Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progress...Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-Aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: All patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.展开更多
The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes ...The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes of APA was analyzed. The mRNA expression of AT1R and AT2R in 50 cases of APA and tissues adjacent to tumors and 12 cases of normal adrenal tissues was detected by using reverse transcriptase polymerase chain reaction (RT-PCR). The expression of AT1R and AT2R proteins in paraffin-embedded slices of tissue was detected by immunohistochemistry. The expression of AT1R in adenoma, tissues adjacent to tumor, and normal tissues of the adrenal gland showed no significant differences. The expression of AT2R in APA tissue was lower than that in normal adrenal gland tissues (P<0.05). Correlation analysis of the mRNA expression level of AT2R and clinical data from patients demonstrated that AT2R expression was negatively related to plasma aldosterone concentration (PAC) (r=-0.467, P<0.05), but positively related with plasma renin activity (PRA) (r=0.604, P<0.05). It is concluded that down-regulation of the AT2R expression is possibly related with the tumorigenesis of APA.展开更多
Obstructive sleep apnea(OSA) is an independent risk factor for cardiovascular diseases. Aldosterone was reported to be increased in patients with OSA and correlated with OSA severity. Many studies investigated the eff...Obstructive sleep apnea(OSA) is an independent risk factor for cardiovascular diseases. Aldosterone was reported to be increased in patients with OSA and correlated with OSA severity. Many studies investigated the effect of continuous positive airway pressure(CPAP) therapy on plasma aldosterone concentrations(PAC) in OSA patients. The results, however, were inconsistent. In the present study, we aimed to evaluate the effects of CPAP therapy on PAC by performing a meta-analysis. Literature search was carried out in electronic databases including Pub Med/Medline, Cochrane Library, Embase and Web of Science. Eligible full-text articles were identified, and important data were extracted. Pooled analysis was performed using the STATA12.0 and Rev Man 5.2. Standardized mean difference(SMD) was calculated to estimate the treatment effects. A total of eight studies involving 219 patients were included for our final analysis. PAC was found unchanged after CPAP treatment in OSA patients(SMD=–0.36, 95% CI: –0.91 to 0.18, Z=1.32, P=0.19). Meanwhile, CPAP therapy showed no impact on PAC(SMD=–0.21, 95% CI: –0.85 to 0.42, Z=0.66, P=0.51) in a separate meta-analysis including 3 randomized controlled trials. In conclusion, the evidence for the use of CPAP therapy to decrease PAC in OSA patients is low, and further studies are still warranted.展开更多
Previous Background: Hemodynamic factors, like blood pressure, have been established to be major determinants of cardiac left ventricular structure. However, several factors other than blood pressure to influence card...Previous Background: Hemodynamic factors, like blood pressure, have been established to be major determinants of cardiac left ventricular structure. However, several factors other than blood pressure to influence cardiac mass have been implicated. When we did medical survey, cardiac left ventricular mass index (LVMI) of one ethnic group that had higher blood pressure was found to be smaller than that of the other ethnic groups with a lower blood pressure. Such contradicted data from the present study were analyzed combining blood pressure, LVMI and chemical parameters obtained from blood and urine. Methods: In a medical survey conducted in Xinjiang, China, 279 people (65 - 70 years old) from three ethnic groups (Kazakh, Uygur and Han) from two separated regions provided blood and urine samples and underwent echocardiography and 24-h ambulatory blood pressure monitoring (ABPM). Results: Systolic and diastolic blood pressure obtained from ABPM and urinary sodium excretion values were significantly higher in Kazakh than that in Uygur and Han. However, LVMI in Kazakh was lower than that in other 2 groups. Plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were significantly lowest in Kazakh. The values of LVMI in all ethnic groups were positively related to both blood pressure and PAC. An inverse correlation was identified between PAC and urinary sodium excretion value. Conclusion: Although higher blood pressure in Kazakh subjects, their LVMI was lower than those of Uygur and Han, whose blood pressure was lower than that in Kazakh. These results suggest that blood pressure is not always a determinant for LVMI value. There is a possibility that relatively lower PAC resulted from higher sodium intake suppressed the rise in LVMI caused by higher blood pressure in Kazakh.展开更多
Quinoxaline 1, 4-dioxides (QdNOs) are quinox-aline derivatives which have been used as an-timicrobial agents and growth promoters in animals widely. They are also assumed to cure human disease such as anticancer, anti...Quinoxaline 1, 4-dioxides (QdNOs) are quinox-aline derivatives which have been used as an-timicrobial agents and growth promoters in animals widely. They are also assumed to cure human disease such as anticancer, antitubercular and inhibiting parasite. QdNOs such as carbadox and their major metabolites induced a special decline of aldosterone production from the swine adrenal in vivo and in vitro, and thus cause hypovolemia, hyponatremia and hyperkalemia. This can also be expected to be the case for human. As a mainly physiological hormone and a novel steroid with potent mineralocorticoid activity, aldosterone plays an important role in the pathophysiological process of brain, renal and heart disease progression and may be a renal and vascular risk factor. Here, we provide evidence to support the hypothesis that QdNOs may lead potential benefits in aldosterone dysmetabolism disease via the synthesis deficiency of aldosterone in adrenal and/or the cardiovascular tissues. If the hypothesis is true, it may provide a new option into the therapy for aldosterone dysmetabolism disease, especially in cardiovascular system, and thus assume a broader application of QdNOs.展开更多
PK11195, a ligand of peripheral-type benzodiazepine receptor can stimulate thealdosterone secretion of isolated adrenal glomerulosa cell: this effect could be abolished by nifedipinewhich mainly blocks the calcium cha...PK11195, a ligand of peripheral-type benzodiazepine receptor can stimulate thealdosterone secretion of isolated adrenal glomerulosa cell: this effect could be abolished by nifedipinewhich mainly blocks the calcium channel in plasma membrane, but could not be abolished bydantrolene, a selective blocker of mitochondria calcium channel. Even under the condition of themaximum stimulative effects on aldosterone secretion, PK11195 could not change the cyclic AMP（cAMP） content in isolated glomerulosa cells. These results indicated that in the modulatory mecha-nism of benzodiazepine receptor on aldosterone secretion, the intracellular messenger might be theCa<sup>2+</sup> from extracellular Ca<sup>2+</sup> pool, but not the Ca<sup>2+</sup> from mitochondria Ca<sup>2+</sup> pool or cAMP.展开更多
