Прямой ингибитор ренина алискирен – самостоятельная стратегия коррекции кардиоренального синдрома при метаболическом синдроме и ожирении


В.В. Фомин, Е.А. Сагинова

Кафедра терапии и профболезней ГОУ ВПО "Первый МГМУ им. И.М. Сеченова" минздравсоцразвития РФ, Москва
Обсуждается роль прямого ингибитора ренина алискирена в торможении прогрессирования хронической болезни почек у больных ожирением и метаболическим синдромом.

Литература


1. Чазова И.Е., Мычка В.Б. Метаболический синдром. М., 2004.
2. Ting S.M., Nair H., Ching I. et al. Overweight, obesity and chronic kidney disease. Nephron. Clin. Pract. 2009; 112(3): c121–c127.
3. Nelson R., Antonetti I., Bisognano J.D., Sloand J. Obesity-related cardiorenal syndrome. J. Clin Hypertens. 2010; 12(1): 59–63.
4. Мухин Н.А., Фомин В.В., Сагинова Е.А. и др. Эндотелиальная дисфункция и поражение почек при ожирении. Вестник РАМН 2006; 12: 32–37.
5. Bravo P.E., Morse S., Borne D.M., Aguilar E.A., Reisin E. Leptin and hypertension in obesity. Vasc. Health Risk Manag. 2006; 2(2):163–169.
6. Fruhbeck G. The adipose tissue as a source of vasoactive factors. Сurr. Med. Chem. Cardiovasc. Hematol. Agents. 2004; 2: 197–208.
7. Sowers J.R., Epstein M., Frohlich E.D. Diabetes, hypertension, and cardiovascular disease: an update. Hypertension. 2001; 37: 1053–1059.
8. Sarzani R., Salvi F., Dessì-Fulgheri P., Rappelli A. Renin-angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J. Hypertens. 2008; 26(5): 831–843.
9. Engeli S., Schling P., Gorzelniak K. et al. The adipose-tissue renin-angiotensinaldosterone system: role in the metabolic syndrome? Int. J. Biochem. Cell Biol. 2003; 35(6): 807–825.
10. Nguyen G., Delarue F., Burcklé C. et al. Pivotal role of the renin/pro-renin receptor in angiotensin II production and cellular responses to renin. J. Clin. Invest/ 2002; 109:1417–1427.
11. Danser A.H.J., Deinum J. Renin, prorenin, and the putative prorenin receptor. Hypertension 2005; 46: 1069–1076. 12. Oliver J.A. Receptor mediated actions of renin and pro-renin. Kidney Int. 2006; 69: 13–15.
13. Huang Y., Wongamorntham S., Kasting J. et al. Renin increases mesangial cell transforming growth factor-beta1 and matrix proteins through receptor-mediated, angiotensin II-independent mechanisms. Kidney Int 2006;69:105–113.
14. Nguen G., Danser A.H.J. Prorenin and (pro)renin receptor: a review of available data from in vitro studies and experimental models in rodents. Exp. Physiol. 2008; 93 (Pt.5): 557–563.
15. Ichihara A., Suzuki F., Nakagawa T. et al. Prorenin receptor blockade inhibits development of glomerulosclerosis in diabetic angiotensin II type 1a receptordeficient mice. J. Am. Soc. Nephrol. 2006; 17:1950–1961.
16. Kaneshiro Y., Ichihara A., Sakoda M. et al. Slowly progressive, angiotensin II-independent glomerulosclerosis in human (pro)rennin receptor-transgenic rats. J. Am. Soc. Nephrol. 2007; 18:1789–1795.
17. Krebs C., Hamming I., Sadaghiani S. et al. Antihypertensive therapy upregulates renin and (pro)renin receptor in the clipped kidney of Goldblatt hypertensive rats. Kidney Int. 2007; 72: 725–730.
18. He M., Zhang L., Shao Y. et al. Inhibition of renin/prorenin receptor attenuated mesangial cell proliferation and reduced associated fibrotic factor release. Eur. J. Pharmacol. 2009; 606(1-3): 155–161.
19. Fisher N.D.L., Hollenberg N.K. Renin inhibition: what are the therapeutic opportunities? J. Am. Soc. Nephrol. 2005; 16: 592–599.
