Mineralocorticoid receptors, salt-sensitive hypertension, and metabolic syndrome. 2010

Toshiro Fujita
Department of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. fujita-dis@h.u-tokyo.ac.jp

Obese persons with metabolic syndrome often have associated with salt-sensitive hypertension, microalbuminuria, and cardiac dysfunction, and the plasma aldosterone level in one-third of metabolic syndrome patients is clearly elevated. Hyperaldosteronism, which may be caused at least partially by certain adipocyte-derived factors, contributes to the development of proteinuria in obese hypertensive rats, and salt loading aggravates the proteinuria and induces cardiac diastolic dysfunction because of inadequate suppression of plasma aldosterone level. However, mineralocorticoid receptor (MR) antagonists prevent salt-induced renal and cardiac damage, suggesting that aldosterone excess and a high-salt diet exert an unfavorable synergistic action on the kidney and heart. In Dahl salt-sensitive rats, however, despite appropriate suppression of plasma aldosterone with a high-salt diet, salt loading paradoxically activated renal MR signaling, and the renal injury was markedly prevented by MR antagonists. Accordingly, we discovered an alternative pathway of MR activation in which Rac1, a small GTP-binding protein, activates MRs. Salt loading activates renal Rac1 in Dahl salt-sensitive rats, and Rac1 in turn induces MR activation, which results in renal injury, and the renal injury has been found to be prevented by Rac1 inhibitors. Moreover, several metabolic syndrome-related factors induce Rac1 activation, and one of them, hyperglycemia, activates MRs via Rac1 activation. Consistent with this, Rac1 inhibitors attenuated the proteinuria and renal injury in obese hypertensive animals. Thus, both salt and obesity activate Rac1 and cause MR activation. Abnormal activation of the aldosterone/MR pathway plays a key role in the development of salt-sensitive hypertension and renal injury in metabolic syndrome.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000450 Aldosterone A hormone secreted by the ADRENAL CORTEX that regulates electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. Aldosterone, (+-)-Isomer,Aldosterone, (11 beta,17 alpha)-Isomer
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D017673 Sodium Chloride, Dietary Sodium chloride used in foods. Dietary Sodium Chloride,Table Salt,Chloride, Dietary Sodium,Salt, Table
D051381 Rats The common name for the genus Rattus. Rattus,Rats, Laboratory,Rats, Norway,Rattus norvegicus,Laboratory Rat,Laboratory Rats,Norway Rat,Norway Rats,Rat,Rat, Laboratory,Rat, Norway,norvegicus, Rattus
D018161 Receptors, Mineralocorticoid Cytoplasmic proteins that specifically bind MINERALOCORTICOIDS and mediate their cellular effects. The receptor with its bound ligand acts in the nucleus to induce transcription of specific segments of DNA. Mineralocorticoid Receptors,Aldosterone Receptor,Aldosterone Receptors,Corticoid I Receptor,Corticoid Type I Receptors,Mineralocorticoid Receptor,Receptors, Aldosterone,Receptors, Corticoid I,Receptors, Corticoid Type I,Receptors, Mineralocorticoids,Corticoid I Receptors,Mineralocorticoids Receptors,Receptor, Aldosterone,Receptor, Corticoid I,Receptor, Mineralocorticoid
D020303 Rats, Inbred Dahl Inbred rats derived from Sprague-Dawley rats and used for the study of salt-dependent hypertension. Salt-sensitive and salt-resistant strains have been selectively bred to show the opposite genetically determined blood pressure responses to excess sodium chloride ingestion. Dahl Hypertensive Rats,Dahl Rat,Dahl Salt-Resistant Rats,Dahl Salt-Sensitive Rat,Dahl Salt-Sensitive Rats,Dahl Rats,Dahl Rats, Inbred,Dahl Salt Resistant Rats,Dahl Salt Sensitive Rat,Dahl Salt Sensitive Rats,Hypertensive Rats, Dahl,Inbred Dahl Rats,Rat, Dahl,Rat, Dahl Salt-Sensitive,Rats, Dahl,Rats, Dahl Hypertensive,Rats, Dahl Salt-Resistant,Rats, Dahl Salt-Sensitive,Salt-Resistant Rats, Dahl,Salt-Sensitive Rat, Dahl,Salt-Sensitive Rats, Dahl
D024821 Metabolic Syndrome A cluster of symptoms that are risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome include ABDOMINAL OBESITY; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. Cardiometabolic Syndrome,Insulin Resistance Syndrome X,Metabolic Syndrome X,Reaven Syndrome X,Dysmetabolic Syndrome X,Metabolic Cardiovascular Syndrome,Metabolic X Syndrome,Syndrome X, Insulin Resistance,Syndrome X, Metabolic,Cardiometabolic Syndromes,Cardiovascular Syndrome, Metabolic,Cardiovascular Syndromes, Metabolic,Metabolic Syndromes,Syndrome X, Dysmetabolic,Syndrome X, Reaven,Syndrome, Cardiometabolic,Syndrome, Metabolic,Syndrome, Metabolic Cardiovascular,Syndrome, Metabolic X,Syndromes, Cardiometabolic,Syndromes, Metabolic,X Syndrome, Metabolic

Related Publications

Toshiro Fujita
January 1997, Recent progress in hormone research,
Toshiro Fujita
November 2009, Trends in endocrinology and metabolism: TEM,
Toshiro Fujita
April 2009, American journal of physiology. Regulatory, integrative and comparative physiology,
Toshiro Fujita
June 1995, The Journal of steroid biochemistry and molecular biology,
Toshiro Fujita
January 2012, Clinical and experimental pharmacology & physiology,
Toshiro Fujita
March 2020, Trends in endocrinology and metabolism: TEM,
Copied contents to your clipboard!