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The effect of renal denervation on central mechanisms of cardiovascular regulation in pressure-overload induced heart failure accompanied by renal failure

Research Project

Project/Area Number 17K16010
Research Category

Grant-in-Aid for Young Scientists (B)

Allocation TypeMulti-year Fund
Research Field Cardiovascular medicine
Research InstitutionKyushu University

Principal Investigator

Nishihara Masaaki  九州大学, 大学病院, 助教 (70641017)

Project Period (FY) 2017-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2017: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Keywords高血圧症 / 慢性腎臓病 / 腎除神経術 / アンジオテンシンⅡ受容体拮抗薬 / 中枢性交感神経調節 / 中枢性交感神経活動 / 心不全 / 腎除神経 / 中枢性循環調節 / 交感神経活動
Outline of Final Research Achievements

Augmented sympathetic nerve activity (SNA) is involved in the pathogenesis of hypertension (HT) accompanied by chronic kidney disease (CKD). Oxidative stress in the cardiovascular center in the brain increases SNA in HT. Administration of an angiotensin Ⅱ receptor blocker (ARB) or renal denervation (RDN) exerts an antihypertensive effect in HT with CKD; however, the precise mechanisms of the combination therapy are not fully elucidated.
In the present study, 5/6-nephrectomized mice (Nx-mice) presented HT, accompanied by increased SNA and albuminuria. Nx-mice were orally administered ARB (Nx-ARB) or underwent RDN during ARB administration (Nx-ARB/RDN). In Nx-ARB/RDN, blood pressure (BP) was decreased greater than that in Nx-ARB and both SNA and oxidative stress levels in the brain were suppressed.
In conclusion, the combination therapy with ARB/RDN has antihypertensive effects in association with suppressing SNA by reducing oxidative stress in the brain in hypertensive mice with CKD.

Academic Significance and Societal Importance of the Research Achievements

慢性腎臓病に合併する高血圧はしばしば治療抵抗性であり、その機序に交感神経活動の活性化が示唆されている。今回の研究では慢性腎臓病合併高血圧モデルへのアンジオテンシンⅡ受容体拮抗薬(ARB)と腎除神経術(RDN)の併用により強力な降圧効果、脳内酸化ストレス抑制に伴う交感神経活動低下を認めた。今回の成果により当併用療法が慢性腎臓病合併高血圧患者に対する有用な治療選択肢になり得ると考えられる。

Report

(3 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • Research Products

    (3 results)

All 2018 2017

All Journal Article (1 results) (of which Peer Reviewed: 1 results) Presentation (2 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Olemsartan combined with renal denervation reduces blood pressure in association with sympatho-inhibitory aned aldosterone-reducing effects in hypertensive mice with chronic kidney disease.2018

    • Author(s)
      Nishihara M, Takesue K, Hirooka Y
    • Journal Title

      Clinical and Experimental Hypertension

      Volume: 40 Issue: 3 Pages: 211-219

    • DOI

      10.1080/10641963.2018.1465075

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Presentation] Combining Olmesartan and Renal Denervation Elicits Strong Blood Pressure Reduction in Association with Sympatho-inhibitory and Aldosterone-reducing Effects in Hypertensive Mice with Chronic Kidney Disease2017

    • Author(s)
      Masaaki Nishihara
    • Organizer
      AHA Council on Hypertension 2017
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] 慢性腎臓病合併高血圧モデルマウスに対するオルメサルタンと腎除神経術併用は交感神経活動及び血中アルドステロンを抑制し強力な降圧効果を有する2017

    • Author(s)
      西原正章
    • Organizer
      第40回日本高血圧学会総会
    • Related Report
      2017 Research-status Report

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Published: 2017-04-28   Modified: 2020-03-30  

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