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中国临床药理学与治疗学 ›› 2022, Vol. 27 ›› Issue (4): 450-456.doi: 10.12092/j.issn.1009-2501.2022.04.016

• 心血管疾病药物治疗最新研究进展 • 上一篇    下一篇

非奈利酮的研究应用新进展

程宽   

  1. 复旦大学附属中山医院心内科,上海市心血管病研究所,上海 200032
  • 出版日期:2022-04-26 发布日期:2022-05-17
  • 作者简介:程宽,男,博士,主治医师,研究方向:高血压,心律失常。 E-mail: cheng.kuan@zs-hospital.sh.cn
  • 基金资助:
    上海市科学技术委员会基金(21015802000)

New progress in research and application of fenneridone

CHENG Kuan   

  1. Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China
  • Online:2022-04-26 Published:2022-05-17

摘要:

醛固酮是肾上腺皮质产生的一种盐皮质激素,主要作用于肾小球远曲小管和集合管,促进钠的重吸收和钾的分泌。醛固酮可促进炎症反应,导致心肌重构和纤维化。醛固酮通过盐皮质激素受体(MR)起作用,MR主要在心脏、肾脏和血管中表达。MR过度活化,可引起内皮功能障碍、纤溶紊乱、氧化应激和心血管、肾脏纤维化,最终导致器官损伤、功能障碍甚至衰竭。盐皮质激素受体拮抗剂(MRA)可通过抑制MR激活引起的炎症和纤维化达到心肾保护作用。新型非甾体类MRA非奈利酮以其高选择性、有效阻断MR,带来了确切的心肾保护作用。

关键词: 盐皮质激素受体拮抗剂, 非奈利酮, 螺内脂, 依普利酮, 醛固酮

Abstract:

Aldosterone is a mineralocorticoid hormone produced by the adrenal cortex, which acts on receptors in the distal and collecting tubules of the nephron, causing reabsorption of sodium and secretion of potassium. Aldosterone can promote inflammatory response and lead to myocardial remodeling and fibrosis. Aldosterone acts through mineralocorticoid receptor (MR), which is mainly expressed in heart, kidney and blood vessels. Excessive activation of MR can cause endothelial dysfunction, fibrinolysis disorder, oxidative stress, cardiovascular and renal fibrosis, and eventually lead to organ injury, dysfunction and even organ failure. Mineralocorticoid receptor antagonist (MRA) can achieve cardiorenal protection by inhibiting inflammation and fibrosis caused by MR activation. The novel nonsteroidal MRA fenneridone can effectively block MR with its high selectivity and bring definite cardiac and renal protective effects.

Key words: mineralocorticoid receptor antagonist, finerenone, spironolactone, eplerenone, aldosterone

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