Na+ transport occurs across many epithelial surfaces and plays a key role in regulating salt and water absorption. The molecular pathway underlying this Na+ transport is the epithelial Na channel (ENaC), which is stri...Na+ transport occurs across many epithelial surfaces and plays a key role in regulating salt and water absorption. The molecular pathway underlying this Na+ transport is the epithelial Na channel (ENaC), which is strictly determined by a variety of hormones like aldosterone, ADH and glucocorticoids. In this study, we found that stimulation of either aldosterone or dexameth- asone (Dex) distributed ENaC channel on the apical membrane of mouse cortical collecting duct cells (M1). In the single channel recordings from excised membrane, high density ENaC was found in the cell with a dome shape by the treatment of either dex or aldosterone. However, low active ENaC was revealed in intact cells treated with dex, when compared to cells treated with aldosterone. Only 5.84% of cells treated with dex containing ENaC exhibited ENaC current transition in the cell-attach recording, whereas 40% of cells treated with aldosterone containing ENaC exhibited ENaC current transition. ENaC currents appeared rapid rundown within 5 min-utes since formation of inside-out configuration in cells treated with aldosterone but not with dex. SKF-525A, a general antagonist of CYP, failed to significantly enhance ENaC activity in intact cells treated with dex, but EGTA, which deforming the cells, increased the ENaC activity in the cells treated with dex. PTX, an antagonist of G-protein, reversed the effect of aldosterone on number of active ENaC in intact cells. Based on our obser-vation, we concluded that there are different mechanisms in regulation of ENaC activity be-tween stimulation of aldosterone and glucocor-ticoids. The activation of G-protein is required to maintain the activity of ENaC in the collecting ducts.展开更多
In this article, we describe the clinical picture and follow-up of two children diagnosed as suffering from pseudohypoaldosteronism when they were infants, and it was later recognized as isolated aldosterone deficienc...In this article, we describe the clinical picture and follow-up of two children diagnosed as suffering from pseudohypoaldosteronism when they were infants, and it was later recognized as isolated aldosterone deficiency in both. We illustrate the clinical differences between the two patients in terms of hydroelectrolytic balance, laboratory data and growth. In fact, while the growth and hematological parameters of the electrolytes and acid-base balance were normal in the first patient, and also without treatment with fludrocortisone thanks to very high renin activity, in the second patient, this treatment was vitally necessary to maintain normal growth and biochemical data. Despite the absence of a molecular analysis which could have confirmed this diagnosis, we believe that the description of the clinical evolution of these two cases from the moment of the incorrect diagnosis until the correct diagnosis and action taken, could be useful to highlight the extreme clinical variability of this rare disease.展开更多
Objective:A cell model of cardiac fibroblasts proliferation induced by aldosterone was established to observe the effect of aldosterone on the proliferation of rat cardiac fibroblasts.Methods:Primary cardiac fibroblas...Objective:A cell model of cardiac fibroblasts proliferation induced by aldosterone was established to observe the effect of aldosterone on the proliferation of rat cardiac fibroblasts.Methods:Primary cardiac fibroblasts were cultured by trypsin digestion method and differential adhesion method,primary cardiac fibroblasts were sub-cultured by conventional digestion method,and the immunocytochemical assay was used to identify cardiac fibroblasts.The second-generation cardiac fibroblasts were randomly divided into five groups:standard control group,10-9 mol/L aldosterone(ALD1)group,10-8 mol/L aldosterone(ALD2)group,10-7 mol/L aldosterone(ALD3)group,and 10-6 mol/L aldosterone(ALD4)group.The viability of fibroblast cells in each group was detected by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.Results:Vimentin staining assay showed that the cultured cells staining positive,and the purity of cultured mouse cardiac fibroblasts was 95%.The results of methyl thiazolyl tetrazolium showed that compared with the control group,the low concentration of aldosterone(10-9 mol/L)had no significant effect on the proliferation of normal cardiac fibroblasts.With the increase in the intensity of(10-8–10-6)mol/L,aldosterone could significantly promote the proliferation of cardiac fibroblasts.Moreover,there was no significant difference in absorbance value between the aldosterone group(10-6 mol/L)and the aldosterone group(10-7 mol/L)(P>0.05).The highest concentration of aldosterone group 10-7 mol/L promoted the proliferation of cardiac the optimum concentration was 10-7 mol/L.Conclusion:Aldosterone can promote the spread of cardiac fibroblasts in a specific concentration range.展开更多
Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, w...Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, weighing 46 - 83 kg, scheduled for elective caesarean section were randomized into epidural anesthesia group (EA, n = 30) and combined spinal-epidural anesthesia group ( CSEA, n = 30). All patients were premedicated with intramuscular atropine 0. 5 mg and phenolbarbital 100 mg. In CSEA group a 26 G/16 GChina Medical Abstracts (Surgery) single use spinal/epidural needle (B- D) was used. Spinal and/or epidural anesthesia was performed at L2-3 interspace and a catheter was threaded into the epidural space cephalad for 3 - 5 cm in both groups. In EA group a loading dose of 12 - 16 ml 2 % lidocaine was given and an additional 6-8 ml 2% lidocaine was injected when anesthesia became indadequate during the operation. In CSEA group 2.0-2.5 ml hyperbaric 0.5% bupivacaine (10 - 12.5 mg) was given展开更多
