Inappropriate activity of local renin-angiotensin-aldosterone system during high salt intake: impact on the cardio-renal axis

Abstract

Atividade inadequada do sistema renina-angiotensina-aldosterona local durante período de alta ingestão de sal: impacto sobre o eixo cardiorrenal Apesar de haver uma concordância geral sobre a necessidade de redução na ingestão de sal como questão de saúde publica, o mecanismo pelo qual a alta ingesta de sal deflagra efeitos patológicos sobre o eixo cardiorrenal não está ainda completamente elucidado. Cada vez mais evidencias indicam que o sistema renina-angiotensinaaldosterona (S-RAA) seja o principal alvo da alta ingesta de Na + . Uma ativação inadequada do S-RAA tecidual pode causar hipertensão e dano ao órgão. Nós revisamos o impacto da dieta com alto teor de sódio sobre o eixo cardiorrenal, destacando as vias moleculares que causam a lesão. Também fizemos uma avaliação de recentes estudos observacionais relacionados às consequên-cias do acúmulo de Na + não osmoticamente ativo, quebrando assim o paradigma de que a alta ingestão de sódio necessariamente aumenta a concentração sérica de Na + , assim promovendo a retenção de água. ResumoPalavras-chave: Renina; Angiotensina II; Sódio na Dieta; Rim; Coração.Although there is a general agreement on the recommendation for reduced salt intake as a public health issue, the mechanism by which high salt intake triggers pathological effects on the cardio--renal axis is not completely understood. Emerging evidence indicates that the renin-angiotensin-aldosterone system (RAAS) is the main target of high Na + intake. An inappropriate activation of tissue RAAS may lead to hypertension and organ damage. We reviewed the impact of high salt intake on the RAAS on the cardio-renal axis highlighting the molecular pathways that leads to injury effects. We also provide an assessment of recent observational studies related to the consequences of non-osmotically active Na + accumulation, breaking the paradigm that high salt intake necessarily increases plasma Na + concentration promoting water retention AbstRAct

Physical exercise as a tool to help the immune system against COVID-19: an integrative review of the current literature

“…The anti-inflammatory, antioxidant and endothelial activation inhibitor benefits may also be linked to the reduction in hypercoagulability related to COVID-19. This is because, as previously mentioned, the exacerbated activation of the immune system increases the expression of the tissue factor and, consequently, the predisposition to the formation of thrombi; in addition, metabolic disorders, oxidant stress and changes in senescence positively stimulate the vasoconstrictor axis ECA/Ang/AT1R, contributing to endothelial imbalances [46,47,[49][50][51][52][53]69]. Therefore, the immunometabolic improvements promoted by physical exercise may help in the control of coagulation disorders in the COVID-19 (Fig.…”

“…Some authors also elucidate the virus's relationship with the ECA2 functional receptor, present in the arterial and venous endothelial cells of most human organs and part of both axes of the renin-angiotensin system, the vasoconstrictor ECA/Ang/AT1R and the vasodilator ECA2/Ang-(1-7)/MAS [50,51]. Dalan et al [52] cite that both aging and metabolic disorders positively regulate the ECA/Ang/AT1R axis, leading to inflammatory, oxidative, vasoconstrictor and fibrotic effects.…”

“…It was observed that the expression of ACE2 in the adipose tissue of obese patients allows viral entry in adipocytes and makes this tissue a reservoir for the viral dissemination of SARS-CoV-2, since it is viscerally distributed [43,51]. In addition, obesity is an important factor for the development of T2DM-especially when associated with low levels of physical activity and poor physical conditioning-and as mentioned, both diseases are related to higher expression of ACE2, increasing the risk of advanced infection by SARS-CoV-2 [43].…”

High-Salt Loading Downregulates Nrf2 Expression in a Sodium-Dependent Manner in Renal Collecting Duct Cells

“…A high-salt diet is known to induce excessive oxidative stress in the kidney (Feng et al, 2012;Fellner et al, 2014). The local renin-angiotensin-aldosterone system (RAAS) is enhanced in Dahl salt-sensitive rats on a high-salt diet through activation of sodium channels and sodium reabsorption (Kobori et al, 2003;Gonsalez et al, 2018). High salt intake also induces abundant production of cyclooxygenase-2 (COX-2)-derived prostaglandins in the renal medulla to modulate sodium balance (Yang et al, 1998;Yang and Liu, 2017).…”

Fatores De Risco Para O Surgimento Da Hipertensão Arterial Sistêmica: Saber Para Prevenir / Risk Factors for the Arising of Systemic Arterial Hypertension: Knowing to Prevent

“…there is an increase in vasoconstriction, which consequently increases peripheral vascular resistance, thus causing SAH (3). Diets rich in sodium are also major contributors to the emergence of hypertension, as they also act in the RASA, so that they increase their activation (4). Another important factor that contributes to the elevation of pressure is smoking, since nicotine, one of the main substances found in cigarettes, acts to increase the release of noradrenaline, adrenaline and vasopressin, which are responsible for the control of blood pressure and also of activity heart rate (5).…”