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Vol. 50. Núm. 1.
Páginas 14-18 (enero 2003)
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Vol. 50. Núm. 1.
Páginas 14-18 (enero 2003)
Acceso a texto completo
Especificidad de acción de la aldosterona e hipertensión arterial
Specificity of the action of aldosterone and arterial hypertension
Visitas
8180
N. Saval, A. Botey, E. Poch
Autor para correspondencia
epoch@medicina.ub.es

Correspondencia: Dr. E. Poch. Servicio de Nefrología. Hospital Clínic. Villarroel, 170. 08036 Barcelona. España
Servicio de Nefrología. Hospital Clínic. IDIBAPS. Barcelona. España
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Abstract

La enzima 11 beta-hidroxiesteroide deshidrogenasa tipo 2 (11βHSD2) confiere la especificidad de la acción de la aldosterona respecto a otros corticoides circulantes (cortisol) en los tejidos que deben responder de forma específica a los mineralocorticoides. Esta especificidad debe darse sobre todo en ciertos epitelios transportadores de sodio como el túbulo distal del riñón y en el colon. Esta enzima, poco conocida hasta hace unos años, se está revelando como de gran importancia, ya que interviene en la regulación de la presión arterial. En primer lugar, mutaciones del gen que codifica la enzima causan una forma rara de hipertensión sal sensible de herencia mendeliana autosómica recesiva conocida como exceso aparente de mineralocorticoides (AME). En segundo lugar, se ha determinado que en la población normal, polimorfismos genéticos en 11βHSD2 se asocian con una reducción de la actividad de la enzima in vivo. Esta reducción de la actividad enzimática así como los polimorfismos genéticos que la determinan se han relacionado con un incremento de la respuesta presora a la ingestión elevada de sal, fenómeno conocido como sensibilidad a la sal, tanto en sujetos sanos como en pacientes con hipertensión arterial esencial. Por tanto, es un gen candidato que intervendría en la patogenia de la hipertensión arterial (HTA) “gesencial”h, sobre todo sensible a la sal y que debe aún ser estudiado en mayor profundidad.

Palabras clave:
Aldosterona
Hipertensión
HSD11K
Túbulo renal distal
Abstract

The specificity of aldosterone with respect to other circulating corticoids (i.e. cortisol) in tissues which have to respond only to mineralocorticoids is provided by the enzime 11 beta hydroxysteroid dehydrogenase type 2 (11βHSD2). This specificity is especially criticval in certain Na-transporting epithelia such as the renal distal convoluted tubule and the distal colon. This enzime is emerging as a critical regulator of systemic blood pressure. Firstly, mutations in the gene encoding for this enzime are the cause of a rare autosomal recessive salt sensitive hypertension known as the apparent mineralocorticoid excess (AME).

Abstract

Secondly, common polymorphisms in this gene in the general population have been shown to influence the activity of the enzyme. Polymorphisms determining low enzymatic activity have been associated with increased pressor response to salt, a phenomenon known as salt-sentitivity, both in normal and in hypertensive subjects. Therefore, the gen encoding for 11βHSD2 is a candidate gene for essential hypertension, particularly the low-renin, salt sensitive form and deserves further study in hypertensive populations.

Key words:
Aldosterone
Hipertension
HSD11K
Distal convoluted tubule
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Copyright © 2003. Elsevier España, S.L.. Todos los derechos reservados
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