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1.
Kidney Int ; 91(5): 1115-1125, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28081856

RESUMEN

Angiotensin II type 1 receptor-associated protein (ATRAP) promotes AT1R internalization along with suppression of hyperactivation of tissue AT1R signaling. Here, we provide evidence that renal ATRAP plays a critical role in suppressing hypertension in a mouse remnant kidney model of chronic kidney disease. The effect of 5/6 nephrectomy on endogenous ATRAP expression was examined in the kidney of C57BL/6 and 129/Sv mice. While 129/Sv mice with a remnant kidney showed decreased renal ATRAP expression and developed hypertension, C57BL/6 mice exhibited increased renal ATRAP expression and resistance to progressive hypertension. Consequently, we hypothesized that downregulation of renal ATRAP expression is involved in pathogenesis of hypertension in the remnant kidney model of chronic kidney disease. Interestingly, 5/6 nephrectomy in ATRAP-knockout mice on the hypertension-resistant C57BL/6 background caused hypertension with increased plasma volume. Moreover, in knockout compared to wild-type C57BL/6 mice after 5/6 nephrectomy, renal expression of the epithelial sodium channel α-subunit and tumor necrosis factor-α was significantly enhanced, concomitant with increased plasma membrane angiotensin II type 1 receptor in the kidneys. Thus, renal ATRAP downregulation is involved in the onset and progression of blood pressure elevation caused by renal mass reduction, and implicates ATRAP as a therapeutic target for hypertension in chronic kidney disease.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Hipertensión/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Insuficiencia Renal Crónica/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Animales , Presión Sanguínea , Regulación hacia Abajo , Canales Epiteliales de Sodio/metabolismo , Humanos , Riñón/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Insuficiencia Renal Crónica/complicaciones , Renina/sangre , Renina/metabolismo , Sistema Renina-Angiotensina , Transducción de Señal , Factor de Necrosis Tumoral alfa/metabolismo
2.
Int J Mol Sci ; 18(3)2017 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-28335584

RESUMEN

Activation of tissue renin-angiotensin system (RAS), mainly mediated by an angiotensin II (Ang II) type 1 receptor (AT1R), plays an important role in the development of obesity-related metabolic disorders. We have shown that AT1R-associated protein (ATRAP), a specific binding protein of AT1R, functions as an endogenous inhibitor to prevent excessive activation of tissue RAS. In the present study, we newly generated ATRAP/Agtrap-floxed (ATRAPfl/fl) mice and adipose tissue-specific ATRAP downregulated (ATRAPadipoq) mice by the Cre/loxP system using Adipoq-Cre. Using these mice, we examined the functional role of adipose ATRAP in the pathogenesis of obesity-related metabolic disorders. Compared with ATRAPfl/fl mice, ATRAPadipoq mice exhibited a decreased ATRAP expression in visceral white adipose tissue (WAT) and brown adipose tissue (BAT) by approximately 30% and 85%, respectively. When mice were fed a high-fat diet, ATRAPfl/fl mice showed decreased endogenous ATRAP expression in WAT that was equivalent to ATRAPadipoq mice, and there was no difference in the exacerbation of dietary obesity and glucose and lipid metabolism. These results indicate that ATRAP in BAT does not influence the pathogenesis of dietary obesity or metabolic disorders. Future studies that modulate ATRAP in WAT are necessary to assess its in vivo functions in the development of obesity-related metabolic disorders.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Tejido Adiposo Pardo/metabolismo , Enfermedades Metabólicas/metabolismo , Obesidad/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Animales , Dieta Alta en Grasa/efectos adversos , Glucosa/metabolismo , Metabolismo de los Lípidos , Enfermedades Metabólicas/etiología , Enfermedades Metabólicas/genética , Ratones , Obesidad/complicaciones , Obesidad/etiología
3.
Clin Exp Hypertens ; 38(8): 738-743, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27936941

RESUMEN

We compared the therapeutic effects of aliskiren (direct renin inhibitor (DRI) group) with angiotensin II (Ang II) type 1 receptor blockers (ARBs) (ARB group) on clinic blood pressure (BP) and ambulatory BP in 36 hypertensive chronic kidney disease (CKD) patients. The baseline clinic BP levels and the after-treatment/baseline (A/B) ratios of clinic BP levels, estimated after 24-week treatment period, were similar in DRI group (n = 18) and ARB group (n = 18). With respect to the effects on ambulatory BP, the A/B ratios of the daytime and nighttime systolic BP in DRI group were significantly higher than those in ARB group. The A/B ratio of ankle-brachial pressure index after the study was higher in the DRI group compared with the ARB group. The results of the present study suggest that DRI therapy is not superior to ARB therapy in lowering ambulatory BP in hypertensive CKD patients, in spite of comparable clinic BP-lowering effects.


