New Approaches to Blockade of the Renin–Angiotensin–Aldosterone System: Characteristics and Usefulness of the Direct Renin Inhibitor Aliskiren
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概要
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Since renin inhibition interferes with the first and rate-limiting steps in the renin–angiotensin system, the renin step is a very attractive target for lowering blood pressure and minimizing target-organ damage. The newly developed direct renin inhibitor aliskiren has several attractive characteristics: it definitively reduces plasma renin activity among inhibitors of the renin–angiotensin system, is remarkably specific for human renin, exhibits a long half-life in plasma comparable to that of amlodipine, and has a high affinity for renal glomeruli and vasculature. Although these characteristics suggest the clinical usefulness and safety of aliskiren, several problems remain unsolved. Why does aliskiren have beneficial effects on the heart and kidneys of patients treated with angiotensin-converting enzyme (ACE) inhibitors and/or angiotensin II type 1–receptor blockers (ARBs)? Is the blood-pressure–lowering effect of aliskiren dependent on the plasma renin activity? Does aliskiren exert a possible adverse effect via (pro)renin receptor–dependent intracellular signals? Here, we review the characteristics and usefulness of aliskiren and discuss the current issues associated with this direct renin inhibitor.
著者
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ICHIHARA Atsuhiro
Department of Endocrinology & Anti-Aging Medicine, Keio University School of Medicine
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SAKODA Mariyo
Department of Internal Medicine, Keio University School of Medicine
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NARITA Tatsuya
Department of Internal Medicine, Keio University School of Medicine
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KINOUCHI Kenichiro
Department of Internal Medicine, Keio University School of Medicine
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ITOH Hiroshi
Department of Internal Medicine, Keio University School of Medicine
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Kurauchi-Mito Asako
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of
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Bokuda Kanako
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of
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Kurauchi-mito Asako
慶応義塾大学 医学部抗加齢内分泌学
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Narita Tatsuya
Department Of Internal Medicine Keio University School Of Medicine
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Itoh Hiroshi
Department Of Astronomy Kyoto University
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Sakoda Mariyo
Department Of Internal Medicine Keio University School Of Medicine
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Ichihara Atsuhiro
Department Of Endocrinology & Anti-aging Medicine Keio University School Of Medicine
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Kinouchi Kenichiro
Department Of Internal Medicine Keio University School Of Medicine
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Kurauchi-mito Asako
Departments Of Anti-aging Medicine & Endocrinology And Internal Medicine Keio University School
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Itoh Hiroshi
Department Of Aeronautics And Astronautics The University Of Tokyo
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Itoh Hiroshi
Department Of Advanced Materials Science Faculty Of Engineering Kagawa University
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Kinouchi Kenichiro
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of Medicine, Japan
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Bokuda Kanako
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of Medicine, Japan
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Narita Tatsuya
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of Medicine, Japan
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Kurauchi-Mito Asako
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of Medicine, Japan
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Ichihara Atsuhiro
Departments of Anti-Aging Medicine & Endocrinology and Internal Medicine, Keio University School of Medicine, Japan
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