Aorticorenal ganglion as a novel target for renal neuromodulation

Hori, Yuichi; Temma, Taro; Wooten, Christian; Sobowale, Christopher O; Tahmasian, Sarah; Chan, Christopher; Swid, Mohammed Amer; Zuckerman, Jonathan E.; Peacock, Warwick J.; Ajijola, Olujimi A.

doi:10.1016/j.hrthm.2021.06.1192

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…Direct arterial renal denervation has shown promise as a treatment for resistant hypertension and chronic kidney disease in animal models but showed suboptimal results in human trials (Reetu et al, 2018; Song et al, 2020). Hori et al, (2021) studied the possibility of aorticorenal ganglion block in pigs and found it highly effective. However, their results from two human cadavers do not match what we found other than the vast number of interconnections.…”

Section: Discussionmentioning

confidence: 99%

“…The varied results from the clinical trials, has led researchers to investigate the anatomy of the surrounding area as well as the potential of blocking the aorticorenal ganglion instead (Hori et al, 2021; Reetu et al, 2018). A recent study by Hori et al, (2021) investigated the possibility of aorticorenal ganglion ablation as an alternative means of renal denervation in pigs. They found the procedure to be effective yielding better results than direct renal denervation, with few complications.…”

Section: Introductionmentioning

confidence: 99%

“…In one clinical trial this resulted in nearly 50% of patients to be unsuitable for direct renal denervation therapy (Schönherr et al, 2016; Song et al, 2020). The varied results from the clinical trials, has led researchers to investigate the anatomy of the surrounding area as well as the potential of blocking the aorticorenal ganglion instead (Hori et al, 2021; Reetu et al, 2018). A recent study by Hori et al, (2021) investigated the possibility of aorticorenal ganglion ablation as an alternative means of renal denervation in pigs.…”

Section: Introductionmentioning

confidence: 99%

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A comprehensive study of the abdominal ganglia part 2: Aorticorenal ganglia

2022

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Investigation into reports of pain treatment for abdominal cancer and abdominal pain syndromes revealed the lack of human studies on some of the abdominal sympathetic ganglia. Recent studies on renal artery denervation therapy as treatment for resistant hypertension has made the aorticorenal ganglia of particular importance. The aim of this study was to investigate the location, morphology, interconnections, and histological nature of aorticorenal ganglia. We dissected nine abdominal cavities and harvested 37 aorticorenal ganglia. Hematoxylin and Eosin, and Masson's staining techniques were used to study the histological structure. Additionally, ganglia harvested from five individuals were stained with immunohistochemical techniques to test for tyrosine hydroxylase activity. All aorticorenal ganglia were located in proximity to the renal artery, and the majority were close to the vessel origin. Identification of multiple aorticorenal ganglia was the norm, and ranged from 2 to 4 on the left and 1 to 3 on the right. While the pattern of aorticorenal ganglia seemed to be unique in each individual case, the interconnections between these and other ganglia were vast. The aorticorenal ganglia shared direct connections with the celiac, gonadal, inferior mesenteric, and first lumbar sympathetic trunk ganglion. Contributions from the greater, lesser, and least thoracic splanchnic nerves were also observed. While the results of our study may not have direct clinical implications in isolation, the vast number of interconnections with the other abdominal ganglia may cause complications in procedures such as celiac ganglion block. In addition, aorticorenal innervation interruption may lead to hypotension.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comprehensive study of the abdominal ganglia part 2: Aorticorenal ganglia

2022

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“…Interestingly, the addition of RDN to bilateral cardiac sympathetic denervation also demonstrated efficacy in patients with recalcitrant ventricular tachycardia or fibrillation (VT/VF). 5 Further, in a large animal model of ischemia-induced VT/VF, 6 aortico-renal ganglion ablation reduced the risk of VT/VF compared with sham ablation pigs. These latter studies suggest that the benefits of RDN extend to both atrial and ventricular arrhythmias.…”

Section: Article See P 814mentioning

confidence: 96%

Chronic Kidney Disease: A Nerve-Racking Situation for the Heart

Ajijola¹

2022

Circulation Research

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“…[194][195][196] Interestingly, ablation of aorticorenal ganglion or RDN was protective against ventricular arrhythmias and sudden death after myocardial infarction in pigs. 197 A randomized clinical trial also shows the antiarrhythmic effect of RDN on atrial fibrillation. The ERADICATE-AF trial (Renal Denervation in Addition to Catheter Ablation to Eliminate Atrial Fibrillation) has shown that RDN added to pulmonary vein isolation enhanced long-term antiarrhythmic efficacy compared with pulmonary vein isolation alone in hypertensive patients with atrial fibrillation.…”

Section: Renal Afferentsmentioning

confidence: 99%

Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

Patel

Katsurada

Zheng

2022

Circulation Research

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The maintenance of cardiovascular homeostasis is highly dependent on tightly controlled interactions between the heart and the kidneys. Therefore, it is not surprising that a dysfunction in one organ affects the other. This interlinking relationship is aptly demonstrated in the cardiorenal syndrome. The characteristics of the cardiorenal syndrome state include alterations in neurohumoral drive, autonomic reflexes, and fluid balance. The evidence suggests that several factors contribute to these alterations. These may include peripheral and central nervous system abnormalities. However, accumulating evidence from animals with experimental models of congestive heart failure and renal dysfunction as well as humans with the cardiorenal syndrome suggests that alterations in neural pathways, from and to the kidneys and the heart, including the central nervous system are involved in regulating sympathetic outflow and may be critically important in the alterations in neurohumoral drive, autonomic reflexes, and fluid balance commonly observed in the cardiorenal syndrome. This review focuses on studies implicating neural pathways, particularly the afferent and efferent signals from the heart and the kidneys integrating at the level of the paraventricular nucleus in the hypothalamus to alter neurohumoral drive, autonomic pathways, and fluid balance. Further, it explores the potential mechanisms of action for the known beneficial use of various medications or potential novel therapeutic manipulations for the treatment of the cardiorenal syndrome. A comprehensive understanding of these mechanisms will enhance our ability to treat cardiorenal conditions and their cardiovascular complications more efficaciously and thoroughly.

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Aorticorenal ganglion as a novel target for renal neuromodulation

Cited by 7 publications

References 27 publications

A comprehensive study of the abdominal ganglia part 2: Aorticorenal ganglia

A comprehensive study of the abdominal ganglia part 2: Aorticorenal ganglia

Chronic Kidney Disease: A Nerve-Racking Situation for the Heart

Cardiorenal Syndrome: The Role of Neural Connections Between the Heart and the Kidneys

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