Asunto(s)
Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea/efectos de los fármacos , Tasa de Filtración Glomerular/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Insuficiencia Renal Crónica/complicaciones , Renina/antagonistas & inhibidores , Adulto , Anciano , Antagonistas de Receptores de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Presión Sanguínea/fisiología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/etiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/fisiopatología , Renina/sangre
4.
Clin Exp Hypertens ; 38(8): 744-750, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27936999

RESUMEN

We examined the efficacy of single-pill irbesartan/amlodipine combination-based therapy for 12 weeks in 20 hypertensive chronic kidney disease (CKD) patients, by evaluating self-measured home blood pressure (BP) profile. The single-pill irbesartan/amlodipine combination-based therapy decreased clinic BP and home BP (morning, evening, and nighttime BPs), and improved within-visit clinic BP variability, day-by-day home BP variability (morning and evening), and nighttime home BP variability. Furthermore, the single-pill combination-based therapy reduced albuminuria and exerted improved parameters of vascular function. These results indicate that this single-pill combination-based therapy may exert beneficial effects on clinic and home BP profiles as well as on renal and vascular damages, in hypertension with CKD.


Asunto(s)
Amlodipino/administración & dosificación , Compuestos de Bifenilo/administración & dosificación , Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Insuficiencia Renal Crónica/complicaciones , Tetrazoles/administración & dosificación , Anciano , Bloqueadores del Receptor Tipo 1 de Angiotensina II/administración & dosificación , Presión Sanguínea/fisiología , Bloqueadores de los Canales de Calcio/administración & dosificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/etiología , Hipertensión/fisiopatología , Irbesartán , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/fisiopatología , Factores de Tiempo , Resultado del Tratamiento
5.
Lipids Health Dis ; 14: 161, 2015 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-26645467

RESUMEN

BACKGROUND: In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia. METHODS: This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of <100 mg/dl. RESULTS: The statin treatment by pitavastatin was well tolerated in all of the patients without any significant adverse events and the average dose of pitavastatin was 1.0 ± 0.0 mg daily after treatment. After the 12-months treatment period, LDL-C was significantly lower in the diet-plus-statin therapy group compared with the diet therapy group (diet vs diet-plus-statin: LDL-C, 126 ± 5 vs 83 ± 4 mg/dL, P < 0.001). On the other hand, the diet-plus-statin therapy did not significantly reduce albuminuria or delay the decline in eGFR compared with the diet therapy, and there was no relationship between the change in LDL-C and the change in eGFR or albuminuria. However, diet therapy as well as diet-plus-statin therapy exerted similar lowering effects on the pentosidine levels (diet therapy group, baseline vs 12 months: 40 ± 4 vs 24 ± 3 ng/mL, P = 0.001; diet-plus-statin therapy, 46 ± 7 vs 34 ± 6 ng/mL, P = 0.008). Furthermore, the results of multivariate regression analysis indicated that the change in pentosidine was a significant contributor to the change in eGFR (ß = -0.536, P = 0.011). CONCLUSIONS: Although statin add-on therapy did not show additive renal protective effects, the diet therapy as well as the diet-plus-statin therapy could contribute to the reduction in plasma pentosidine in CKD patients with albuminuria and dyslipidemia.


Asunto(s)
Albuminuria/tratamiento farmacológico , Anticolesterolemiantes/uso terapéutico , Dieta/métodos , Dislipidemias/tratamiento farmacológico , Quinolinas/uso terapéutico , Insuficiencia Renal Crónica/tratamiento farmacológico , Anciano , Albuminuria/sangre , Albuminuria/dietoterapia , Albuminuria/patología , Arginina/análogos & derivados , Arginina/antagonistas & inhibidores , Arginina/sangre , HDL-Colesterol/sangre , LDL-Colesterol/antagonistas & inhibidores , LDL-Colesterol/sangre , Dislipidemias/sangre , Dislipidemias/dietoterapia , Dislipidemias/patología , Femenino , Tasa de Filtración Glomerular , Productos Finales de Glicación Avanzada/antagonistas & inhibidores , Productos Finales de Glicación Avanzada/sangre , Humanos , Lisina/análogos & derivados , Lisina/antagonistas & inhibidores , Lisina/sangre , Masculino , Persona de Mediana Edad , Estrés Oxidativo/efectos de los fármacos , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/dietoterapia , Insuficiencia Renal Crónica/patología , Triglicéridos/sangre , Rigidez Vascular/efectos de los fármacos
6.
J Biol Chem ; 288(26): 19238-49, 2013 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-23653383

RESUMEN

The angiotensin II type 1 receptor (AT1R)-associated protein (ATRAP/Agtrap) promotes constitutive internalization of the AT1R so as to specifically inhibit the pathological activation of its downstream signaling yet preserve the base-line physiological signaling activity of the AT1R. Thus, tissue-specific regulation of Agtrap expression is relevant to the pathophysiology of cardiovascular and renal disease. However, the regulatory mechanism of Agtrap gene expression has not yet been fully elucidated. In this study, we show that the proximal promoter region from -150 to +72 of the mouse Agtrap promoter, which contains the X-box, E-box, and GC-box consensus motifs, is able to elicit substantial transcription of the Agtrap gene. Among these binding motifs, we showed that the E-box specifically binds upstream stimulatory factor (Usf) 1 and Usf2, which are known E-box-binding transcription factors. It is indicated that the E-box-Usf1/Usf2 binding regulates Agtrap expression because of the following: 1) mutation of the E-box to prevent Usf1/Usf2 binding reduces Agtrap promoter activity; 2) knockdown of Usf1 or Usf2 affects both endogenous Agtrap mRNA and Agtrap protein expression, and 3) the decrease in Agtrap mRNA expression in the afflicted kidney by unilateral ureteral obstruction is accompanied by changes in Usf1 and Usf2 mRNA. Furthermore, the results of siRNA transfection in mouse distal convoluted tubule cells and those of unilateral ureteral obstruction in the afflicted mouse kidney suggest that Usf1 decreases but Usf2 increases the Agtrap gene expression by binding to the E-box. The results also demonstrate a functional E-box-USF1/USF2 interaction in the human AGTRAP promoter, thereby suggesting that a strategy of modulating the E-box-USF1/USF2 binding has novel therapeutic potential.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Angiotensina II/metabolismo , Regulación de la Expresión Génica , Factores Estimuladores hacia 5'/metabolismo , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Secuencia de Bases , Células HEK293 , Humanos , Ratones , Ratones Endogámicos C57BL , Datos de Secuencia Molecular , Regiones Promotoras Genéticas , Unión Proteica , ARN Interferente Pequeño/metabolismo , Sistema Renina-Angiotensina , Transcripción Genética
7.
Kidney Int ; 86(3): 570-81, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24694992