Background: Dialysis centres around the world use different concentrations of calcium in dialysate solution,ranging from 1. 25 to 1. 75 mmol / L. However,a dialysate concentration of 1. 25 mmol / L is recommended. [1]...Background: Dialysis centres around the world use different concentrations of calcium in dialysate solution,ranging from 1. 25 to 1. 75 mmol / L. However,a dialysate concentration of 1. 25 mmol / L is recommended. [1] Higher or lower dialysate calcium concentrations are indicated in patients,depending on their co-morbid factors. We explored the effects of using a calcium dialysate solution of 1. 50 mmol / L compared to a 1. 75 mmol / L calcium dialysate solution on the Blood Pressure (BP) ,serum concentrations of Calcium,Parathyroid Hormone (PTH) and Aldosterone in chronic hemodialysis (HD) patients. Method: 42 patients were enrolled in the study. First a 1. 50 mmol / L low calcium dialysate solution (LCDS) was used for 4 hour dialysis,and for the next session of HD,a 1. 75 mmol / L (NCDS) normal calcium dialysate solution was used. Blood pressure was measured at 5 intervals of time: pre HD,at 60,120,180 and 240 minutes into the HD session. Pre and post HD blood samples were taken for serum calcium,PTH and Aldosterone levels. Results: All 42 patients completed the study. With LCDS,the post HD serum calcium levels were (2. 51 ± 0. 14) mmol / L,compared to (2. 85 ± 0. 17) mmol / L for NCDS (P < 0. 01) . A post HD serum PTH level of (80. 6 ± 144. 93) pg / ml was observed when using LCDS,whereas a (52. 25 ± 115. 89) pg / ml serum PTH level was noted with NCDS (P < 0. 01) . As for aldosterone,a post HD value of (161. 77 ± 80. 42) ng / L was obtained with LCDS and (165. 50 ± 78. 84) ng / L with NCDS (P < 0. 01) . The mean post HD systolic blood pressure was (129. 17 ± 25. 42) mmHg with LCDS dialysis compared to (132. 50 ± 20. 32) mmHg for NCDS dialysis (P < 0. 01) and the diastolic BP values observed were (75. 10 ±10. 34) mmHg and (78. 26 ±11. 63) mm Hg(P <0. 01) ,respectively. Conclusion: LCDS can more effectively improve hypercalcemic status in dialysis patients than NCDS. Using LCDS stimulates the secretion of PTH more than when using NCDS. LCDS decreases aldosterone levels more than NCDS. Patients undergoing dialysis with LCDS have a lower post dialysis BP compared to those using NCDS. LCDS has a greater effect in decreasing both the post systolic and diastolic blood pressure than NCDS. Serum calcium,PTH and aldosterone levels have a greater decreasing effect on BP in LCDS than NCDS. Dialysate calcium profiling might be used as a means of therapy to control hypercalcemia, especially in patients who are hemodynamically stable.展开更多
Objective: To determine whether vasculature depends on circulatory or locally produced renin toinitiate its renin angiotensin-aldosterone system (RAAS), and to evaluate the effect of nephrectomy on vascular aldosteron...Objective: To determine whether vasculature depends on circulatory or locally produced renin toinitiate its renin angiotensin-aldosterone system (RAAS), and to evaluate the effect of nephrectomy on vascular aldosterone biosynthesis. Methods: The expression of vascular renin mRNA was observed by reversetranscription polyrnerase chain reaction (RT-PCR) 30 h after nephrectomy, and the production of aldosteroneand angiotensin Ⅱ in vessels measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Results: Aorta was still able to express renin mRNA after nephrectorny when plasmarenin activity disappeared. There were no significant differences among the control group, the sham operationgroup and the nephrectomy group for both the levels of aldosterone and angiotensin Ⅱ (P >0. 05) althoughthe levels of both ACTH and potassium were significantly increased in the nephrectomy group as comparedwith the control group (P <0. 01 ). However, there were significant differences between the control groupand ACEI-perindopril group for both aldosterone and angiotensin Ⅱ (P <0. 05). Conclusion: The resultssuggest that there exists an independent RAAS in vasculature which is different from that of the heart whichdepends on plasma renin and the biosynthesis of vascular aldosterone is induced mainly by angiotensin Ⅱ.展开更多
Serum aldosterone is associated with cardiac remodeling,which contributes to morbidity and mortality in heart failure(HF);however,the prognostic value of aldosterone in HF with a preserved ejection fraction(HFpEF)is u...Serum aldosterone is associated with cardiac remodeling,which contributes to morbidity and mortality in heart failure(HF);however,the prognostic value of aldosterone in HF with a preserved ejection fraction(HFpEF)is unclear.We used liquid chromatography-tandem mass spectrometry to quantify serum aldosterone in 873 patients with HFpEF in a Registry Study of Biomarkers for HF.The retrospective study was conducted at Beijing Anzhen Hospital from May 2017 to October 2019.The primary endpoint was a composite of all-cause mortality and rehospitalization for HF.Aldosterone concentrations in patients with and without events were 124.22 pmol L^(-1)(interquartile range(IQR):48.62–256.20)and 96.33 pmol L^(-1)(IQR:37.33–215.76),respectively(P=0.023).Aldosterone independently predicted all-cause mortality(adjusted hazard ratio(aHR),1.55;95%confidence interval(95%CI),1.06–2.27;P=0.024)and the primary endpoint(a HR,1.43;95%CI,1.11–1.85;P=0.006).Patients with high aldosterone concentrations were at higher risk of concentric remodeling(adjusted odds ratio(aOR),1.45;95%CI,1.03–2.04;P=0.034).Patients with high aldosterone and B-type natriuretic peptide concentrations were at a higher risk of the primary endpoint(hazard ratio(HR),1.85;95%CI,1.29–2.66;P=0.001).We conclude that elevated aldosterone is associated with a risk of rehospitalization with HF and all-cause mortality in patients with HFpEF.展开更多
In recent years,Percutaneous coronary intervention(PCI) as an effective treatment for coronary heart disease has been widely carried out in China.However,people is still confronted with the problem that the incidence ...In recent years,Percutaneous coronary intervention(PCI) as an effective treatment for coronary heart disease has been widely carried out in China.However,people is still confronted with the problem that the incidence of in-stent restenosis (ISR) after PCI.Some risk factors of coronary heart disease have been obviously known,but the in-dependent predictor factors for the ISR has not been clear.Clarifying risk factors for ISR to establish interfering meas-ures may be a new direction for PCI treatment in the future.At present,it has been reported that aldosterone (ALD) may be involved in ISR.In order to further investigate the relationship between the serum ALD levels and ISR,our re-search was to determine the ALD and other serum markers to explore the impact factors of ISR.Methods We meas-ured serum ALD,high sensitivity C-reactive protein (hs-CRP) ,adiponectin (ADP) and other indicators in 258 pa-tients with coronary stenting,and made routine follow-up for 6-9 months to perform coronary angiography.According to the results of coronary angiography,all patients were divided into restenosis group and non-restenosis group.We an-alyzed the relationship between ALD,other indicators and ISR to explore whether serum ALD was an independent risk factor ISR.Results Serum ALD levels were significantly higher in restenosis group than non-restenosis group.Logis-tic regression analysis showed that diabetes,ALD,hs-CRP and complex lesions were also independent risk factors for ISR (P < 0.05) ,while the ADP was as a protective factor for ISR (P < 0.05) .Conclusions ALD is one of inde-pendent risk factors for ISR after undergoing coronary stent implantation in patients.It has the possibility of becoming one new method in this medical field.展开更多
