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Gitelman's and Bartter's Syndromes: From Genetics to the Molecular Basis of Hypertension and More
Verdiana Ravarotto1, Giovanni Bertoldi1, Lucia Federica Stefanelli1
1Department of Medicine (DIMED) Nephrology, Dialysis and Transplantation Unit University of Padova, Padova, Italy.
Background:
Gitelman's and Bartter's syndromes (GS/BS) are rare genetic tubulopathies characterized by electrolyte imbalance and activation of the renin-angiotensin-aldosterone system (RAAS). These syndromes have intriguing biochemical and hormonal abnormalities that lead them to be protected from hypertension and cardiovascular and renal remodeling.
Summary:
In this review, we explore the biochemical/molecular mechanisms induced by the activation of the RAAS and its counterregulatory arm which is particularly activated in GS/BS patients, in the context of blood pressure regulation. In addition, we report our findings in the context of the COVID-19 pandemic where we observed GS/BS subjects being protected from infection.
Key Messages:
The intracellular pathways induced by Ang II, starting from induction of oxidative stress and vasoconstriction, are crucial for the progression toward cardiovascular-renal remodeling and might be useful targets in order to reduce/halt the progression of Ang II/oxidative stress-induced cardiovascular-renal morbidity in several diseases.
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