RESUMEN

Angiotensin II type 1 receptor (AT1R)-associated protein (ATRAP) promotes AT1R internalization along with suppression of pathological activation of tissue AT1R signaling. However, the functional significance of ATRAP in renal sodium handling and blood pressure regulation under pathological stimuli is not fully resolved. Here we show the blood pressure of mice with a gene-targeted disruption of ATRAP was comparable to that of wild-type mice at baseline. However, in ATRAP-knockout mice, angiotensin II-induced hypertension was exacerbated and the extent of positive sodium balance was increased by angiotensin II. Renal expression of the sodium-proton antiporter 3, a major sodium transporter in the proximal tubules, urinary pH, renal angiotensinogen production, and angiotensin II content was unaffected. Stimulation of the renal expression and activity of the epithelial sodium channel (ENaC), a major sodium transporter in the distal tubules, was significantly enhanced by chronic angiotensin II infusion. The circulating and urinary aldosterone levels were comparable. The blood pressure response and renal ENaC expression by aldosterone were not affected. Thus, ATRAP deficiency exacerbated angiotensin II-mediated hypertension by pathological activation of renal tubular AT1R by angiotensin II. This directly stimulates ENaC in the distal tubules and enhances sodium retention in an aldosterone-independent manner.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Angiotensina II/farmacología , Hipertensión/genética , Reabsorción Renal/efectos de los fármacos , Sodio/metabolismo , Vasoconstrictores/farmacología , Proteínas Adaptadoras Transductoras de Señales/deficiencia , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Aldosterona/sangre , Aldosterona/orina , Angiotensinógeno/metabolismo , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/genética , Canales Epiteliales de Sodio/efectos de los fármacos , Eliminación de Gen , Concentración de Iones de Hidrógeno , Hipertensión/inducido químicamente , Túbulos Renales Distales/metabolismo , Túbulos Renales Proximales/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , ARN Mensajero/metabolismo , Receptor de Angiotensina Tipo 1/genética , Receptor de Angiotensina Tipo 1/metabolismo , Reabsorción Renal/genética , Intercambiador 3 de Sodio-Hidrógeno , Intercambiadores de Sodio-Hidrógeno/metabolismo , Urinálisis
8.
Int J Med Sci ; 11(6): 646-51, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24834011

RESUMEN

Recent studies indicate that the functional renin-angiotensin system (RAS) exists in the adipose tissue. The adipose tissue RAS is proposed in the pathophysiology of metabolic disorders. In the present study, we examined therapeutic effects of irbesartan, an angiotensin II (Ang II) type 1 receptor (AT1R)-specific blocker, in genetically obese diabetic KKAy mice, a model of human metabolic disorders without any dietary loading, with our focus on the analysis on possible effect of irbesartan on the adipose tissue. The treatment with irbesartan significantly lowered systolic blood pressure with a concomitant decrease in body weight in KKAy mice. In addition, irbesartan significantly decreased the adipose leptin mRNA expression and tended to decrease IL-6 mRNA expression in the adipose tissue of KKAy mice. Furthermore irbesartan preserved the adipose gene expression of AT1R-associated protein (ATRAP), an endogenous inhibitory molecule of tissue AT1R signaling, with a concomitant tendency of up-regulation of adipose tissue ATRAP/AT1R ratio. Collectively, these results suggest that the irbesartan-induced beneficial suppressive effect on the leptin-IL-6 axis in the adipose tissue in KKAy mice is partly mediated by a trend of up-regulation of the adipose ATRAP/AT1R ratio as one of pleiotropic effects of irbesartan.


