Aorticorenal ganglion ablation for blood pressure lowering in canine models.

Abstract

Studies have shown that renal denervation (RDN) can lower blood pressure (BP) in patients with refractory hypertension, but issues such as renal sympathetic nerve reinnervation and suboptimal BP reduction remain unresolved. In this study, we identified the aorticorenal ganglion (ARG) in canines by observing ambulatory BP responses following electrical stimulation of the ARG. We injected cholera toxin subunit B combined with Alexa Fluor™ 555, a nerve tracer, into the identified ARG and confirmed its innervation of the renal artery and kidney by observing fluorescence in adjacent tissues. Twelve experimental canines were divided equally into an intervention group, which received ARG ablation using 95% ethanol, and a sham control group, which received normal saline. Our results demonstrated that ARG ablation significantly reduced systolic, diastolic, and mean arterial pressures, with minimal impact on heart rate. Additionally, ARG ablation lowered plasma and renal cortex norepinephrine levels, and reduced tyrosine hydroxylase expression in the renal cortex. No adverse events were observed during the 3-month follow-up period. These findings suggest that the ARG may serve as a novel target for RDN and could offer a therapeutic alternative for patients who do not respond to or experience elevated BP after RDN.