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Minireview: The involvement of renal afferents in the maintenance of cardiorenal diseases
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology ( IF 2.2 ) Pub Date : 2020-11-04 , DOI: 10.1152/ajpregu.00225.2020
Amanda C. Veiga 1 , Maycon I. O. Milanez 1 , Ruy R. Campos 1 , Cassia T. Bergamaschi 1 , Erika E. Nishi 1
Affiliation  

Elevated sympathetic vasomotor activity is a common feature of cardiorenal diseases. Therefore, the sympathetic nervous system is an important therapeutic target, particularly the fibers innervating the kidneys. In fact, renal denervation has been applied clinically and shown promising results in patients with hypertension and chronic kidney disease. However, the underlying mechanisms involved in the cardiorenal protection induced by renal denervation have not yet been fully clarified. This mini-review highlights historical and recent aspects related to the role of renal sensory fibers in the control of cardiorenal function under normal conditions and in experimental models of cardiovascular disease. Results have demonstrated that alterations in renal sensory function participate in the maintenance of elevated sympathetic vasomotor activity and cardiorenal changes; as such, renal sensory fibers may be a potential therapeutic target for the treatment of cardiorenal diseases. Although it has not yet been applied in clinical practice, selective afferent renal denervation may be promising, since such an approach maintains efferent activity and can provide more refined control of renal function compared to total renal denervation. However more studies are needed to understand the mechanisms by which renal afferents partially contribute to such changes, in addition to the need to evaluate the safety and advantages of the approach for application in the clinical practice.

中文翻译:

Minireview:肾传入神经参与维持心脏肾脏疾病

交感性血管舒缩活性升高是心肾疾病的共同特征。因此,交感神经系统是重要的治疗目标,尤其是支配肾脏的纤维。实际上,肾脏去神经支配已在临床上得到应用,并在高血压和慢性肾脏病患者中显示出令人鼓舞的结果。但是,尚未完全阐明由肾脏去神经支配引起的心脏肾脏保护的潜在机制。这份小型回顾重点介绍了在正常条件下和心血管疾病实验模型中,肾感觉纤维在控制心肾功能中的作用有关的历史和最新方面。结果表明,肾感觉功能的改变参与了交感性血管舒缩活性和心肾变化的维持;因此,肾感觉纤维可能是治疗心肾疾病的潜在治疗靶标。尽管尚未在临床实践中应用,但选择性入肾肾神经支配可能是有希望的,因为与总肾神经支配相比,这种方法可维持传出活性并可以提供对肾功能的更精细控制。然而,除了需要评估在临床实践中应用该方法的安全性和优势之外,还需要更多的研究来了解肾传入部分地促成这种变化的机制。肾感觉纤维可能是治疗心肾疾病的潜在治疗靶标。尽管尚未在临床实践中应用,但选择性入肾肾神经支配可能是有希望的,因为与总肾神经支配相比,这种方法可维持传出活性并可以提供对肾功能的更精细控制。然而,除了需要评估在临床实践中应用该方法的安全性和优势之外,还需要更多的研究来了解肾传入部分地促成这种变化的机制。肾感觉纤维可能是治疗心肾疾病的潜在治疗靶标。尽管尚未在临床实践中应用,但选择性入肾肾神经支配可能是有希望的,因为与总肾神经支配相比,这种方法可维持传出活性并可以提供对肾功能的更精细控制。然而,除了需要评估在临床实践中应用该方法的安全性和优势外,还需要更多的研究来了解肾传入部分地促成这种变化的机制。因为与总的肾脏去神经支配相比,这种方法可以维持传出的活动并可以更好地控制肾功能。然而,除了需要评估在临床实践中应用该方法的安全性和优势之外,还需要更多的研究来了解肾传入部分地促成这种变化的机制。因为与总的肾脏去神经支配相比,这种方法可以维持传出的活动并可以更好地控制肾脏功能。然而,除了需要评估在临床实践中应用该方法的安全性和优势之外,还需要更多的研究来了解肾传入部分地促成这种变化的机制。
更新日期:2020-11-06
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