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Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms 心血管疾病中盐皮质激素受体的激活和拮抗作用:细胞和分子机制
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.001
Johann Bauersachs , Achim Lother
{"title":"Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms","authors":"Johann Bauersachs ,&nbsp;Achim Lother","doi":"10.1016/j.kisu.2021.11.001","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.001","url":null,"abstract":"<div><p>Aldosterone controls salt–water homeostasis by acting on the mineralocorticoid receptor (MR), a ligand-activated transcription factor, in kidney epithelial cells. However, it is now evident that the MR is expressed in multiple cell types and tissues, acting as a key driver of cardiovascular disease. MR antagonists have proven to be highly efficient in patients with heart failure and reduced ejection fraction, and they are a cornerstone of contemporary therapy. In the past decade, a series of experimental studies using models with cell type–specific MRs uncovered the cellular and molecular mechanisms underlying its detrimental effect on left ventricular remodeling. Based on these findings, the potential of MR antagonists has been evaluated in other cardiovascular diseases, including coronary artery disease, arterial hypertension, heart failure with preserved ejection fraction, pulmonary hypertension, atrial fibrillation, and heart valve disease. The present review summarizes the current knowledge on MR activation and antagonism in cardiovascular disease.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Pages 19-26"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171621000642/pdfft?md5=a3000fc24bd71b0fe3ce2e9fe9439f00&pid=1-s2.0-S2157171621000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72089521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Considerations for the future: current and future treatment paradigms with mineralocorticoid receptor antagonists—unmet needs and underserved patient cohorts 对未来的考虑:盐皮质激素受体拮抗剂的当前和未来治疗模式——未满足的需求和服务不足的患者群体
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.008
Murray Epstein
{"title":"Considerations for the future: current and future treatment paradigms with mineralocorticoid receptor antagonists—unmet needs and underserved patient cohorts","authors":"Murray Epstein","doi":"10.1016/j.kisu.2021.11.008","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.008","url":null,"abstract":"<div><p>The recent successful demonstrations that the nonsteroidal mineralocorticoid receptor (MR) antagonist finerenone provides effective kidney and cardiovascular (CV) protection in patients with chronic kidney disease (CKD) and type 2 diabetes constitutes a platform for considering and implementing an array of future clinical trials in patients with nondiabetic CKD. Activation of the MR, with consequent inflammation and fibrosis, should be operative as a pathogenetic mediator not only in patients with diabetic CKD but also in those with nondiabetic kidney disease. Consequently, it is proposed that MR antagonism therapy will be equally efficacious in patients with nondiabetic CKD. Recently, a major new clinical trial has been initiated testing finerenone in patients with nondiabetic kidney disease (FIND-CKD; NCT05047263). A second clinical development program, FIONA, is dedicated to studies of finerenone in children with glomerular and nonglomerular CKD. Finally, the interrelationship of fibroblast growth factor 23 (FGF23), membrane αKlotho (hereafter called Klotho), and aldosterone may be a propitious subject for future investigation. The interplay and intersection of these seemingly disparate yet intricate relationships may unmask novel, and indeed compelling, opportunities for therapeutic interventions that are capable of interrupting the vicious cycle of excess aldosterone/MR activation and FGF23 secretion with concomitant Klotho insufficiency characteristically present in patients with CKD.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Pages 69-75"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171621000733/pdfft?md5=ac07a929ec6ce0ee8dd18eac0dd8541c&pid=1-s2.0-S2157171621000733-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72120627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Subscription Information 订阅信息
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/S2157-1716(22)00004-1
{"title":"Subscription Information","authors":"","doi":"10.1016/S2157-1716(22)00004-1","DOIUrl":"https://doi.org/10.1016/S2157-1716(22)00004-1","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Page A2"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171622000041/pdfft?md5=7f31e1ce44a1c261f769ac06e0af8e32&pid=1-s2.0-S2157171622000041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72021824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nonepithelial mineralocorticoid receptor activation as a determinant of kidney disease 非上皮性盐皮质激素受体激活是肾脏疾病的决定因素
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.004
Toshifumi Nakamura , Sophie Girerd , Frederic Jaisser , Jonatan Barrera-Chimal
{"title":"Nonepithelial mineralocorticoid receptor activation as a determinant of kidney disease","authors":"Toshifumi Nakamura ,&nbsp;Sophie Girerd ,&nbsp;Frederic Jaisser ,&nbsp;Jonatan Barrera-Chimal","doi":"10.1016/j.kisu.2021.11.004","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.004","url":null,"abstract":"<div><p>Chronic kidney disease is a major global health challenge, and mineralocorticoid receptor (MR) signaling is thought to play a role in disease progression. The classic role of the MR is the regulation of fluid and electrolyte homeostasis via differential gene expression, and recently its role in modulating inflammation and fibrosis has been identified. In addition to expression of the MR in renal epithelial cells, it is also found in nonepithelial cells, such as endothelial cells, vascular smooth muscle cells, podocytes, and fibroblasts. Targeting the MR in these cells may play a role in offering protection against inflammation and fibrosis in the kidneys and the cardiovascular system. Herein, data from preclinical cell-specific MR knockout mouse models and <em>in vitro</em> studies that help uncover the role of the MR in nonepithelial cells are presented. This review also discusses several potential targets that offer opportunities for the targeting of MR signaling in nonepithelial cells.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Pages 12-18"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171621000678/pdfft?md5=27b2621b6f4303bfa54b88b13ba7ce87&pid=1-s2.0-S2157171621000678-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72120628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: an extraordinary paradigm shift 醛固酮和矿化皮质激素受体信号作为心血管和肾脏损伤的决定因素:一个非凡的范式转变
