RESUMEN
Hypertension is a leading risk factor for stroke, heart disease and chronic kidney disease. Multiple interacting factors and organ systems increase blood pressure and cause target-organ damage. Among the many molecular elements involved in the development of hypertension are reactive oxygen species (ROS), which influence cellular processes in systems that contribute to blood pressure elevation (such as the cardiovascular, renal, immune and central nervous systems, or the renin-angiotensin-aldosterone system). Dysregulated ROS production (oxidative stress) is a hallmark of hypertension in humans and experimental models. Of the many ROS-generating enzymes, NADPH oxidases are the most important in the development of hypertension. At the cellular level, ROS influence signalling pathways that define cell fate and function. Oxidative stress promotes aberrant redox signalling and cell injury, causing endothelial dysfunction, vascular damage, cardiovascular remodelling, inflammation and renal injury, which are all important in both the causes and consequences of hypertension. ROS scavengers reduce blood pressure in almost all experimental models of hypertension; however, clinical trials of antioxidants have yielded mixed results. In this Review, we highlight the latest advances in the understanding of the role and the clinical implications of ROS in hypertension. We focus on cellular sources of ROS, molecular mechanisms of oxidative stress and alterations in redox signalling in organ systems, and their contributions to hypertension.
RESUMEN
Inflammatory responses in small vessels play an important role in the development of cardiovascular diseases, including hypertension, stroke, and small vessel disease. This involves various complex molecular processes including oxidative stress, inflammasome activation, immune-mediated responses, and protein misfolding, which together contribute to microvascular damage. In addition, epigenetic factors, including DNA methylation, histone modifications, and microRNAs influence vascular inflammation and injury. These phenomena may be acquired during the aging process or due to environmental factors. Activation of proinflammatory signaling pathways and molecular events induce low-grade and chronic inflammation with consequent cardiovascular damage. Identifying mechanism-specific targets might provide opportunities in the development of novel therapeutic approaches. Monoclonal antibodies targeting inflammatory cytokines and epigenetic drugs, show promise in reducing microvascular inflammation and associated cardiovascular diseases. In this article, we provide a comprehensive discussion of the complex mechanisms underlying microvascular inflammation and offer insights into innovative therapeutic strategies that may ameliorate vascular injury in cardiovascular disease.
Asunto(s)
Inflamación , Animales , Humanos , Arterias/metabolismo , Enfermedades Cardiovasculares/metabolismo , Epigénesis Genética , Inflamación/metabolismo , Inflamación/inmunología , Estrés Oxidativo/fisiología , Transducción de Señal/fisiología , Vasculitis/metabolismo , Vasculitis/inmunologíaRESUMEN
PURPOSE: Disorders/differences of sex development (DSD) result from variants in many different human genes but, frequently, have no detectable molecular cause. METHODS: Detailed clinical and genetic phenotyping was conducted on a family with three children. A Sec31a animal model and functional studies were used to investigate the significance of the findings. RESULTS: By trio whole-exome DNA sequencing we detected a heterozygous de novo nonsense SEC31A variant, in three children of healthy non-consanguineous parents. The children had different combinations of disorders that included complete gonadal dysgenesis and multiple pituitary hormone deficiency. SEC31A encodes a component of the COPII coat protein complex, necessary for intracellular anterograde vesicle-mediated transport between the endoplasmic reticulum (ER) and Golgi. CRISPR-Cas9 targeted knockout of the orthologous Sec31a gene region resulted in early embryonic lethality in homozygous mice. mRNA expression of ER-stress genes ATF4 and CHOP was increased in the children, suggesting defective protein transport. The pLI score of the gene, from gnomAD data, is 0.02. CONCLUSIONS: SEC31A might underlie a previously unrecognised clinical syndrome comprising gonadal dysgenesis, multiple pituitary hormone deficiencies, dysmorphic features and developmental delay. However, a variant that remains undetected, in a different gene, may alternatively be causal in this family.
Asunto(s)
Disgenesia Gonadal , Hipopituitarismo , Animales , Niño , Preescolar , Femenino , Humanos , Masculino , Ratones , Disgenesia Gonadal/genética , Hipopituitarismo/genética , Hipopituitarismo/metabolismo , Ratones Noqueados , Linaje , Hormonas Hipofisarias/deficiencia , Hormonas Hipofisarias/genética , Proteínas de Transporte Vesicular/genéticaRESUMEN
Os efeitos produzidos por fármacos ou medicamentos utilizados no tratamento da hipertensão arterial são decorrentes de sua interação com componentes macromoleculares das células, como receptores, enzimas, proteínas transportadoras, canais iônicos. A ativação de um receptor modifica a função de componentes interligados ao mesmo, iniciando uma série de alterações intracelulares, como ativação de proteínas efetoras e geração de mensageiros secundários, que irão determinar mudanças na função celular. Existem quatro famílias de receptores: (1) acoplados a proteínas G; (2) nucleares; (3) com atividade enzimática intrínseca e (4) tipo canais iônicos. Os mensageiros secundários mais conhecidos são AMPc, GMPc, IP 3' DAG, íons Ca2+ e óxido nítrico. Os alvos celulares para os medicamentos utilizados no tratamento da hipertensão arterial são apresentados no texto