Asunto(s)
Tejido Adiposo/efectos de los fármacos , Bloqueadores del Receptor Tipo 1 de Angiotensina II/administración & dosificación , Compuestos de Bifenilo/administración & dosificación , Obesidad/tratamiento farmacológico , Receptor de Angiotensina Tipo 1/genética , Tetrazoles/administración & dosificación , Proteínas Adaptadoras Transductoras de Señales/biosíntesis , Animales , Presión Sanguínea/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Humanos , Irbesartán , Leptina/biosíntesis , Ratones , Obesidad/genética , Obesidad/patología , Receptor de Angiotensina Tipo 1/metabolismo , Transducción de Señal/efectos de los fármacos
9.
Int J Mol Sci ; 14(8): 16866-81, 2013 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-23959116

RESUMEN

Ambulatory blood pressure (BP) and heart rate (HR) profile are proposed to be related to renal deterioration and cardiovascular complication in hypertension and chronic kidney disease (CKD). In this study, we examined the beneficial effects cilnidipine, a unique L/N-type calcium channel blocker (CCB), in addition to renin-angiotensin system inhibitors, on ambulatory BP and HR profile, as well as cardiorenal function in hypertensive CKD patients. Forty-five patients were randomly assigned to the cilnidipine replacement group (n = 21) or the control CCBs group (n = 24) during a 24-week active treatment period. Although clinical BP values were similar in the cilnidipine and control CCBs groups after the treatment period, the results of ambulatory BP monitoring showed that the 24-h and daytime systolic BP levels in the cilnidipine group were significantly lower compared with the control group after the study. Furthermore, the left ventricular mass index (LVMI) was significantly decreased in the cilnidipine group compared to the control group after the study (LVMI, 135.3 ± 26.4 versus 181.2 ± 88.4, p = 0.031), with a significant difference in the changes in the LVMI between the cilnidipine and control groups (change in LVMI, -12.4 ± 23.7 versus 26.2 ± 64.4, p = 0.007). These results indicate that cilnidipine is beneficial for the suppression of pathological cardiac remodeling, at least partly, via a superior improving effect on ambulatory BP profile compared with control CCBs in hypertensive CKD patients.


Asunto(s)
Antagonistas de Receptores de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Cardiomegalia/tratamiento farmacológico , Dihidropiridinas/uso terapéutico , Hipertensión/tratamiento farmacológico , Insuficiencia Renal Crónica/fisiopatología , Anciano , Anciano de 80 o más Años , Antagonistas de Receptores de Angiotensina/farmacología , Antihipertensivos/farmacología , Presión Sanguínea/efectos de los fármacos , Monitoreo Ambulatorio de la Presión Arterial , Bloqueadores de los Canales de Calcio/farmacología , Bloqueadores de los Canales de Calcio/uso terapéutico , Canales de Calcio Tipo L/metabolismo , Canales de Calcio Tipo N/metabolismo , Cardiomegalia/fisiopatología , Dihidropiridinas/farmacología , Quimioterapia Combinada , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/tratamiento farmacológico , Sistema Renina-Angiotensina/efectos de los fármacos , Resultado del Tratamiento
10.
Int J Mol Sci ; 14(8): 15361-75, 2013 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-23887656

RESUMEN

An altered ambulatory blood pressure (BP) and heart rate (HR) profile is related to chronic kidney disease (CKD) and cardiorenal syndrome. In this study, we examined the effects of aliskiren, when added to angiotensin II type 1 receptor blockers, on ambulatory BP and cardiorenal function in CKD. Thirty-six hypertensive CKD patients were randomly assigned to the aliskiren add-on group (n = 18) or the benazepril add-on group (n = 18). Ambulatory BP and cardiorenal function parameters were measured at baseline and 24 weeks after treatment. Compared with the benazepril group, nighttime systolic BP variability in the aliskiren group was lower after treatment. Albuminuria was decreased in the aliskiren group, but not in the benazepril group. In addition, left ventricular mass index (LVMI) was significantly lower in the aliskiren group than in the benazepril group after treatment. In the aliskiren group, multivariate linear regression analysis showed an association between changes in albuminuria and changes in nighttime systolic BP. Furthermore, there were associations between changes in LVMI and changes in daytime HR variability, as well as between changes in LVMI and changes in plasma aldosterone concentration. These results suggest that aliskiren add-on therapy may be beneficial for suppression of renal deterioration and pathological cardiac remodeling through an improvement that is effected in ambulatory BP and HR profiles.


Asunto(s)
Amidas/uso terapéutico , Antagonistas de Receptores de Angiotensina/uso terapéutico , Antihipertensivos/uso terapéutico , Benzazepinas/uso terapéutico , Fumaratos/uso terapéutico , Insuficiencia Renal Crónica/tratamiento farmacológico , Anciano , Albuminuria/tratamiento farmacológico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Síndrome Cardiorrenal/tratamiento farmacológico , Femenino , Pruebas de Función Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hipertrofia Ventricular Izquierda/tratamiento farmacológico , Pruebas de Función Renal , Masculino , Estrés Oxidativo/efectos de los fármacos
11.
Clin Exp Hypertens ; 34(4): 264-9, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22578052

RESUMEN

Strict blood pressure (BP) control is reportedly important for the management of hypertensive patients with chronic kidney disease (CKD). The purpose of this cross-sectional study was to examine whether the variables of ambulatory BP and the heart rate (HR) profile, central hemodynamics, and arterial stiffness were closely related to the renal function parameters (urine albumin excretion rate [UACR] and estimated glomerular filtration rate [eGFR]) observed in 25 consecutive hospitalized hypertensive patients with CKD. There were significant positive relationships between UACR and 24-hour, daytime, and nighttime ambulatory systolic BP. In addition, there were significant negative relationships between UACR and 24-hour and daytime HR variability. The circulating B-type natriuretic peptide level and hemoglobin A1c were also positively related to UACR. With respect to eGFR, although the 24-hour and nighttime HR variability were positively associated with eGFR, the circulating pentosidine and nighttime HR had a negative relationship with eGFR. On the other hand, central hemodynamics and arterial stiffness did not exhibit any significant association with renal function parameters. These results indicate that ambulatory BP and the HR profile are closely modulated by renal function deterioration. Further studies are needed to investigate the causal relationship between ambulatory BP and the HR profile and renal function parameters in hypertensive patients with CKD.


