Cortex Hormones; Adrenal Glands; Adverse effects; Affinity; Agonist; Aldosterone; Binding; Biological; Blood; Blood Circulation; Blood Vessels; Blood Volume; Brain; Brain region; Cardiac; Cardiac Myocytes; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Cell Line; Cells; Chronic; Clinical Research; Colon; Corticosterone; Desire for food; Development; Disease; Endothelial Cells; Ensure; Enzymes; Epithelial; Epithelium; Exercise; Extracellular Fluid; Genes; Glucocorticoids; Goals; Health; Heart; Heart failure; Hippocampus (Brain); Hormones; Hydrocortisone; Hydroxysteroid Dehydrogenases; Hypertension; Injury; Kidney; Knockout Mice; Lesion; Ligands; Mechanics; Mediating; Metabolism; Mineralocorticoid Receptor; Mineralocorticoids; Molecular; Morbidity - disease rate; Mus; Myocardial Infarction; Organ; Pathology; Patients; Pharmaceutical Preparations; Physiological; Reaction; Relative (related person); Role; Site; Sodium Chloride; Steroid Receptors; Steroids; System; Testing; Tissues; Vascular Diseases; Vascular Smooth Muscle; body system; mortality; receptor; response; standard care

DESCRIPTION (provided by applicant): The classical targets cells of aldosterone (Aldo) reside in the kidney and colon. However, mineralocorticoid receptors (MRs) are also expressed in non-epithelial tissues including the brain, heart and vasculature, but the role of these MRs in cardiovascular function remains largely unexplored. The MR has equal affinity for Aldo and the glucocorticoids cortisol/corticosterone (Cort). While in epithelial tissues Cort is degraded thereby allowing Aldo to occupy the MR, in non-epithelial tissues Cort metabolism is low, and thus both Aldo and Cort can bind the MR. Interestingly, there is increasing evidence that the two hormones can initiate distinct, even opposing effects through the MR. Recent clinical studies demonstrated a remarkable improvement in mortality and morbidity of patients with chronic heart failure (CHF) when MR blockers (MRBs) are introduced in addition to standard care. MRBs also reduce end-organ damage resulting from inappropriate Aldo-to-volume status, and ameliorate atherosclerotic vascular lesions. However, the organ systems that mediate these beneficial effects, the ligand(s) displaced by MRBs and the underlying molecular mechanisms remain poorly understood. Our hypothesis is that the physiological role of non-epithelial MRs is to guard against cardiovascular collapse during severe volume depletion but their activation becomes maladaptive in a setting of volume expansion. We also hypothesize that in severe volume depletion and in CHF the MR is converted from a Cort- to an Aldo-bound state, and the cardiovascular maladaptations are brought about by this ligand switch. The overall goals of this project are to localize the MR-mediated cardiovascular effects of corticosteroids in health and disease, to determine which hormone mediates these effects, and to understand the underlying cellular and molecular mechanisms. Specifically, in Aim 1 we will use genetically modified mice and the Cre/LoxP system to perform tissue-specific deletion of the MR in the heart, brain or vasculature, and examine the cardiovascular adaptation of such mice to (a) severe volume depletion, (b) myocardial infarction and (c) mechanical injury-induced vasculopathy. In Aim 2 we will test the hypothesis that Aldo and Cort exert distinct biological and transcriptional effects via the MR. We will compare and contrast both early and late cardiovascular effects of Aldo and Cort and will determine the transcriptional responses to these hormones in cardiomyocytes. A better understanding of the role of cardiovascular MRs and the cellular and molecular mechanisms that adrenal steroids initiate via these receptors could pave the way toward the development of more effective new drugs with fewer adverse effects for the treatment of cardiovascular disease.

描述（由申请人提供）：醛固酮（Aldo）的经典靶细胞位于肾脏和结肠中。然而，盐皮质激素受体（MR）也在非上皮组织中表达，包括大脑、心脏和脉管系统，但这些 MR 在心血管功能中的作用在很大程度上仍未被探索。 MR 对 Aldo 和糖皮质激素皮质醇/皮质酮 (Cort) 具有相同的亲和力。在上皮组织中，Cort 被降解，从而允许 Aldo 占据 MR，而在非上皮组织中，Cort 代谢较低，因此 Aldo 和 Cort 都可以结合 MR。有趣的是，越来越多的证据表明这两种激素可以通过 MR 引发不同的甚至相反的作用。最近的临床研究表明，除了标准治疗外，引入 MR 阻滞剂 (MRB) 可以显着改善慢性心力衰竭 (CHF) 患者的死亡率和发病率。 MRB 还可以减少因 Aldo 容量状态不当导致的终末器官损伤，并改善动脉粥样硬化血管病变。然而，介导这些有益作用的器官系统、被 MRB 取代的配体以及潜在的分子机制仍然知之甚少。我们的假设是，非上皮 MR 的生理作用是在容量严重不足时防止心血管衰竭，但在容量扩张的情况下，它们的激活会变得适应不良。我们还假设，在严重的容量不足和CHF中，MR从Cort-结合状态转变为Aldo-结合状态，并且心血管适应不良是由这种配体转换引起的。该项目的总体目标是定位皮质类固醇在健康和疾病中的 MR 介导的心血管效应，确定哪种激素介导这些效应，并了解潜在的细胞和分子机制。具体来说，在目标 1 中，我们将使用转基因小鼠和 Cre/LoxP 系统对心脏、大脑或脉管系统中的 MR 进行组织特异性删除，并检查此类小鼠对 (a) 严重血容量不足、(b) 心肌梗死和 (c) 机械损伤引起的血管病变的心血管适应性。在目标 2 中，我们将测试 Aldo 和 Cort 通过 MR 发挥不同的生物学和转录效应的假设。我们将比较和对比 Aldo 和 Cort 的早期和晚期心血管作用，并将确定心肌细胞中这些激素的转录反应。更好地了解心血管 MR 的作用以及肾上腺类固醇通过这些受体启动的细胞和分子机制，可以为开发更有效、副作用更少的治疗心血管疾病的新药铺平道路。