The determination of the plasma level of aldosterone is very helpful to the diagnosis of aldosteronism. A radioimmunoassay for plasma aldosterene was first established in the Department of Endocrinology of the Capital...The determination of the plasma level of aldosterone is very helpful to the diagnosis of aldosteronism. A radioimmunoassay for plasma aldosterene was first established in the Department of Endocrinology of the Capital Hospital, Beijing in July 1977. Our method and its clinical application are summarized as follows. (1) Preparation of the aldosterone-3-carboxymethoxime. 9.4mg of aldosterone dissolved展开更多
Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically re...Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA,so as to provide guidance for clinical diagnosis.Methods:We searched PubMed,Embase,and Cochrane Library from the establishment of the database to March 2021.We included studies that report the true positive,false positive,true negative,and false negative values for the diagnosis of primary aldosteronism,and we excluded duplicate publications,research without full text,incomplete information,or inability to conduct data extraction,animal experiments,reviews,and systematic reviews.STATA 15.1 was used to analyze the data.Results:The pooled results showed that ARR(plasma aldosterone concentration[PAC]/PRC)had a sensitivity of 0.82(95%confidence interval[CI]:0.78-0.86),a specificity of 0.94(95%CI:0.92-0.95),a positive-likelihood ratio(LR)of 12.77(95%CI:7.04-23.73),a negative LR of 0.11(95%CI:0.07-0.17),and symmetric area under the curve(SAUC)of 0.982,respectively.Furthermore,the diagnostic odds ratio(DOR)of ARR(PAC/PRC)was 180.21.Additionally,the pooled results showed that ARR(PAC/PRA)had a sensitivity of 0.91(95%CI:0.86-0.95),a specificity of 0.91(95%CI:0.90-0.93),a positive LR of 7.30(95%CI:2.99-17.99),a negative LR of 0.10(95%CI:0.04-0.26),and SAUC of 0.976,respectively.The DOR of ARR(PAC/PRA)was 155.52.Additionally,we conducted a subgroup analysis for the different thresholds(<35 or≥35)of PAC/PRC.The results showed that the DOR of the cut-off≥35 groups was higher than the cut-off<35 groups(DOR=340.15,95%CI:38.32-3019.66;DOR=116.40,95%CI=23.28-581.92).Conclusions:The research results suggest that the determination of ARR(PAC/PRC)and ARR(PAC/PRA)was all effective screening tools for PA.The diagnostic accuracy and diagnostic value of ARR(PAC/PRC)are higher than ARR(PAC/PRA).In addition,within a certain range,the higher the threshold,the better the diagnostic value.展开更多
Exorbitant aldosterone is closely associated with various severe diseases,including congestive heart failure and chronic kidney disease.As aldosterone synthase is the pivotal enzyme in aldosterone biosynthesis,its inh...Exorbitant aldosterone is closely associated with various severe diseases,including congestive heart failure and chronic kidney disease.As aldosterone synthase is the pivotal enzyme in aldosterone biosynthesis,its inhibition constitutes a promising treatment for these diseases.Via a structure-based approach,a series of pyridyl substituted 3,4-dihydrobenzo[f][1,4]oxazepin-5(2 H)-ones were designed as inhibitors of aldosterone synthase.Six compounds(5 j,5 l,5 m 5 w,5 x and 5 y)distinguished themselves with potent inhibition(IC50<100 nmol/L)and high selectivity over homogenous 11β-hydroxylase.As the most promising compound,5 x exhibited an IC_(50) of 12 nmol/L and an excellent selectivity factor(SF)of157,which are both superior to those of the re ference fadrazole(IC_(50)=21 nmol/L,SF=7).Importantly,5 x showed no inhibition against steroidogenic CYP17,CYP19 and a panel of hepatic CYP enzymes indicating an outstanding sa fety profile.As it manifested satis factory pharmacokinetic pro perties in rats,compound5 x was considered as a drug candidate for further development.展开更多
Hyperaldosteronism is a common disease that is closely related to endocrine hypertension and other cardiovascular diseases. Cytochrome P450 11 B2(CYP11 B2), an important enzyme in aldosterone(ALD) synthesis, is a prom...Hyperaldosteronism is a common disease that is closely related to endocrine hypertension and other cardiovascular diseases. Cytochrome P450 11 B2(CYP11 B2), an important enzyme in aldosterone(ALD) synthesis, is a promising target for the treatment of hyperaldosteronism. However, selective inhibitors targeting CYP11 B2 are still lacking due to the high similarity with CYP11 B1. In this study,atractylenolide-I(AT-I) was found to significantly reduce the production of ALD but had no effect on cortisol synthesis, which is catalyzed by CYP11 B1. Chemical biology studies revealed that due to the presence of Ala320, AT-I is selectively bound to the catalytic pocket of CYP11 B2, and the C8/C9 double bond of AT-I can be epoxidized, which then undergoes nucleophilic addition with the sulfhydryl group of Cys450 in CYP11 B2. The covalent binding of AT-I disrupts the interaction between heme and CYP11 B2 and inactivates CYP11 B2, leading to the suppression of ALD synthesis;AT-I shows a significant therapeutic effect for improving hyperaldosteronism.展开更多
To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-...To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.展开更多
文摘Background: Hypertension (HTN) is present in up to 90% of end stage kidney disease (ESRD) patients irrespective of the etiology of their kidney disease. Moreover, it is an important modifiable risk factor for progression to ESRD and its overall cardiovascular morbidity and mortality. Objective: to evaluate, prospectively, the role of Renin-Angiotensin-Aldosterone System blockade (RAAS) in HTN, resistant to 3 conventional antihypertensives, in patients on maintenance hemodialysis (MHD). Patients and methods: A total of 52 such patients were treated with Ramipril and 5 with Losartan after intolerable cough/shortness of breath following Ramipril-use. None of the patients had fluid depletion, renal artery stenosis and primary endocrinopathy. The study group was compared to a matched control group of MHD patients with normal blood pressure following 3 drugs-combination therapies. Results: All patients, with resistant HTN, had significant activation of RAAS system prior to treatment compared to inactive one in the control group. In those with resistant HTN, control of HTN, was established within 2 weeks of therapy and was associated with suppression of the RAAS. Such therapy was associated with minor side effects. Conclusion: Our study has shown that RAAS blockade is safe and effective in controlling such resistant HTN in MHD patients.