Asunto(s)
Hipertensión Renal/fisiopatología , Fallo Renal Crónico/fisiopatología , Insuficiencia Renal Crónica/fisiopatología , Anciano , Albuminuria/complicaciones , Albuminuria/fisiopatología , Índice Tobillo Braquial , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Frecuencia Cardíaca , Humanos , Hipertensión Renal/complicaciones , Fallo Renal Crónico/complicaciones , Masculino , Persona de Mediana Edad , Insuficiencia Renal Crónica/complicaciones , Rigidez Vascular
12.
Clin Exp Hypertens ; 34(4): 249-57, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22571446

RESUMEN

Recent guidelines recommend combination antihypertensive therapy to achieve the target blood pressure (BP) and to suppress target organ damage. This study aimed to examine the beneficial effects of combination therapy with candesartan and amlodipine on BP control and markers of target organ function in Japanese essential hypertensive patients (N = 20) who did not achieve the target BP level during the monotherapy period with either candesartan or amlodipine. After the monotherapy period, for patients already being treated with amlodipine, a once-daily 8 mg dose of candesartan was added on during the combination therapy period (angiotensin II receptor blocker [ARB] add-on group, N = 10), and a once-daily 5 mg dose of amlodipine was added on for those already being treated with candesartan (calcium channel blocker [CCB] add-on group, N = 10). Combination therapy with candesartan and amlodipine for 12 weeks significantly decreased clinic and home systolic blood pressure (SBP) and diastolic blood pressure (DBP). In addition, the combination therapy was able to significantly reduce urine albumin excretion without decrease in estimated glomerular filtration ratio and resulted in significant improvements in brachial-ankle pulse wave velocity, central SBP, and insulin sensitivity. Furthermore, the CCB add-on group showed a significantly greater decrease in clinic and home DBP than the ARB add-on group. The calcium channel blocker add-on group also exhibited better improvements in vascular functional parameters than the ARB add-on group. These results suggest that combination therapy with candesartan and amlodipine is an efficient therapeutic strategy for hypertension with pleiotropic benefits.


Asunto(s)
Amlodipino/administración & dosificación , Bloqueadores del Receptor Tipo 1 de Angiotensina II/administración & dosificación , Antihipertensivos/administración & dosificación , Bencimidazoles/administración & dosificación , Presión Sanguínea , Bloqueadores de los Canales de Calcio/administración & dosificación , Hipertensión/tratamiento farmacológico , Tetrazoles/administración & dosificación , Anciano , Albuminuria/tratamiento farmacológico , Compuestos de Bifenilo , Presión Sanguínea/efectos de los fármacos , Creatinina/orina , Quimioterapia Combinada , Femenino , Tasa de Filtración Glomerular/efectos de los fármacos , Humanos , Hipertensión/fisiopatología , Resistencia a la Insulina , Japón , Masculino , Persona de Mediana Edad
13.
Physiol Genomics ; 43(14): 884-94, 2011 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-21586669

RESUMEN

We previously cloned a molecule that interacts with angiotensin II type 1 (AT1) receptor to exert an inhibitory function on AT1 receptor signaling that we named ATRAP/Agtrap (for AT1 receptor-associated protein). In the present study we examined the regulation of basal ATRAP gene expression using renal distal convoluted tubule cells. We found that serum starvation upregulated basal expression of ATRAP gene, a response that required de novo mRNA and protein synthesis. Luciferase assay revealed that the proximal promoter region directs transcription and that a putative binding site of runt-related transcription factors (RBE) is important for transcriptional activation. The results of RBE-decoy transfection and endogenous knockdown by small interference RNA showed that the runt-related transcription factor Runx3 is involved in ATRAP gene expression. Chromatin immunoprecipitation assay also supported the binding of Runx3 to the ATRAP promoter in renal distal convoluted tubule cells. Immunohistochemistry demonstrated the expression of Runx3 and ATRAP proteins in the distal convoluted and connecting tubules of the kidney in consecutive sections. Furthermore, the Runx3 immunostaining was decreased together with a concomitant suppression of ATRAP expression in the affected kidney after 7 days of unilateral ureteral obstruction. These findings indicate that Runx3 plays a role in ATRAP gene expression in renal distal tubular cells both in vitro and in vivo.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Subunidad alfa 3 del Factor de Unión al Sitio Principal/metabolismo , Activación Transcripcional/genética , Animales , Secuencia de Bases , Sitios de Unión , Línea Celular , Medio de Cultivo Libre de Suero , Técnicas de Silenciamiento del Gen , Túbulos Renales Distales/citología , Túbulos Renales Distales/metabolismo , Ratones , Ratones Endogámicos C57BL , Datos de Secuencia Molecular , Regiones Promotoras Genéticas/genética , Unión Proteica , Biosíntesis de Proteínas , ARN Mensajero/genética , ARN Mensajero/metabolismo , Proteínas Smad/metabolismo , Transcripción Genética , Regulación hacia Arriba/genética
14.
Clin Exp Hypertens ; 33(4): 255-63, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21699452

