Importance of rostral ventrolateral medulla neurons in determining efferent sympathetic nerve activity and blood pressure

Hiroo Kumagai, Naoki Oshima, Tomokazu Matsuura, Kamon Iigaya, Masaki Imai, Hiroshi Onimaru, Katsufumi Sakata, Motohisa Osaka, Toshiko Onami, Chie Takimoto, Tadashi Kamayachi, Hiroshi Itoh, Takao Saruta

Research output: Contribution to journalReview article

92 Citations (Scopus)

Abstract

Accentuated sympathetic nerve activity (SNA) is a risk factor for cardiovascular events. In this review, we investigate our working hypothesis that potentiated activity of neurons in the rostral ventrolateral medulla (RVLM) is the primary cause of experimental and essential hypertension. Over the past decade, we have examined how RVLM neurons regulate peripheral SNA, how the sympathetic and renin-angiotensin systems are correlated and how the sympathetic system can be suppressed to prevent cardiovascular events in patients. Based on results of whole-cell patch-clamp studies, we report that angiotensin II (Ang II) potentiated the activity of RVLM neurons, a sympathetic nervous center, whereas Ang II receptor blocker (ARB) reduced RVLM activities. Our optical imaging demonstrated that a longitudinal rostrocaudal column, including the RVLM and the caudal end of ventrolateral medulla, acts as a sympathetic center. By organizing and analyzing these data, we hope to develop therapies for reducing SNA in our patients. Recently, 2-year depressor effects were obtained by a single procedure of renal nerve ablation in patients with essential hypertension. The ablation injured not only the efferent renal sympathetic nerves but also the afferent renal nerves and led to reduced activities of the hypothalamus, RVLM neurons and efferent systemic sympathetic nerves. These clinical results stress the importance of the RVLM neurons in blood pressure regulation. We expect renal nerve ablation to be an effective treatment for congestive heart failure and chronic kidney disease, such as diabetic nephropathy.

Original languageEnglish
Pages (from-to)132-141
Number of pages10
JournalHypertension Research
Volume35
Issue number2
DOIs
Publication statusPublished - 2012 Feb 1

Keywords

  • RVLM neurons
  • congenic rat
  • optical imaging
  • patch-clamp technique
  • sympathetic nervous system

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Kumagai, H., Oshima, N., Matsuura, T., Iigaya, K., Imai, M., Onimaru, H., Sakata, K., Osaka, M., Onami, T., Takimoto, C., Kamayachi, T., Itoh, H., & Saruta, T. (2012). Importance of rostral ventrolateral medulla neurons in determining efferent sympathetic nerve activity and blood pressure. Hypertension Research, 35(2), 132-141. https://doi.org/10.1038/hr.2011.208