From the Institute for Cardiovascular Studies, College of Pharmacy,
University of Houston (Texas).
AbstractDopamine plays an important
role in the regulation of renal sodium excretion. The synthesis of
dopamine and the presence of dopamine receptor subtypes
(D1A, D1B as D1-like and
D2, and D3 as D2-like) have been
shown within the kidney. The activation of D1-like
receptors located on the proximal tubules causes inhibition of tubular
sodium reabsorption by inhibiting Na,H-exchanger and Na,K-ATPase
activity. The D1-like receptors are linked to the multiple
cellular signaling systems (namely, adenylyl cyclase, phospholipase C,
and phospholipase A2) in the different regions of the
nephron. Defective renal dopamine production and/or dopamine
receptor function have been reported in human primary hypertension as
well as in genetic models of animal hypertension. There may be a
primary defect in D1-like receptors and an altered
signaling system in the proximal tubules that lead to reduced
dopamine-mediated effects on renal sodium excretion in hypertension.
Recently, it has been shown in animal models that the disruption of
either D1A or D3 receptors at the gene level
causes hypertension in mice. Dopamine and dopamine receptor agonists
also provide therapeutic potential in treatment of various
cardiovascular pathological conditions, including
hypertension. However, because of the poor bioavailability of the
currently available compounds, the use of D1-like agonists
is limited to the management of patients with severe hypertension when
a rapid reduction of blood pressure is clinically indicated and in
acute management of patients with heart failure. In conclusion, there
is convincing evidence that dopamine and dopamine receptors play an
important role in regulation of renal function, suggesting that a
defective dopamine receptor/signaling system may contribute to the
development and maintenance of hypertension. Further studies
need to be directed toward establishing a direct correlation between
defective dopamine receptor gene in the kidney and development of
hypertension. Subsequently, it may be possible to use a therapeutic
approach to correct the defect in dopamine receptor gene causing
the hypertension.
© 1998 American Heart Association, Inc.
Review
Renal Dopamine Receptor Function in Hypertension
Key Words: dopamine receptors, dopamine kidney tubules, proximal kidney hypertension, renal
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