RESUMEN

Accumulating evidence has shown that diabetic patients are increasing in number, and renal and cardiovascular complications are the most common cause of death in diabetic patients. Thus, it would be of considerable value to identify the mechanisms involved in the progression of renal impairment and cardiovascular injury associated with diabetes. Recent evidence also indicated that multifactorial intervention is able to reduce the risk of cardiovascular disease and death among patients with diabetes and microalbuninuria. In this pilot study, we examined the effects of intensified multifactorial intervention, with tight glucose regulation and the use of valsartan and fluvastatin on ambulatory blood pressure (BP) profile, estimated glomerular filtration rate (eGFR), and urinary albumin to creatinine ratio (UACR), in 20 hypertensive patients (16 male and 4 female) with type 2 diabetes mellitus and overt nephropathy. After 12 months of intensified treatment, office BP, fasting plasma glucose (FPG), and low-density lipoprotein cholesterol (LDLC) were significantly decreased compared to baseline (systolic blood pressure (SBP), 130 ± 2 vs. 150 ± 1 mmHg; diastolic blood pressure (DBP), 76 ± 1 vs. 86 ± 1 mmHg; FPG, 117 ± 5 vs. 153 ± 7 mg/dl; LDLC, 116 ± 8 vs. 162 ± 5 mg/dl, P < 0.0001). Also, compared to the baseline values, the daytime and nighttime ambulatory BP and short-term BP variability were significantly decreased after 12 months. Furthermore, while eGFR was not altered (44.3 ± 5.1 vs. 44.3 ± 6.5 ml/min/1.73 m(2), not significant (NS)), UACR showed a significant reduction after 12 months of intensified treatment (1228 ± 355 vs. 2340 ± 381 mg/g-cr, P < 0.05). These results suggest that the intensified multifactorial intervention is able to improve ambulatory BP profile, preserve renal function, and reduce urinary albumin excretion in type 2 diabetic hypertensive patients with overt nephropathy.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea/fisiología , Ritmo Circadiano/fisiología , Diabetes Mellitus Tipo 2/fisiopatología , Nefropatías Diabéticas/fisiopatología , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Riñón/fisiopatología , Albuminuria/orina , Anticolesterolemiantes/farmacología , Antihipertensivos/farmacología , Glucemia/metabolismo , Presión Sanguínea/efectos de los fármacos , Comorbilidad , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Nefropatías Diabéticas/etiología , Ácidos Grasos Monoinsaturados/farmacología , Femenino , Fluvastatina , Tasa de Filtración Glomerular/efectos de los fármacos , Tasa de Filtración Glomerular/fisiología , Frecuencia Cardíaca/fisiología , Humanos , Hipertensión/epidemiología , Indoles/farmacología , Lípidos/sangre , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Análisis de Regresión , Tetrazoles/farmacología , Valina/análogos & derivados , Valina/farmacología , Valsartán
15.
Am J Physiol Renal Physiol ; 299(4): F720-31, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20685825

RESUMEN

The intrarenal renin-angiotensin system plays a crucial role in the regulation of renal circulation and sodium reabsorption through the activation of vascular, glomerular, and tubular angiotensin II type 1 (AT(1)) receptor signaling. We previously cloned a molecule that specifically interacted with the murine AT(1) receptor to inhibit AT(1) receptor signaling, which we named ATRAP (for AT(1) receptor-associated protein). Since murine ATRAP was shown to be highly expressed in the kidney, in the present study we investigated expression and distribution of human ATRAP in normal kidney and renal biopsy specimens from patients with IgA nephropathy. In the normal human kidney, both ATRAP mRNA and protein were widely and abundantly distributed along the renal tubules from Bowman's capsule to the medullary collecting ducts. In all renal tubular epithelial cells, the ATRAP protein colocalized with the AT(1) receptor. In renal biopsy specimens with IgA nephropathy, a significant positive correlation between ATRAP and AT(1) receptor gene expression was observed. There was also a positive relationship between tubulointerstitial ATRAP expression and the estimated glomerular filtration rate in patients with IgA nephropathy. Furthermore, we examined the function of the tubular AT(1) receptor using an immortalized cell line of mouse distal convoluted tubule cells (mDCT) and found that overexpression of ATRAP by adenoviral gene transfer suppressed the angiotensin II-mediated increases in transforming growth factor-ß production in mDCT cells. These findings suggest that ATRAP might play a role in balancing the renal renin-angiotensin system synergistically with the AT(1) receptor by counterregulatory effects in IgA nephropathy and propose an antagonistic effect of tubular ATRAP on AT(1) receptor signaling.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Glomerulonefritis por IGA/metabolismo , Riñón/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Animales , Biopsia , Línea Celular , Estudios Transversales , Glomerulonefritis por IGA/patología , Humanos , Riñón/patología , Túbulos Renales Distales/metabolismo , Masculino , Ratones , Modelos Animales , Miocardio/citología , Miocardio/metabolismo , ARN Mensajero/metabolismo , Ratas , Sistema Renina-Angiotensina/fisiología
16.
Gastric Cancer ; 13(1): 25-9, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20373072

