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    "textoCompleto" => "NEFROLOGÍA. Vol. XXIV. Número Extraordinario (I). 2004 Papel del endotelio en la progresión de la enfermedad renal y el daño cardiovascular K. Amann Institut der Universtät Erlangen-Nürnberg. Endothelin-1 (ET-1) was discovered by Yanagisawa et al 1 in 1988&#59; it is known as the most potent vasoconstrictor produced by endothelial cells. ET-1 is a 21 aminoacids protein which is formed via posttranslationale modification from PrePro-ET-1 and Big-ET-1. Other family members are ET-2 and ET-3 which differ from ET-1 in 2 and 6 aminoacids, respectively. ET signaling is mediated via 3 different receptors: the ETA-, ETB and ETC-receptors. The ETA-receptor mediates mainly the vasoconstrictory effect on vascular smooth muscle cells whereas the ETB-receptor transduces mainly the vasodilatatory effect of ET-1. 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Urinary ET-1 excretion is also increased in renal failure and can be lowered by treatment with a selective ETA-receptor antagonist. In parallel, proteinuria is reduced and creatinin-clearance improved by ETA-receptor blockade. In various experimental models of acute and chronic renal disease structural parameters or renal damage were also reduced after treatment with ETAreceptor blockade and this was independent of blood pressure reduction. In type 1 and 2 diabetic nephropathy ET-1 seems to play a pathophysiologcal role as well since glomerular, tubulointerstitial and vascular alterations can be experimentally prevented by ETA-receptor blockade. Increased formation of ET-1 may also be of importance for physiological aging not only of the kidney, but also of the 24 Table I. Diseases with a potential pathophysiological role of ET-1 · · · · · · · Essential hypertension. Kidney diseases. Ischemic heart disease and congestive heart failure. Atherosclerosis and stroke. Diabetes mellitus. Disease of the lung (pulmonary hypertension and asthma). Gastrointestinal diseases (ulcus, M. Crohn, Colitis ulcerosa). whole organism 8. Significantly increased tissue levels of ET-1 are found in aged animals compared to younger ones in different vascular beds, in the glomeruli and in the tubulointerstitium. In addition, there is evidence for a role of ET-1 in the pathophysiology of atherosclerosis 9 and of uremic cardiomyopathy 7. Clinical studies of Demuth et al.6 as well as experimental and autoptical studies documented significantly increased ET-1 plasma- and tissue levels in patients with chronic renal failure. Against this background it is of interest that left ventricular hypertrophy, interstitial myocardial fibrosis and cardiac microarteriopathy in experimental renal failure can be prevented by treatment with an ETAreceptor antagonist. In summary, there is increasing evidence for a pathophysiologic role of ET-1 in various kidney diseases, as well as in aging, in atherosclerosis and in cardiovascular alterations in chronic renal failure. From a therapeutic perspective it is important that in experimental models the majority of alterations associated with these diseases could be experimentally prevented or at least ameliorated by specific ET-1 receptor blockade. Whether this is also true for patients remains to be proven in clinical studies. REFERENCES 1. Yanagisawa M, Kurihara H, Kimura S, Tomobe Y, Kobayashi M, Mitsui Y, Yazaki Y, Goto K, Masaki T: A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 332: 411-5, 1988. PAPEL DEL ENDOTELIO EN LA PROGRESIÓN DE LA ENFERMEDAD RENAL... 2. Lüscher TF, Barton M: Endothelins and endothelin receptor antagonists: therapeutic considerations for a novel class of cardiovascular drugs. Circulation 102: 2434-40, 2000. 3. Benigni A, Remuzzi G: Endothelin antagonists. Lancet 353: 133-8, 1999. 