arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2022-28-4-328-347arthyper-2158Research ArticleСтатьиArticlesАнгиотензин II и предсердный натрийуретический пептид — единство и борьба противоположностей в модели реноваскулярной гипертензии «2 почки, 1 зажим». МетаанализAngiotensin II and atrial natriuretic peptide — unity and struggle of opposites in the model of renovascular hypertension “2 kidneys, 1 clamp”: A meta-analysishttps://orcid.org/0000-0001-6027-7325КузьменкоН. В.KuzmenkoN. V.

Кузьменко Наталия Владимировна — кандидат биологических наук, старший научный сотрудник отдела экспериментальной физиологии и фармакологии НМИЦ им. В.А. Алмазова Минздрава России.

ул. Аккуратова, д. 2, Санкт-Петербург, 197341.

Natalia V. Kuzmenko - Candidate of Biological Sciences, Senior Researcher, Department of Experimental Physiology and Pharmacology, Almazov National Medical Research Centre.

2 Akkuratova street, St Petersburg, 197341.

nat.kuzmencko2011@yandex.ruhttps://orcid.org/0000-0002-7767-8560ЦырлинВ. А.TsyrlinV. A.

Цырлин Виталий Александрович — доктор медицинских наук, главный научный сотрудник отдела экспериментальной физиологии и фармакологии НМИЦ им. В.А. Алмазова Минздрава России.

Санкт-Петербург.

Vitaliy A. Tsyrlin - MD, PhD, DSc, Professor, Chief Researcher, Department of Experimental Physiology and Pharmacology, Almazov National Medical Research Centre.

St Petersburg.

tsyrlinva@mail.ruhttps://orcid.org/0000-0002-1515-1616ПлиссМ. Г.PlissM. G.

Плисс Михаил Гениевич — кандидат медицинских наук, заведующий отделом экспериментальной физиологии и фармакологии НМИЦ им. В.А. Алмазова Минздрава России.

Санкт-Петербург.

Mikhail G. Pliss - PhD, Head, Department of Experimental Physiology and Pharmacology, Almazov National Medical Research Centre.

St Petersburg.

pliss@niiekf.ruНациональный медицинский исследовательский центр имени В.А. Алмазова Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian Federation202219042022284328347Copyright © Кузьменко Н.В., Цырлин В.А., Плисс М.Г., 20222022Кузьменко Н.В., Цырлин В.А., Плисс М.Г.Kuzmenko N.V., Tsyrlin V.A., Pliss M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2158

К настоящему времени модель Голдблатт гипертензии «2 почки, 1 зажим» исследована в большом количестве экспериментальных работ. Известно, что активация ренин-ангиотензиновой системы (РАС) лежит в основе развития данной гипертензии. Основным буфером РАС является предсердный натрийуретический пептид (ПНП), уровень которого существенно повышается в ответ на рост артериального давления (АД) и высокую концентрацию ангиотензина II и ионов Na+. ПНП обладает выраженным гипотензивным действием. Клинические и экспериментальные исследования показывают, что унилатеральная реноваскулярная гипертензия (УРГ) развивается не всегда даже при существенном стенозе почечной артерии. Цель настоящей работы — исследовав с помощью метаанализа литературных данных активность РАС и ПНП, сдвиги в водно-электролитном балансе, а также симпатическую активность почечных нервов, изучить гипертензивные и гипотензивные механизмы в модели реноваскулярной гипертензии «2 почки, 1 зажим». Материалы и методы. Метаанализ был проведен при помощи статистической программы Review Manager 5.3 (Cochrane Library). В метаанализе были использованы данные 76 публикаций, посвященных экспериментальным исследованиям модели УРГ на крысах. Результаты и выводы. Проведенный нами метаанализ показал, что поддержание УРГ обеспечивается высокой активностью РАС и симпатической нервной системы, а также гипокалиемией и ремоделированием сердечно-сосудистой системы. Однако мы не получили убедительных доказательств влияния натрий-объем-зависимых механизмов на подъем АД при данной модели гипертензии.

Background. Today, the Goldblatt model of hypertension “2 kidneys, 1 clamp” has been investigated in a large number of experimental studies. The activation of the renin-angiotensin system (RAS) underlies the development of this type of hypertension. The main buffer of the RAS is the atrial natriuretic peptide (ANP), its level is significantly increased in response to blood pressure (BP) elevation and high concentration of angiotensin II and Na+. ANP has a pronounced hypotensive effect. Clinical and experimental studies show that unilateral renovascular hypertension (URH) does not always develop even in significant stenosis of the renal artery. The purpose of this work is to investigate the activity of the RAS and the ANP, shifts in the water-electrolyte balance and renal sympathetic nervous activity via meta-analysis, to evaluate hypertensive and hypotensive mechanisms in the model of renovascular hypertension “2 kidneys, 1 clamp”. Design and methods. The meta-analysis was carried out by statistical program Review Manager 5.3 (Cochrane Library). In a meta-analysis, we used 76 publications of experimental studies of the model of renovascular hypertension in rats. Results and conclusions. The meta-analysis showed that the maintenance of URH is ensured by the high activity of the RAS and the sympathetic nervous system, as well as hypokalemia and cardiovascular remodeling. However. there is no convincing evidence of the effect of sodium-volume-dependent mechanisms on BP elevation in this model of hypertension.

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The authors declare that there are no conflicts of interest present.