20. Staessen J.A., Li Y., Richart T. Oral renin inhibitors. Lancet 2006; 368: 1449–1456.
21. Whaley-Connel A., Sowers J., Purkayastha D. et al. Combination therapy with aliskiren and hydrochlorothiazide decreases plasma renin activity and oxidative stress versus ramipril while reducing blood pressure in obese patients with stage 2 hypertension. J. Clin. Hypertens. 2010; 12(Suppl. 1): A46.
22. Latini R., Masson S., Anand I. et al. The comparative prognostic value of plasma neurohormones at baseline in patients with heart failure enrolled in Val-HeFT. Eur Heart J. 2004; 25: 292–299.
23. Yeyati N.L., Adrogue H.J. Inappropriately high plasma renin activity accompanies chronic loss of renal function. Am. J. Nephrol. 1996; 16: 471–477.
24. Jordan J., Engeli S., Boye S.W. et al. Direct renin inhibition with aliskiren in obese patients with arterial hypertension. Hypertension. 2007; 49: 1047–1055.
25. Luetscher J.A., Kraemer F.B., Wilson D.M. et al. Increased plasma inactive renin in diabetes mellitus. A marker of microvascular comlications. N. Engl. J. Med. 1985; 312: 1412–1417.
26. Chiarelli F., Pomilio M., De Luca F.A. et al. Plasma prorenin levels may predict persistent microalbuminuria in children with diabetes. Pediatr. Nephrol. 2001; 16: 116–120.
27. Kelly D.J., Zhang Y., Moe G. et al. Aliskiren, a novel renin inhibitor, is renoprotective in a model of advanced diabetic nephropathy in rats. Diabetologia. 2007; 50(11): 2398–2404.
28. Pilz B., Shagdarsuren E., Wellner M. et al. Aliskiren, a human renin inhibitor, ameliorates cardiac and renal damage in double-transgenic rats. Hypertension. 2005; 46(3): 569–576.
29. Parving H.H., Persson F., Lewis J.B., Lewis E.J., Hollenberg N.K.; AVOID Study Investigators. Aliskiren combined with losartan in type 2 diabetes and nephropathy. N. Engl. J. Med. 2008; 358(23): 2433–2446.
30. Persson F., Lewis J.B., Lewis E.J. et al.; for the AVOID study investigators. Impact of baseline renal function on the efficacy and safety of aliskiren added to losartan in patients with type 2 diabetes and nephropathy. Diabetes Care. 2010 Aug 6. [Epub ahead of print]
31. Persson F. et al. Renoprotective effects of direct renin inhibition compared to and in combination with maximum recommended dose of Irbesartan in patients with type 2 diabetes and albuminuria. Diabetologia 2008; 51 (Suppl 1): S492.
32. Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE): rationale and study design. Nephrol. Dial. Transplant. 2009; 24(5): 1663–1671.
33. Delea T.E., Sofrygin O., Palmer J.L. et al. Cost-effectiveness of aliskiren in type 2 diabetes, hypertension, and albuminuria. J. Am. Soc. Nephrol. 2009; 20(10): 2205–2213.
34. Dhaun N., MacIntyre I.M., Bellamy C.O.C., Kluth D.C. Endothelin receptor anthagonism and renin inhibition as treatment options for scleroderma kidney. Am. J. Kidney Dis. 2009; 54: 726–731.
35. Amico P., Kalbermatter S., Kiss D. Aliskiren corrects recurrent hyperreninemia and hyperaldosteronism in autosomal-dominant polycystic kidney disease. Clin Nephrol. 2009; 72(3): 237–239.


Об авторах / Для корреспонденции


Фомин В.В. – профессор кафедры терапии и профболезней, декан факультета довузовского образования ГОУ ВПО “Первый МГМУ им. И.М. Сеченова” Минздравсоцразвития РФ, д.м.н.
E-mail: fomin_vic@mail.ru;
Сагинова Е.А. – ассистент кафедры терапии и профболезней ГОУ ВПО “Первый МГМУ им. И.М. Сеченова” Минздравсоцразвития РФ, к.м.н.
E-mail; med02@yandex.ru


Похожие статьи


Бионика Медиа