RESUMEN

BACKGROUND: The area near the left gastric vein (LGV) is a challenging site at which to perform dissection of the lymph nodes during gastrectomy. Therefore, knowledge of the precise location of the LGV is important. The objective of this study was to examine the usefulness of multidetector computed tomography (MDCT) for the identification of the LGV. METHODS: Eighty-one patients with gastric cancer underwent MDCT, which was performed with contrast media in 76 patients and without contrast media in 5 patients. A 5-mm thin slice of the frontal image was reconstructed. These images were examined preoperatively to detect the location of the LGV. Upon gastrectomy, the LGV was identified and its location compared to that determined by MDCT. RESULTS: The LGV was identified by MDCT in 76 of the 81 patients (93.8%). The LGV was subsequently located during the operation in all 81 patients. The LGV was located dorsal to the common hepatic artery in 40 patients (49.4%), ventral to the common hepatic artery in 18 patients (22.2%), ventral to the splenic artery in 17 patients (21.0%), dorsal to the splenic artery in 2 patients (2.5%) and in other positions in 4 patients (4.9%). In all patients, the location of the LGV detected using MDCT was consistent with that identified during gastrectomy. In the 4 patients with relatively unusual locations of the LGV, these 4 LGV variants were identified preoperatively by MDCT. CONCLUSION: MDCT was useful for identifying the location of the LGV prior to gastrectomy.


Asunto(s)
Gastrectomía/métodos , Cuidados Preoperatorios , Neoplasias Gástricas/cirugía , Estómago/irrigación sanguínea , Estómago/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Humanos , Imagenología Tridimensional , Ganglios Linfáticos/cirugía , Flebografía/métodos , Venas/cirugía
17.
Atherosclerosis ; 269: 236-244, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29407599

RESUMEN

BACKGROUND AND AIMS: The components of the renin-angiotensin system in leukocytes is involved in the pathophysiology of non-communicable diseases (NCDs), including hypertension, atherosclerosis and chronic kidney disease. Angiotensin II type 1 receptor (AT1R)-associated protein (ATRAP) is an AT1R-specific binding protein, and is able to inhibit the pathological activation of AT1R signaling in certain animal models of NCDs. The aim of the present study was to investigate the expression and regulation of ATRAP in leukocytes. METHODS: Human leukocyte ATRAP mRNA was measured with droplet digital polymerase chain reaction system, and analyzed in relation to the clinical variables. We also examined the leukocyte cytokines mRNA in bone-marrow ATRAP-deficient and wild-type chimeric mice after injection of low-dose lipopolysaccharide. RESULTS: The ATRAP mRNA was abundantly expressed in leukocytes, predominantly granulocytes and monocytes, of healthy subjects. In 86 outpatients with NCDs, leukocyte ATRAP mRNA levels correlated positively with granulocyte and monocyte counts and serum C-reactive protein levels. These positive relationships remained significant even after adjustment. Furthermore, the leukocyte ATRAP mRNA was significantly associated with the interleukin-1ß, tumor necrosis factor-α and monocyte chemotactic protein-1 mRNA levels in leukocytes of NCDs patients. In addition, the leukocyte interleukin-1ß mRNA level was significantly upregulated in bone marrow ATRAP-deficient chimeric mice in comparison to wild-type chimeric mice after injection of lipopolysaccharide. CONCLUSIONS: These results suggest that leukocyte ATRAP is an emerging marker capable of reflecting the systemic and leukocyte inflammatory profile, and plays a role as an anti-inflammatory factor in the pathophysiology of NCDs.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Citocinas/metabolismo , Mediadores de Inflamación/metabolismo , Inflamación/metabolismo , Leucocitos/metabolismo , Proteínas Adaptadoras Transductoras de Señales/deficiencia , Proteínas Adaptadoras Transductoras de Señales/genética , Anciano , Anciano de 80 o más Años , Animales , Estudios de Casos y Controles , Citocinas/genética , Modelos Animales de Enfermedad , Femenino , Humanos , Inflamación/inducido químicamente , Inflamación/genética , Inflamación/inmunología , Leucocitos/inmunología , Lipopolisacáridos , Masculino , Ratones Endogámicos C57BL , Ratones Noqueados , Persona de Mediana Edad , Enfermedades no Transmisibles
18.
J Am Heart Assoc ; 6(8)2017 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-28751545