基金supported by the National Natural Science Founds for Distinguished Young Scholar of China (No. 30725040)
文摘The expression of angiotensin Ⅱ type 1 receptor (AT1R) and angiotensin Ⅱ type 2 receptor (AT2R) in aldosterone-producing adenoma (APA) of the adrenal gland was detected, and their relationship with clinical indexes of APA was analyzed. The mRNA expression of AT1R and AT2R in 50 cases of APA and tissues adjacent to tumors and 12 cases of normal adrenal tissues was detected by using reverse transcriptase polymerase chain reaction (RT-PCR). The expression of AT1R and AT2R proteins in paraffin-embedded slices of tissue was detected by immunohistochemistry. The expression of AT1R in adenoma, tissues adjacent to tumor, and normal tissues of the adrenal gland showed no significant differences. The expression of AT2R in APA tissue was lower than that in normal adrenal gland tissues (P<0.05). Correlation analysis of the mRNA expression level of AT2R and clinical data from patients demonstrated that AT2R expression was negatively related to plasma aldosterone concentration (PAC) (r=-0.467, P<0.05), but positively related with plasma renin activity (PRA) (r=0.604, P<0.05). It is concluded that down-regulation of the AT2R expression is possibly related with the tumorigenesis of APA.
文摘Obstructive sleep apnea(OSA) is an independent risk factor for cardiovascular diseases. Aldosterone was reported to be increased in patients with OSA and correlated with OSA severity. Many studies investigated the effect of continuous positive airway pressure(CPAP) therapy on plasma aldosterone concentrations(PAC) in OSA patients. The results, however, were inconsistent. In the present study, we aimed to evaluate the effects of CPAP therapy on PAC by performing a meta-analysis. Literature search was carried out in electronic databases including Pub Med/Medline, Cochrane Library, Embase and Web of Science. Eligible full-text articles were identified, and important data were extracted. Pooled analysis was performed using the STATA12.0 and Rev Man 5.2. Standardized mean difference(SMD) was calculated to estimate the treatment effects. A total of eight studies involving 219 patients were included for our final analysis. PAC was found unchanged after CPAP treatment in OSA patients(SMD=–0.36, 95% CI: –0.91 to 0.18, Z=1.32, P=0.19). Meanwhile, CPAP therapy showed no impact on PAC(SMD=–0.21, 95% CI: –0.85 to 0.42, Z=0.66, P=0.51) in a separate meta-analysis including 3 randomized controlled trials. In conclusion, the evidence for the use of CPAP therapy to decrease PAC in OSA patients is low, and further studies are still warranted.
文摘Previous Background: Hemodynamic factors, like blood pressure, have been established to be major determinants of cardiac left ventricular structure. However, several factors other than blood pressure to influence cardiac mass have been implicated. When we did medical survey, cardiac left ventricular mass index (LVMI) of one ethnic group that had higher blood pressure was found to be smaller than that of the other ethnic groups with a lower blood pressure. Such contradicted data from the present study were analyzed combining blood pressure, LVMI and chemical parameters obtained from blood and urine. Methods: In a medical survey conducted in Xinjiang, China, 279 people (65 - 70 years old) from three ethnic groups (Kazakh, Uygur and Han) from two separated regions provided blood and urine samples and underwent echocardiography and 24-h ambulatory blood pressure monitoring (ABPM). Results: Systolic and diastolic blood pressure obtained from ABPM and urinary sodium excretion values were significantly higher in Kazakh than that in Uygur and Han. However, LVMI in Kazakh was lower than that in other 2 groups. Plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were significantly lowest in Kazakh. The values of LVMI in all ethnic groups were positively related to both blood pressure and PAC. An inverse correlation was identified between PAC and urinary sodium excretion value. Conclusion: Although higher blood pressure in Kazakh subjects, their LVMI was lower than those of Uygur and Han, whose blood pressure was lower than that in Kazakh. These results suggest that blood pressure is not always a determinant for LVMI value. There is a possibility that relatively lower PAC resulted from higher sodium intake suppressed the rise in LVMI caused by higher blood pressure in Kazakh.
文摘Quinoxaline 1, 4-dioxides (QdNOs) are quinox-aline derivatives which have been used as an-timicrobial agents and growth promoters in animals widely. They are also assumed to cure human disease such as anticancer, antitubercular and inhibiting parasite. QdNOs such as carbadox and their major metabolites induced a special decline of aldosterone production from the swine adrenal in vivo and in vitro, and thus cause hypovolemia, hyponatremia and hyperkalemia. This can also be expected to be the case for human. As a mainly physiological hormone and a novel steroid with potent mineralocorticoid activity, aldosterone plays an important role in the pathophysiological process of brain, renal and heart disease progression and may be a renal and vascular risk factor. Here, we provide evidence to support the hypothesis that QdNOs may lead potential benefits in aldosterone dysmetabolism disease via the synthesis deficiency of aldosterone in adrenal and/or the cardiovascular tissues. If the hypothesis is true, it may provide a new option into the therapy for aldosterone dysmetabolism disease, especially in cardiovascular system, and thus assume a broader application of QdNOs.
