The vasoconstrictor endothelin system involvement in chronic kidney diseases pathogenesis is now the most often employed treatment method

Abstract

Over 30,000 publications have been published about the vasoconstrictor endothelin-1, which was identified by Yanagisawa and co-workers in 1988. While the evidence is quite compelling, scientists can only speculate on how the endothelin (ET) system affects blood pressure and renal function at this time. ET system involvement in chronic kidney diseases (CKD) pathogenesis is now the most often employed treatment method. ET1, ET2, and ET3 are all members of the endothelin family. Endothelium, renal, and smooth muscle cells all generate ET-1, a significant isoform found in both cardiovascular and renal systems.Kidney cells act on, and contain, ET-1. The ETA receptor is found in the brain and medulla, but not in the vasa recta or glomeruli. Epithelial and endothelial cells contain the ETB receptor, which is most prominent in collecting duct cells. 3 In several experiments, ET-1 has been established to be largely a preglomerular vasoconstrictor. Mesangial proliferation, contraction, and collagen production are regulated by ET-1 and ETB receptors in podocytes. The epithelium in the collecting duct cells in the medulla is important in controlling Na excretion and BP. Without the ET-1 gene, the mice have hypertension and reduced natriuresis in response to salt loading. Et-1, ETB receptor, and hypertension are shown in mice that have lost the ETB receptor gene. There is no correlation between blood pressure regulation and natriuresis.Combined disruption of the ETA and ETB receptors has greater effects on blood pressure and Na reabsorption than when ETB receptor activity is missing. It appears that the ETB receptor doesn't work until ETB is present. Collecting duct-derived ET receptors reduces the transport of sodium. Src kinase and MAPK1/2 decrease epidermal Na channel (ENaC) function, decreasing water and salt reabsorption. Moreover, inner medullary collecting duct cells and vasa recta-bearing cells will release NO, which decreases sodium transport.

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