RESUMEN

BACKGROUND: The kidney is easily affected by aging-associated changes, including glomerulosclerosis, tubular atrophy, and interstitial fibrosis. Particularly, renal tubulointerstitial fibrosis is a final common pathway in most forms of progressive renal disease. Angiotensin II type 1 receptor (AT1R)-associated protein (ATRAP), which was originally identified as a molecule that binds to AT1R, is highly expressed in the kidney. Previously, we have shown that ATRAP suppresses hyperactivation of AT1R signaling, but does not affect physiological AT1R signaling. METHODS AND RESULTS: We hypothesized that ATRAP has a novel functional role in the physiological age-degenerative process, independent of modulation of AT1R signaling. ATRAP-knockout mice were used to study the functional involvement of ATRAP in the aging. ATRAP-knockout mice exhibit a normal age-associated appearance without any evident alterations in physiological parameters, including blood pressure and cardiovascular and metabolic phenotypes. However, in ATRAP-knockout mice compared with wild-type mice, the following takes place: (1) age-associated renal function decline and tubulointerstitial fibrosis are more enhanced; (2) renal tubular mitochondrial abnormalities and subsequent increases in the production of reactive oxygen species are more advanced; and (3) life span is 18.4% shorter (median life span, 100.4 versus 123.1 weeks). As a key mechanism, age-related pathological changes in the kidney of ATRAP-knockout mice correlated with decreased expression of the prosurvival gene, Sirtuin1. On the other hand, chronic angiotensin II infusion did not affect renal sirtuin1 expression in wild-type mice. CONCLUSIONS: These results indicate that ATRAP plays an important role in inhibiting kidney aging, possibly through sirtuin1-mediated mechanism independent of blocking AT1R signaling, and further protecting normal life span.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Angiotensina II/metabolismo , Riñón/metabolismo , Longevidad , Proteínas Adaptadoras Transductoras de Señales/deficiencia , Proteínas Adaptadoras Transductoras de Señales/genética , Factores de Edad , Angiotensina II/administración & dosificación , Animales , Colágeno/genética , Colágeno/metabolismo , Fibrosis , Genotipo , Riñón/fisiopatología , Riñón/ultraestructura , Ratones Endogámicos C57BL , Ratones Noqueados , Mitocondrias/metabolismo , Estrés Oxidativo , Fenotipo , Especies Reactivas de Oxígeno/metabolismo , Receptor de Angiotensina Tipo 1/metabolismo , Transducción de Señal , Sirtuina 1/genética , Sirtuina 1/metabolismo , Factores de Tiempo , Factor de Crecimiento Transformador beta/genética , Factor de Crecimiento Transformador beta/metabolismo
19.
Physiol Rep ; 5(11)2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28611155

RESUMEN

Plasma membrane calcium pump isoform 1 (PMCA1) is encoded by ATPase plasma membrane Ca2+transporting 1 (ATP2B1), the most likely candidate gene responsible for hypertension. Although PMCA1 is highly expressed in the kidney, little is known about regulation of its renal expression in various pathological conditions in vivo. Our study was designed to elucidate regulation of renal PMCA1 expression in mice. We employed three mouse models for kidney disease. These were the unilateral ureteral obstruction (UUO), the remnant kidney using 5/6 nephrectomy, and chronic angiotensin II administration models. Mice were assessed for systolic blood pressure and renal injury in accordance with the damage induced in the specific model. Kidney PMCA1 mRNA levels were measured in all mice. The UUO model showed renal fibrosis but no changes in blood pressure or renal PMCA1 mRNA expression. Similarly, the 5/6 nephrectomy model exhibited declined renal function without changes in blood pressure or renal PMCA1 mRNA expression. In contrast, chronic angiotensin II administration increased albuminuria and blood pressure as well as significantly increasing renal PMCA1 mRNA and protein expression. These results suggest that renal PMCA1 has a role as one of the molecules involved in angiotensin II-induced hypertension and kidney injury.


Asunto(s)
Angiotensina II/metabolismo , Regulación de la Expresión Génica/fisiología , Hipertensión/metabolismo , ATPasas Transportadoras de Calcio de la Membrana Plasmática/biosíntesis , Angiotensina II/toxicidad , Animales , Regulación de la Expresión Génica/efectos de los fármacos , Hipertensión/inducido químicamente , Masculino , Ratones , Ratones Endogámicos C57BL , Nefrectomía , Obstrucción Ureteral/metabolismo
20.
Ind Health ; 43(1): 213-20, 2005 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-15732326

RESUMEN

In order to evaluate the effect of pre-heating on biosolubility and water-resistance of alkaline earth silicate (AES) fibers in MgO-SrO-SiO2 and MgO-CaO-SrO-SiO2 compositions, dissolution experiments of the heat-treated (from 110 degrees C to 1,260 degrees C) AES fibers have been carried out in a glycine solution and in distilled water at 40 degrees C for 50 h. The dissolution experiments show that the heat-treatment around 700 degrees C has made the AES fibers more soluble in the glycine solution. This is due to the phase separation of the AES fibers resulting from the heat-treatment. Probably, alkaline earth-rich glassy phases formed by the phase separation facilitate the dissolution of the heat-treated AES fibers in the glycine solution. The heat-treatment around 700 degrees C is possible to decrease the toxicity of the AES fibers further. Meanwhile, this heat-treatment around 700 degrees C has given little effect on the dissolution of the AES fibers in the distilled water. This indicates that the resistance of the AES fibers to water or humidity remains unaffected by the heat-treatment. The water-resistance is a very useful property for MMVFs. This study suggests that the heat-treatment around 700 degrees C is probably an useful treatment in order to enhance the total performance, biosolubility and water-resistance, of AES fibers.


Asunto(s)
Glicina , Calor , Fibras Minerales/análisis , Silicatos/química , Solubilidad , Soluciones/química , Agua , Humanos , Trastornos Respiratorios/etiología , Silicatos/toxicidad , Dióxido de Silicio/química , Dióxido de Silicio/toxicidad , Difracción de Rayos X
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