文摘PK11195, a ligand of peripheral-type benzodiazepine receptor can stimulate thealdosterone secretion of isolated adrenal glomerulosa cell: this effect could be abolished by nifedipinewhich mainly blocks the calcium channel in plasma membrane, but could not be abolished bydantrolene, a selective blocker of mitochondria calcium channel. Even under the condition of themaximum stimulative effects on aldosterone secretion, PK11195 could not change the cyclic AMP（cAMP） content in isolated glomerulosa cells. These results indicated that in the modulatory mecha-nism of benzodiazepine receptor on aldosterone secretion, the intracellular messenger might be theCa<sup>2+</sup> from extracellular Ca<sup>2+</sup> pool, but not the Ca<sup>2+</sup> from mitochondria Ca<sup>2+</sup> pool or cAMP.
文摘Na+ transport occurs across many epithelial surfaces and plays a key role in regulating salt and water absorption. The molecular pathway underlying this Na+ transport is the epithelial Na channel (ENaC), which is strictly determined by a variety of hormones like aldosterone, ADH and glucocorticoids. In this study, we found that stimulation of either aldosterone or dexameth- asone (Dex) distributed ENaC channel on the apical membrane of mouse cortical collecting duct cells (M1). In the single channel recordings from excised membrane, high density ENaC was found in the cell with a dome shape by the treatment of either dex or aldosterone. However, low active ENaC was revealed in intact cells treated with dex, when compared to cells treated with aldosterone. Only 5.84% of cells treated with dex containing ENaC exhibited ENaC current transition in the cell-attach recording, whereas 40% of cells treated with aldosterone containing ENaC exhibited ENaC current transition. ENaC currents appeared rapid rundown within 5 min-utes since formation of inside-out configuration in cells treated with aldosterone but not with dex. SKF-525A, a general antagonist of CYP, failed to significantly enhance ENaC activity in intact cells treated with dex, but EGTA, which deforming the cells, increased the ENaC activity in the cells treated with dex. PTX, an antagonist of G-protein, reversed the effect of aldosterone on number of active ENaC in intact cells. Based on our obser-vation, we concluded that there are different mechanisms in regulation of ENaC activity be-tween stimulation of aldosterone and glucocor-ticoids. The activation of G-protein is required to maintain the activity of ENaC in the collecting ducts.
文摘In this article, we describe the clinical picture and follow-up of two children diagnosed as suffering from pseudohypoaldosteronism when they were infants, and it was later recognized as isolated aldosterone deficiency in both. We illustrate the clinical differences between the two patients in terms of hydroelectrolytic balance, laboratory data and growth. In fact, while the growth and hematological parameters of the electrolytes and acid-base balance were normal in the first patient, and also without treatment with fludrocortisone thanks to very high renin activity, in the second patient, this treatment was vitally necessary to maintain normal growth and biochemical data. Despite the absence of a molecular analysis which could have confirmed this diagnosis, we believe that the description of the clinical evolution of these two cases from the moment of the incorrect diagnosis until the correct diagnosis and action taken, could be useful to highlight the extreme clinical variability of this rare disease.
基金This study was supported by the project of Hebei Provincial Administration of traditional Chinese Medicine(No.2018161)the Hebei Health and Family Planning Commission(No.20170875)the Scientific Research Project of College students in Chengde Medical College(No.2019033).
文摘Objective:A cell model of cardiac fibroblasts proliferation induced by aldosterone was established to observe the effect of aldosterone on the proliferation of rat cardiac fibroblasts.Methods:Primary cardiac fibroblasts were cultured by trypsin digestion method and differential adhesion method,primary cardiac fibroblasts were sub-cultured by conventional digestion method,and the immunocytochemical assay was used to identify cardiac fibroblasts.The second-generation cardiac fibroblasts were randomly divided into five groups:standard control group,10-9 mol/L aldosterone(ALD1)group,10-8 mol/L aldosterone(ALD2)group,10-7 mol/L aldosterone(ALD3)group,and 10-6 mol/L aldosterone(ALD4)group.The viability of fibroblast cells in each group was detected by the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.Results:Vimentin staining assay showed that the cultured cells staining positive,and the purity of cultured mouse cardiac fibroblasts was 95%.The results of methyl thiazolyl tetrazolium showed that compared with the control group,the low concentration of aldosterone(10-9 mol/L)had no significant effect on the proliferation of normal cardiac fibroblasts.With the increase in the intensity of(10-8–10-6)mol/L,aldosterone could significantly promote the proliferation of cardiac fibroblasts.Moreover,there was no significant difference in absorbance value between the aldosterone group(10-6 mol/L)and the aldosterone group(10-7 mol/L)(P>0.05).The highest concentration of aldosterone group 10-7 mol/L promoted the proliferation of cardiac the optimum concentration was 10-7 mol/L.Conclusion:Aldosterone can promote the spread of cardiac fibroblasts in a specific concentration range.
