糖尿病和非糖尿病慢性病中的内末林受体对手
Vanja Ivković1,2, Annette Bruchfeld3,4
1University Hospital Center Zagreb, Department of Nephrology, Hypertension, Dialysis and Transplantation, Zagreb, Croatia.
Clinical kidney journal
|April 25, 2024
概括
内甲素受体对抗剂在治疗慢性病 (CKD) 中表现有前途. 本综述探讨了它们在糖尿病和非糖尿病患者中的安全性和有效性,强调了未来的研究方向.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性病 (CKD) 影响全球超过8亿人,是致病率和死亡率的重要原因.
- 目前对CKD的治疗选择往往缺乏针对潜在的病理生理过程的有针对性的方法.
- 内甲蛋白系统在CKD病理生理学中发挥作用,这表明了潜在的治疗点.
研究的目的:
- 审查最近关于内甲素受体对抗剂 (ERA) 在慢性病患者的安全性和疗效的研究结果.
- 检查ERAs在糖尿病和非糖尿病CKD人群中的作用.
- 讨论未来的研究方向和CKD治疗中的新兴治疗方法.
主要方法:
- 对最近的临床试验和相关文献进行系统审查.
- 对内甲素受体抗剂的安全性和疗效数据的分析.
- 综合证据关于ERA对糖尿病和非糖尿病慢性病的影响.
主要成果:
- 内甲素受体对抗剂在CKD患者中显示出越来越多的疗效证据.
- 关于ERA在糖尿病和非糖尿病CKD中的安全性和有效性的数据正在积极调查中.
- 最近的试验表明,情况正在发生变化,对CKD有新的治疗途径.
结论:
- 内甲素受体对抗剂代表了治疗慢性病的有前途的治疗类.
- 需要进一步的研究,以充分阐明不同CKD人群中ERA的长期安全性和有效性概况.
- 这些发现支持探索ERA作为CKD的向治疗方法,解决关键的病理生理机制.
相关概念视频
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
422
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
422
Antihypertensive Drugs: Direct Renin Inhibitors
606
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
606
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
156
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
156
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
621
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
621
Antihypertensive Drugs: Angiotensin II Receptor Blockers
716
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
716
Heart Failure Drugs: Diuretics
370
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
370


