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Pizzo TRF, Valverde AP, Orzari LE, Terciotti LG, de Lima RD, Costa do Bomfim FR, Esquisatto MAM, de Andrade TAM, Corezola do Amaral ME, de Oliveira CA, Felonato M. Caloric restriction improves inflammation in different tissues of the Wistar rats with obesity and 2K1C renovascular hypertension. Can J Physiol Pharmacol 2023; 101:661-671. [PMID: 37746936 DOI: 10.1139/cjpp-2022-0452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Renovascular hypertension (RHV) is the cause of high blood pressure due to left renal ischemia, and obesity and hypertension cause an inflammatory response. This work analyzed the inflammatory and tissue repair profile in renal, hepatic, and cardiac tissues in an animal model of RVH associated with a high-fat diet and caloric restriction. The expressions of RORγ-t, IL-17, T-bet, and TNF-α decreased and IFN-γ increased in the right kidney. In relation to the left kidney, caloric restriction decreased the expression of IFN-γ. In the liver, caloric restriction decreased RORγ-t, IL-17, and T-bet. Hypertension associated with obesity decreased the expression of IFN-γ, while caloric restriction increased. In the right kidney, hypertension and obesity, associated or not with caloric restriction, increased the area of collagen fibers. In the heart and liver, caloric restriction reduced the area of collagen fibers. Caloric restriction increased vascular endothelial growth factor, reduced levels of growth transformation factor-β1 (TGF-β), and increased collagen I in the left kidney. Hypertension/obesity, submitted or not having caloric restriction, increased TGF-β in liver. The results suggest that caloric restriction has beneficial effects in lowering blood pressure and regulating tissue proinflammatory cytokines. However, there was no change in the structure and composition of tissue repair markers.
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Affiliation(s)
- Thayane Rafaela Feola Pizzo
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Ana Paula Valverde
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Lucas Eduardo Orzari
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Luiz Gustavo Terciotti
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Robson Damasceno de Lima
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Fernando Russo Costa do Bomfim
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Marcelo Augusto Marreto Esquisatto
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Thiago Antônio Moretti de Andrade
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Maria Esméria Corezola do Amaral
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Camila Andrea de Oliveira
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
| | - Maíra Felonato
- Graduate Program of Biomedical Sciences, University Center of Herminio Ometto Foundation-FHO, Av. Dr. Maximiliano Baruto, 500-Jd. Universitário, 13607-339, Araras, São Paulo, Brasil
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Renovascular hypertension in pediatric patients: update on diagnosis and management. Pediatr Nephrol 2021; 36:3853-3868. [PMID: 33851262 DOI: 10.1007/s00467-021-05063-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 01/03/2023]
Abstract
Renovascular hypertension (RVH) is defined as an elevated blood pressure caused by kidney hypoperfusion, generally as a result of anatomic stenosis of the renal artery with consequent activation of the Renin Angiotensin-Aldosterone System. The main causes include genetic and inflammatory disorders, extrinsic compression, and idiopathic alterations. RVH is often asymptomatic and should be suspected in any child with refractory hypertension, especially if other suggestive findings are present, including those with severe hypertension, abdominal bruit, and abrupt fall of glomerular filtration rate after administration of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. There is a consensus that digital subtraction angiography is the gold standard method for the diagnosis of RVH. Nevertheless, the role of non-invasive imaging studies such as Doppler ultrasound, magnetic resonance angiography, or computed tomographic angiography remains controversial, especially due to limited pediatric evidence. The therapeutic approach should be individualized, and management options include non-surgical pharmacological therapy and revascularization with percutaneous transluminal renal angioplasty (PTRA) or surgery. The prognosis is related to the procedure performed, and PTRA has a higher restenosis rate compared to surgery, although a decreased risk of complications. This review summarizes the causes, physiopathology, diagnosis, treatment, and prognosis of RVH in pediatric patients. Further studies are required to define the best approach for RVH in children.
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