文摘Objective To assess the effect of combined spinal-epidural anesthesia (CSEA) for caesarean section on maternal and neonatal rennin-angiotensin-aldosterone system (RAAS). Methods Sixty ASA I primiparae aged 22-29 yr, weighing 46 - 83 kg, scheduled for elective caesarean section were randomized into epidural anesthesia group (EA, n = 30) and combined spinal-epidural anesthesia group ( CSEA, n = 30). All patients were premedicated with intramuscular atropine 0. 5 mg and phenolbarbital 100 mg. In CSEA group a 26 G/16 GChina Medical Abstracts (Surgery) single use spinal/epidural needle (B- D) was used. Spinal and/or epidural anesthesia was performed at L2-3 interspace and a catheter was threaded into the epidural space cephalad for 3 - 5 cm in both groups. In EA group a loading dose of 12 - 16 ml 2 % lidocaine was given and an additional 6-8 ml 2% lidocaine was injected when anesthesia became indadequate during the operation. In CSEA group 2.0-2.5 ml hyperbaric 0.5% bupivacaine (10 - 12.5 mg) was given
文摘Background: Dialysis centres around the world use different concentrations of calcium in dialysate solution,ranging from 1. 25 to 1. 75 mmol / L. However,a dialysate concentration of 1. 25 mmol / L is recommended. [1] Higher or lower dialysate calcium concentrations are indicated in patients,depending on their co-morbid factors. We explored the effects of using a calcium dialysate solution of 1. 50 mmol / L compared to a 1. 75 mmol / L calcium dialysate solution on the Blood Pressure (BP) ,serum concentrations of Calcium,Parathyroid Hormone (PTH) and Aldosterone in chronic hemodialysis (HD) patients. Method: 42 patients were enrolled in the study. First a 1. 50 mmol / L low calcium dialysate solution (LCDS) was used for 4 hour dialysis,and for the next session of HD,a 1. 75 mmol / L (NCDS) normal calcium dialysate solution was used. Blood pressure was measured at 5 intervals of time: pre HD,at 60,120,180 and 240 minutes into the HD session. Pre and post HD blood samples were taken for serum calcium,PTH and Aldosterone levels. Results: All 42 patients completed the study. With LCDS,the post HD serum calcium levels were (2. 51 ± 0. 14) mmol / L,compared to (2. 85 ± 0. 17) mmol / L for NCDS (P < 0. 01) . A post HD serum PTH level of (80. 6 ± 144. 93) pg / ml was observed when using LCDS,whereas a (52. 25 ± 115. 89) pg / ml serum PTH level was noted with NCDS (P < 0. 01) . As for aldosterone,a post HD value of (161. 77 ± 80. 42) ng / L was obtained with LCDS and (165. 50 ± 78. 84) ng / L with NCDS (P < 0. 01) . The mean post HD systolic blood pressure was (129. 17 ± 25. 42) mmHg with LCDS dialysis compared to (132. 50 ± 20. 32) mmHg for NCDS dialysis (P < 0. 01) and the diastolic BP values observed were (75. 10 ±10. 34) mmHg and (78. 26 ±11. 63) mm Hg(P <0. 01) ,respectively. Conclusion: LCDS can more effectively improve hypercalcemic status in dialysis patients than NCDS. Using LCDS stimulates the secretion of PTH more than when using NCDS. LCDS decreases aldosterone levels more than NCDS. Patients undergoing dialysis with LCDS have a lower post dialysis BP compared to those using NCDS. LCDS has a greater effect in decreasing both the post systolic and diastolic blood pressure than NCDS. Serum calcium,PTH and aldosterone levels have a greater decreasing effect on BP in LCDS than NCDS. Dialysate calcium profiling might be used as a means of therapy to control hypercalcemia, especially in patients who are hemodynamically stable.
文摘Objective: To determine whether vasculature depends on circulatory or locally produced renin toinitiate its renin angiotensin-aldosterone system (RAAS), and to evaluate the effect of nephrectomy on vascular aldosterone biosynthesis. Methods: The expression of vascular renin mRNA was observed by reversetranscription polyrnerase chain reaction (RT-PCR) 30 h after nephrectomy, and the production of aldosteroneand angiotensin Ⅱ in vessels measured by high performance liquid chromatography (HPLC) and radioimmunoassay (RIA). Results: Aorta was still able to express renin mRNA after nephrectorny when plasmarenin activity disappeared. There were no significant differences among the control group, the sham operationgroup and the nephrectomy group for both the levels of aldosterone and angiotensin Ⅱ (P >0. 05) althoughthe levels of both ACTH and potassium were significantly increased in the nephrectomy group as comparedwith the control group (P <0. 01 ). However, there were significant differences between the control groupand ACEI-perindopril group for both aldosterone and angiotensin Ⅱ (P <0. 05). Conclusion: The resultssuggest that there exists an independent RAAS in vasculature which is different from that of the heart whichdepends on plasma renin and the biosynthesis of vascular aldosterone is induced mainly by angiotensin Ⅱ.
基金supported by the National Key Research and Development Program of China(2017YFC0908400)the National Natural Science Foundation of China(91939303,81790622,81861128025)。
文摘Serum aldosterone is associated with cardiac remodeling,which contributes to morbidity and mortality in heart failure(HF);however,the prognostic value of aldosterone in HF with a preserved ejection fraction(HFpEF)is unclear.We used liquid chromatography-tandem mass spectrometry to quantify serum aldosterone in 873 patients with HFpEF in a Registry Study of Biomarkers for HF.The retrospective study was conducted at Beijing Anzhen Hospital from May 2017 to October 2019.The primary endpoint was a composite of all-cause mortality and rehospitalization for HF.Aldosterone concentrations in patients with and without events were 124.22 pmol L^(-1)(interquartile range(IQR):48.62–256.20)and 96.33 pmol L^(-1)(IQR:37.33–215.76),respectively(P=0.023).Aldosterone independently predicted all-cause mortality(adjusted hazard ratio(aHR),1.55;95%confidence interval(95%CI),1.06–2.27;P=0.024)and the primary endpoint(a HR,1.43;95%CI,1.11–1.85;P=0.006).Patients with high aldosterone concentrations were at higher risk of concentric remodeling(adjusted odds ratio(aOR),1.45;95%CI,1.03–2.04;P=0.034).Patients with high aldosterone and B-type natriuretic peptide concentrations were at a higher risk of the primary endpoint(hazard ratio(HR),1.85;95%CI,1.29–2.66;P=0.001).We conclude that elevated aldosterone is associated with a risk of rehospitalization with HF and all-cause mortality in patients with HFpEF.
文摘In recent years,Percutaneous coronary intervention(PCI) as an effective treatment for coronary heart disease has been widely carried out in China.However,people is still confronted with the problem that the incidence of in-stent restenosis (ISR) after PCI.Some risk factors of coronary heart disease have been obviously known,but the in-dependent predictor factors for the ISR has not been clear.Clarifying risk factors for ISR to establish interfering meas-ures may be a new direction for PCI treatment in the future.At present,it has been reported that aldosterone (ALD) may be involved in ISR.In order to further investigate the relationship between the serum ALD levels and ISR,our re-search was to determine the ALD and other serum markers to explore the impact factors of ISR.Methods We meas-ured serum ALD,high sensitivity C-reactive protein (hs-CRP) ,adiponectin (ADP) and other indicators in 258 pa-tients with coronary stenting,and made routine follow-up for 6-9 months to perform coronary angiography.According to the results of coronary angiography,all patients were divided into restenosis group and non-restenosis group.We an-alyzed the relationship between ALD,other indicators and ISR to explore whether serum ALD was an independent risk factor ISR.Results Serum ALD levels were significantly higher in restenosis group than non-restenosis group.Logis-tic regression analysis showed that diabetes,ALD,hs-CRP and complex lesions were also independent risk factors for ISR (P < 0.05) ,while the ADP was as a protective factor for ISR (P < 0.05) .Conclusions ALD is one of inde-pendent risk factors for ISR after undergoing coronary stent implantation in patients.It has the possibility of becoming one new method in this medical field.