4. Hocher B, Thöne-Reineke C, Rohmeiss P, Schmager F, Slowinski T, Burst V, Siegmund F, Quertermous T, Bauer C, Neumayer HH, Schleuning WD, Theuring F: Endothelin-1 transgenic mice develop glomerulosclerosis, interstitial fibrosis, and renal cysts but not hypertension. J Clin Invest 99: 1380-9, 1997. 5. Brochu E, Lacasse S, Moreau C, Lebel M, Kingma I, Grose JH, Lariviere R: Endothelin ET(A) receptor blockade prevents the progression of renal failure and hypertension in uraemic rats. Nephrol Dial Transplant 14: 1881-8, 1999. 6. Demuth K, Blacher J, Guerin AP, Benoit MO, Moatti N, Safar ME, London GM: Endothelin and cardiovascular remodelling in end-stage renal disease. Nephrol Dial Transplant 13: 37583, 1998. 7. Orth SR, Viedt C, Amann K, Ritz E: Endothelin in renal diseases and cardiovascular remodeling in renal failure. Intern Med 40: 285-91, 2001. 8. Goettsch W, Lattmann T, Amann K, Szibor M, Morawietz H, Munter K, Muller SP, Shaw S, Barton M: Increased expression of endothelin-1 and inducible nitric oxide synthase isoform II in aging arteries in vivo: implications for atherosclerosis. Biochem Biophys Res Commun 280: 90813, 2001. 9. Amann K, Münter K, Wessels S, Wagner J, Balajew V, Hergenroder S, Mall G, Ritz E: Endothelin A receptor blockade prevents capillary/myocyte mismatch in the heart of uremic animals. J Am Soc Nephrol 11: 1702-11, 2000. 10. Barton M, Haudenschild CC, d'Uscio LV, Shaw S, Münter K, Luscher TF: Endothelin ETA receptor blockade restores NOmediated endothelial function and inhibits atherosclerosis in apolipoprotein E-deficient mice. Proc Natl Acad Sci U S A 95: 14367-72, 1998. 25 "
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Papel del endotelio en la progresión de la enfermedad renal y el daño cardiovascular
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2023 Marzo 26 21 47
2023 Febrero 22 22 44
2023 Enero 37 23 60
2022 Diciembre 46 32 78
2022 Noviembre 30 31 61
2022 Octubre 36 35 71
2022 Septiembre 38 34 72
2022 Agosto 43 30 73
2022 Julio 33 47 80
2022 Junio 28 30 58
2022 Mayo 31 28 59
2022 Abril 37 40 77
2022 Marzo 42 37 79
2022 Febrero 35 29 64
2022 Enero 38 41 79
2021 Diciembre 39 32 71
2021 Noviembre 26 35 61
2021 Octubre 24 32 56
2021 Septiembre 35 44 79
2021 Agosto 19 30 49
2021 Julio 36 34 70
2021 Junio 13 19 32
2021 Mayo 32 31 63
2021 Abril 45 39 84
2021 Marzo 36 26 62
2021 Febrero 25 23 48
2021 Enero 28 17 45
2020 Diciembre 16 12 28
2020 Noviembre 32 9 41
2020 Octubre 11 12 23
2020 Septiembre 16 3 19
2020 Agosto 34 8 42
2020 Julio 60 12 72
2020 Junio 29 12 41
2020 Mayo 30 13 43
2020 Abril 49 15 64
2020 Marzo 36 15 51
2020 Febrero 33 12 45
2020 Enero 38 21 59
2019 Diciembre 36 19 55
2019 Noviembre 42 13 55
2019 Octubre 22 8 30
2019 Septiembre 17 13 30
2019 Agosto 16 15 31
2019 Julio 30 23 53
2019 Junio 23 15 38
2019 Mayo 25 35 60
2019 Abril 42 31 73
2019 Marzo 12 17 29
2019 Febrero 14 11 25
2019 Enero 15 14 29
2018 Diciembre 39 21 60
2018 Noviembre 43 14 57
2018 Octubre 38 9 47
2018 Septiembre 31 11 42
2018 Agosto 15 7 22
2018 Julio 27 11 38
2018 Junio 14 11 25
2018 Mayo 26 10 36
2018 Abril 22 8 30
2018 Marzo 22 7 29
2018 Febrero 21 5 26
2018 Enero 12 4 16
2017 Diciembre 17 5 22
2017 Noviembre 19 4 23
2017 Octubre 16 6 22
2017 Septiembre 12 5 17
2017 Agosto 11 3 14
2017 Julio 9 5 14
2017 Junio 10 5 15
2017 Mayo 13 8 21
2017 Abril 12 16 28
2017 Marzo 16 8 24
2017 Febrero 10 7 17
2017 Enero 10 4 14
2016 Diciembre 22 5 27
2016 Noviembre 16 6 22
2016 Octubre 16 2 18
2016 Septiembre 50 2 52
2016 Agosto 67 1 68
2016 Julio 84 6 90
2016 Junio 91 0 91
2016 Mayo 75 0 75
2016 Abril 51 0 51
2016 Marzo 52 0 52
2016 Febrero 59 0 59
2016 Enero 42 0 42
2015 Diciembre 69 0 69
2015 Noviembre 53 0 53
2015 Octubre 44 0 44
2015 Septiembre 46 0 46
2015 Agosto 37 0 37
2015 Julio 35 0 35
2015 Junio 21 0 21
2015 Mayo 18 0 18
2015 Abril 7 0 7
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