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バソペプチダース阻害剤:心臓血管疾患における新しい治療概念?
R Corti1, J C Burnett, J L Rouleau
1CardioVascular Center, Cardiology, University Hospital Zurich, Switzerland. cardiotfl@gmx.ch
Circulation
|October 10, 2001
まとめ
バソペプチダース阻害剤は,ACEと中性エンドペプチダース (NEP) の両方を阻害することで,心血管疾患に対する有望な新しい治療法を提供します. この二重抑制は有益なナトリウレチンペプチドとキニンを強化し,血圧を低下させ,血管機能を改善します.
科学分野:
- 心血管生理学 心血管の生理学
- 薬理学 薬理学とは
背景:
- 心血管系は,ホメオスタシスのための血液動力学的および神経幽默的調節に依存しています.
- ニューロ・ヒューモラルシステムの調節障害は,高血圧や心不全などの心血管疾患に寄与する.
- 中性エンドペプチダゼ (NEP) は,血管の健康に不可欠なナトリウレチンペプチド,キニン,アドレノメドゥリンを分解します.
研究 の 目的:
- 心血管疾患における中性エンドペプチダース (NEP) 抑制の治療の可能性を調査する.
- 新規の治療戦略として,ACEとNEPの結合阻害を評価する.
主な方法:
- 中性エンドペプチダース (NEP) の酵素活性と基板特異性を調査した.
- ナトリウレチンペプチド,キニン,アドレノメドゥリンのレベルに対するNEP阻害の効果を調べた.
- 結合されたACEとNEPの阻害が血管収縮,血管拡張,血圧に与える影響を評価した.
主要な成果:
- NEPを阻害すると,ナトリウレチンペプチド (ANP,BNP,CNP),ブラジキニン,アドレノメドゥリンのレベルが上昇する.
- ACEとNEPの結合阻害は,血管収縮を軽減し,血管拡張を高める.
- この二重抑制は,ナトリウムと水のバランスを改善し,外周血管抵抗を低下させ,血圧を下げる.
結論:
- ACEと中性エンドペプチダース (NEP) の結合阻害は,心血管疾患に対する新しい治療アプローチを表しています.
- バソペプチダース阻害剤は,複数の神経律系を調節することにより,高血圧,動脈硬化,心不全の治療に有望であることが示されています.
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