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Norepinephrine Reuptake Inhibition, an Emergent Treatment for Neurogenic Orthostatic Hypotension.
Mwesigwa, Naome; Shibao, Cyndya A.
Afiliación
  • Mwesigwa N; Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (N.M., C.A.S.).
  • Shibao CA; Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (N.M., C.A.S.).
Hypertension ; 81(7): 1460-1466, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38766862
ABSTRACT
The NET (norepinephrine transporter) is situated in the prejunctional plasma membrane of noradrenergic neurons. It is responsible for >90% of the norepinephrine uptake that is released in the autonomic neuroeffector junction. Inhibitors of this cell membrane transporter, known as norepinephrine reuptake inhibitors (NRIs), are commercially available for the treatment of depression and attention deficit hyperactivity disorder. These agents increase norepinephrine levels, potentiating its action in preganglionic and postganglionic adrenergic neurons, the latter through activation of α-1 adrenoreceptors. Previous studies found that patients with neurogenic orthostatic hypotension can improve standing blood pressure and reduce symptoms of neurogenic orthostatic hypotension after a single administration of the selective NRI atomoxetine. This effect was primarily observed in patients with impaired central autonomic pathways with otherwise normal postganglionic sympathetic fibers, known as multiple system atrophy. Likewise, patients with normal or high norepinephrine levels may benefit from NRIs. The long-term efficacy of NRIs for the treatment of neurogenic orthostatic hypotension-related symptoms is currently under investigation. In summary, an in-depth understanding of the pathophysiology of neurogenic orthostatic hypotension resulted in the discovery of a new therapeutic pathway targeted by NRI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Norepinefrina / Inhibidores de Captación Adrenérgica / Clorhidrato de Atomoxetina / Hipotensión Ortostática Límite: Humans Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Norepinefrina / Inhibidores de Captación Adrenérgica / Clorhidrato de Atomoxetina / Hipotensión Ortostática Límite: Humans Idioma: En Revista: Hypertension Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos