Central control of blood pressure: neurotransmitters, receptors, signal transduction and gene expression

大脑控制血压的方式对我们的日常生存至关重要。大脑下部和脊髓的神经使血压维持在适当的水平，以进行各种日常活动，从血压很低时的睡眠到血压很高时的锻炼。大约10%的印度人患有高血压，他们的血压升高到损害大脑、心脏、肾脏和眼睛等器官的程度。现在看来，大多数高血压病例的基础是大脑通过交感神经系统控制心脏和血管的方式出现了紊乱。许多不同的大脑系统需要在不同的时间改变血液在体内的分布方式。例如，当我们吃东西时，血液优先流向肠道；如果我们运动，对我们的心脏和肌肉；如果我们觉得冷，对我们的皮肤来说，当我们思考时，对我们的大脑来说。这种对血流的特殊调节是由大脑下部神经和脊髓的相互作用完成的。它涉及大量特殊的化学信使，通过不同的细胞内机制作用于特定的受体，并涉及基因的开启或关闭。这些神经递质系统中只有少数被很好地理解。在我们建议的核心，我们的目标是确定哪些神经递质系统对哪些心血管功能是重要的。我们预计，这一新信息将允许开发新的方法来管理高血压。其原因是，由于不同的途径使用不同的信使系统，应该有可能定制治疗，以适应高血压，而不会产生不良的副作用。

The way that the brain controls blood pressure is of crucial significance to our day-to-day survival. Nerves in the lower brain and spinal cord cause blood pressure to be maintained at appropriate levels for all types of daily activities ranging from sleep, when blood pressure is very low, to exercise when blood pressure can be very high. In hypertension, a disorder that afflicts around 10% of the community, blood pressure is elevated to an extent that damages organs such as the brain, heart, kidney and eye. It now appears that most cases of hypertension have as their basis a disorder of the way that the brain, through the sympathetic nervous system, controls the heart and blood vessels. Many different brain systems need to change the way that blood is distributed in the body at different times. For example, when we eat, blood goes preferentially to our gut; if we exercise, to our heart and muscles; if we are cold, to our skin and when we think, to our brain. This specialised regulation of blood flow is accomplished by the interaction of nerves in the lower brain and spinal cord. It involves a vast array of special chemical messengers acting on specific receptors through different intracellular mechanisms and involving the turning on or off of genes. Only a few of these neurotransmitter systems are well understood. At the core of our proposal, we aim to determine which neurotransmitters systems are important for which cardiovascular functions. We anticipate that this new information will permit the development of new approaches to the management of hypertension. The reason for this is that since different pathways use different messenger systems, it should become possible to tailor therapy to suit hypertension without causing undesirable side-effects.