文摘The determination of the plasma level of aldosterone is very helpful to the diagnosis of aldosteronism. A radioimmunoassay for plasma aldosterene was first established in the Department of Endocrinology of the Capital Hospital, Beijing in July 1977. Our method and its clinical application are summarized as follows. (1) Preparation of the aldosterone-3-carboxymethoxime. 9.4mg of aldosterone dissolved
基金supported by a grant from the Science and Technology Project of Guangdong Province(No.2016A020215136)。
文摘Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA,so as to provide guidance for clinical diagnosis.Methods:We searched PubMed,Embase,and Cochrane Library from the establishment of the database to March 2021.We included studies that report the true positive,false positive,true negative,and false negative values for the diagnosis of primary aldosteronism,and we excluded duplicate publications,research without full text,incomplete information,or inability to conduct data extraction,animal experiments,reviews,and systematic reviews.STATA 15.1 was used to analyze the data.Results:The pooled results showed that ARR(plasma aldosterone concentration[PAC]/PRC)had a sensitivity of 0.82(95%confidence interval[CI]:0.78-0.86),a specificity of 0.94(95%CI:0.92-0.95),a positive-likelihood ratio(LR)of 12.77(95%CI:7.04-23.73),a negative LR of 0.11(95%CI:0.07-0.17),and symmetric area under the curve(SAUC)of 0.982,respectively.Furthermore,the diagnostic odds ratio(DOR)of ARR(PAC/PRC)was 180.21.Additionally,the pooled results showed that ARR(PAC/PRA)had a sensitivity of 0.91(95%CI:0.86-0.95),a specificity of 0.91(95%CI:0.90-0.93),a positive LR of 7.30(95%CI:2.99-17.99),a negative LR of 0.10(95%CI:0.04-0.26),and SAUC of 0.976,respectively.The DOR of ARR(PAC/PRA)was 155.52.Additionally,we conducted a subgroup analysis for the different thresholds(<35 or≥35)of PAC/PRC.The results showed that the DOR of the cut-off≥35 groups was higher than the cut-off<35 groups(DOR=340.15,95%CI:38.32-3019.66;DOR=116.40,95%CI=23.28-581.92).Conclusions:The research results suggest that the determination of ARR(PAC/PRC)and ARR(PAC/PRA)was all effective screening tools for PA.The diagnostic accuracy and diagnostic value of ARR(PAC/PRC)are higher than ARR(PAC/PRA).In addition,within a certain range,the higher the threshold,the better the diagnostic value.
基金supported by the National Natural Science Foundation of China(No.81872739)the Zhujiang Distinguish Professorship of Guangdong Province,China(2018)+1 种基金the International Scientific Collaboration Program of Guangdong Province,China(No.2020A0505100053)the Key Research and Development Program of Guangdong Province,China(No.2019B02021002)。
文摘Exorbitant aldosterone is closely associated with various severe diseases,including congestive heart failure and chronic kidney disease.As aldosterone synthase is the pivotal enzyme in aldosterone biosynthesis,its inhibition constitutes a promising treatment for these diseases.Via a structure-based approach,a series of pyridyl substituted 3,4-dihydrobenzo[f][1,4]oxazepin-5(2 H)-ones were designed as inhibitors of aldosterone synthase.Six compounds(5 j,5 l,5 m 5 w,5 x and 5 y)distinguished themselves with potent inhibition(IC50<100 nmol/L)and high selectivity over homogenous 11β-hydroxylase.As the most promising compound,5 x exhibited an IC_(50) of 12 nmol/L and an excellent selectivity factor(SF)of157,which are both superior to those of the re ference fadrazole(IC_(50)=21 nmol/L,SF=7).Importantly,5 x showed no inhibition against steroidogenic CYP17,CYP19 and a panel of hepatic CYP enzymes indicating an outstanding sa fety profile.As it manifested satis factory pharmacokinetic pro perties in rats,compound5 x was considered as a drug candidate for further development.
基金supported by the National Key R&D Program of China(Nos.2018YFC1704500 and 2018YFC1704505)。
文摘Hyperaldosteronism is a common disease that is closely related to endocrine hypertension and other cardiovascular diseases. Cytochrome P450 11 B2(CYP11 B2), an important enzyme in aldosterone(ALD) synthesis, is a promising target for the treatment of hyperaldosteronism. However, selective inhibitors targeting CYP11 B2 are still lacking due to the high similarity with CYP11 B1. In this study,atractylenolide-I(AT-I) was found to significantly reduce the production of ALD but had no effect on cortisol synthesis, which is catalyzed by CYP11 B1. Chemical biology studies revealed that due to the presence of Ala320, AT-I is selectively bound to the catalytic pocket of CYP11 B2, and the C8/C9 double bond of AT-I can be epoxidized, which then undergoes nucleophilic addition with the sulfhydryl group of Cys450 in CYP11 B2. The covalent binding of AT-I disrupts the interaction between heme and CYP11 B2 and inactivates CYP11 B2, leading to the suppression of ALD synthesis;AT-I shows a significant therapeutic effect for improving hyperaldosteronism.
基金1·3·5 project for disciplines of excellence, West China Hospital, Sichuan University(No. ZYGD18017)
文摘To the Editor:Primary aldosteronism,characterized by hypertension,with or without hypokalemia,is the most frequent form of endocrine hypertension,which is mostly caused by bilateral adrenal hyperplasia or aldosterone-producing adrenocortical adenomas(APAA).However,it can also be induced by aldosterone-producing adrenocortical carcinoma(APAC),which is rare.Because of the rarity and malignancy.
