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01-05-2013 | Educational Review

Endothelin antagonists in hypertension and kidney disease

Authors: Kevin E. C. Meyers, Christine Sethna

Published in: Pediatric Nephrology | Issue 5/2013

Abstract

The endothelin (ET) system seems to play a pivotal role in hypertension and in proteinuric kidney disease, including the micro- and macro-vascular complications of diabetes. Endothelin-1 (ET-1) is a multifunctional peptide that primarily acts as a potent vasoconstrictor with direct effects on systemic vasculature and the kidney. ET-1 and ET receptors are expressed in the vascular smooth muscle cells, endothelial cells, fibroblasts and macrophages in systemic vasculature and arterioles of the kidney, and are associated with collagen accumulation, inflammation, extracellular matrix remodeling, and renal fibrosis. Experimental evidence and recent clinical studies suggest that endothelin receptor blockade, in particular selective ET_AR blockade, holds promise in the treatment of hypertension, proteinuria, and diabetes. Concomitant blockade of the ET_B receptor is not usually beneficial and may lead to vasoconstriction and salt and water retention. The side-effect profile of ET receptor antagonists and relatively poor antagonist selectivity for ET_A receptor are limitations that need to be addressed. This review will discuss what is currently known about the endothelin system, the role of ET-1 in the pathogenesis of hypertension and kidney disease, and summarize literature on the therapeutic potential of endothelin system antagonism.

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Title: Endothelin antagonists in hypertension and kidney disease
Authors: Kevin E. C. Meyers
Christine Sethna
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 5/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-012-2316-4

At a glance: The STEP trials

Springer Medicine

Endothelin antagonists in hypertension and kidney disease

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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