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Артериальная гипертензия

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Эндогенные кардиотонические стероиды: клинические перспективы

https://doi.org/10.18705/1607-419X-2008-14-3-220-232

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Аннотация

В настоящее время выявлено несколько эндогенных кардиотонических стероидов, или дигиталис-подобных факторов, у человека; среди них уабаин, относящийся к классу карденолидов, и маринобуфагенин, из класса буфадиенолидов, изучены наиболее подробно. Физиологической функцией кардиотонических стероидов является поддержание гомеостаза натрия и регуляция натрийуреза на уровне почек. Эндогенные кардиотонические стероиды, связываясь с Na/K-АТФ-азой, не только ингибируют трансмембранный транспорт моновалентных катионов, а также активируют Src-EGF-опосредованный путь клеточной сигнализации. У крыс линии Dahl с соль-индуцированной артериальной гипертензией эндогенный уабаин действует как нейрогормон, стимулируя высвобождение маринобуфагенина, обладающего натриуретическим и сосудосуживающим свойствами. У ряда больных полиморфизм гена альфа-аддуцина на фоне повышения уровня эндогенного уабаина приводит к активации Na/K-АТФ-азы в почечных канальцах и ретенции натрия, что является триггером развития гипертензии. Эндогенные кардиотонические стероиды также вносят вклад в патогенез хронической сердечной недостаточности, преэклампсии и сахарного диабета. Иммунонейтрализация, антагонизм рецепторов кардиотонических стероидов, ингибирование протеин-киназы С и активация протеин-киназы G являются потенциальными подходами к фармакологическому антагонизму нежелательных эффектов кардиотонических стероидов.

Об авторах

О. Федорова
Национальный институт старения, Национальные институты здоровья
Россия


Л. Коростовцева
Федеральный центр сердца, крови и эндокринологии им. В.А. Алмазова
Россия


Д. Шапиро
Медицинский колледж Университета Толедо
Россия


А. Багров
Национальный институт старения, Национальные институты здоровья
Россия


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Для цитирования:


Федорова О., Коростовцева Л., Шапиро Д., Багров А. Эндогенные кардиотонические стероиды: клинические перспективы . Артериальная гипертензия. 2008;14(3):220-232. https://doi.org/10.18705/1607-419X-2008-14-3-220-232

For citation:


Fedorova O.V., Korostovtseva L., Shapiro J., Bagrov A. Endogenous cardiotonic steroids: clinical perspectives . "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2008;14(3):220-232. (In Russ.) https://doi.org/10.18705/1607-419X-2008-14-3-220-232

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