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.007
Murray Epstein
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引用次数: 4
Title Page 标题页
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/S2157-1716(22)00005-3
{"title":"Title Page","authors":"","doi":"10.1016/S2157-1716(22)00005-3","DOIUrl":"https://doi.org/10.1016/S2157-1716(22)00005-3","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Page A3"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171622000053/pdfft?md5=899a1166eac79cddcb5fb97c1b1b2730&pid=1-s2.0-S2157171622000053-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72056445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The innate immune response, microenvironment proteinases, and the COVID-19 pandemic: pathophysiologic mechanisms and emerging therapeutic targets 先天免疫反应、微环境蛋白酶与COVID-19大流行:病理生理机制和新出现的治疗靶点
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.12.001
Morley D. Hollenberg , Murray Epstein
{"title":"The innate immune response, microenvironment proteinases, and the COVID-19 pandemic: pathophysiologic mechanisms and emerging therapeutic targets","authors":"Morley D. Hollenberg ,&nbsp;Murray Epstein","doi":"10.1016/j.kisu.2021.12.001","DOIUrl":"10.1016/j.kisu.2021.12.001","url":null,"abstract":"<div><p>The coronavirus disease 2019 (COVID-19) pandemic, causing considerable mortality and morbidity worldwide, has fully engaged the biomedical community in attempts to elucidate the pathophysiology of COVID-19 and develop robust therapeutic strategies. To this end, the predominant research focus has been on the adaptive immune response to COVID-19 infections stimulated by mRNA and protein vaccines and on the duration and persistence of immune protection. In contrast, the role of the innate immune response to the viral challenge has been underrepresented. This overview focuses on the innate immune response to COVID-19 infection, with an emphasis on the roles of extracellular proteases in the tissue microenvironment. Proteinase-mediated signaling caused by enzymes in the extracellular microenvironment occurs upstream of the increased production of inflammatory cytokines that mediate COVID-19 pathology. These enzymes include the coagulation cascade, kinin-generating plasma kallikrein, and the complement system, as well as angiotensin-generating proteinases of the renin–angiotensin system. Furthermore, in the context of several articles in this Supplement elucidating and detailing the trajectory of diverse profibrotic pathways, we extrapolate these insights to explore how fibrosis and profibrotic pathways participate importantly in the pathogenesis of COVID-19. We propose that the lessons garnered from understanding the roles of microenvironment proteinases in triggering the innate immune response to COVID-19 pathology will identify potential therapeutic targets and inform approaches to the clinical management of COVID-19. Furthermore, the information may also provide a template for understanding the determinants of COVID-19–induced tissue fibrosis that may follow resolution of acute infection (so-called “long COVID”), which represents a major new challenge to our healthcare systems.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Pages 48-62"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8931295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40313446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Clinical perspective-evolving evidence of mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes. 慢性肾病和2型糖尿病患者使用矿皮质激素受体拮抗剂的临床研究进展
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.005
P. Rossing
{"title":"Clinical perspective-evolving evidence of mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes.","authors":"P. Rossing","doi":"10.1016/j.kisu.2021.11.005","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.005","url":null,"abstract":"","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"44 1","pages":"27-35"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88637651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
The role of mineralocorticoid receptor activation in kidney inflammation and fibrosis 盐皮质激素受体激活在肾脏炎症和纤维化中的作用
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.006
James M. Luther , Agnes B. Fogo
{"title":"The role of mineralocorticoid receptor activation in kidney inflammation and fibrosis","authors":"James M. Luther ,&nbsp;Agnes B. Fogo","doi":"10.1016/j.kisu.2021.11.006","DOIUrl":"https://doi.org/10.1016/j.kisu.2021.11.006","url":null,"abstract":"<div><p>Chronic kidney disease is characterized by progressive scarring that results in loss of normal tissue in the kidney and eventually end-stage kidney disease. Interstitial fibrosis and tubular atrophy have been most closely correlated with decline in renal function. Potential mechanisms include profibrotic changes in tubules, influx of profibrotic rather than healing reparative macrophages, and an increase in activated myofibroblasts. Aldosterone activates the mineralocorticoid receptor in the collecting duct to increase sodium reabsorption, resulting in increased blood pressure. Aldosterone also promotes inflammation and fibrosis in the kidney by activating the mineralocorticoid receptor in other cellular compartments, including podocytes, mesangial cells, epithelial cells, and myeloid cells. Aldosterone also may act indirectly by stimulating factors in epithelial tissues that contribute to inflammatory macrophage polarization, myofibroblast differentiation, and progressive fibrosis. This review discusses the potential mechanisms by which aldosterone and mineralocorticoid receptor activation promotes inflammation and fibrosis via nonclassical pathways in the kidney.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"12 1","pages":"Pages 63-68"},"PeriodicalIF":5.5,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2157171621000691/pdfft?md5=a7ec8f6991b7907b657001d663b2504a&pid=1-s2.0-S2157171621000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72098619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 17
Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: an extraordinary paradigm shift 醛固酮和盐皮质激素受体信号传导是心血管和肾损伤的决定因素:一个非同寻常的范式转变
IF 5.5 2区 医学
Kidney International Supplements Pub Date : 2022-04-01 DOI: 10.1016/j.kisu.2021.11.007
Murray Epstein
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引用次数: 5
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