Angiotensin II and AT<sub>1a</sub> Receptors in the Proximal Tubules of the Kidney: New Roles in Blood Pressure Control and Hypertension

oleh: Ana Paula de Oliveira Leite, Xiao C. Li, Sarah M. Nwia, Rumana Hassan, Jia L. Zhuo

Format: Article
Diterbitkan: MDPI AG 2022-02-01

Deskripsi

Contrary to public perception, hypertension remains one of the most important public health problems in the United States, affecting 46% of adults with increased risk for heart attack, stroke, and kidney diseases. The mechanisms underlying poorly controlled hypertension remain incompletely understood. Recent development in the <i>Cre/LoxP</i> approach to study gain or loss of function of a particular gene has significantly helped advance our new insights into the role of proximal tubule angiotensin II (Ang II) and its AT<sub>1</sub> (AT<sub>1a</sub>) receptors in basal blood pressure control and the development of Ang II-induced hypertension. This novel approach has provided us and others with an important tool to generate novel mouse models with proximal tubule-specific loss (deletion) or gain of the function (overexpression). The objective of this invited review article is to review and discuss recent findings using novel genetically modifying proximal tubule-specific mouse models. These new studies have consistently demonstrated that deletion of AT<sub>1</sub> (AT<sub>1a</sub>) receptors or its direct downstream target Na<sup>+</sup>/H<sup>+</sup> exchanger 3 (NHE3) selectively in the proximal tubules of the kidney lowers basal blood pressure, increases the pressure-natriuresis response, and induces natriuretic responses, whereas overexpression of an intracellular Ang II fusion protein or AT<sub>1</sub> (AT<sub>1a</sub>) receptors selectively in the proximal tubules increases proximal tubule Na<sup>+</sup> reabsorption, impairs the pressure-natriuresis response, and elevates blood pressure. Furthermore, the development of Ang II-induced hypertension by systemic Ang II infusion or by proximal tubule-specific overexpression of an intracellular Ang II fusion protein was attenuated in mutant mice with proximal tubule-specific deletion of AT<sub>1</sub> (AT<sub>1a</sub>) receptors or NHE3. Thus, these recent studies provide evidence for and new insights into the important roles of intratubular Ang II via AT<sub>1</sub> (AT<sub>1a</sub>) receptors and NHE3 in the proximal tubules in maintaining basal blood pressure homeostasis and the development of Ang II-induced hypertension.