The mineralocorticoid receptor (MR) plays a key role in cardiovascular and renal injury. The underlying mechanisms seem to involve the epidermal growth factor receptor (EGFR) for the development of fibrosis and vascular dysfunction. Both enhanced EGFR transactivation by activated MR as well as upregulation of EGFR expression by aldosterone-bound MR have been described. While the former seems to be mediated by the tyrosine kinase cSrc, reporter gene assays and chromatin immunoprecipitation data indicate that the latter is caused by an interaction between MR and the EGFR promoter. Pharmacological inhibition of EGFR function prevents some of MR´s pathological actions in cell culture systems, like vascular smooth muscle cells. Thus, transactivation as well as enhanced expression of EGFR may be an important switch for the pathophysiological actions in the reno-cardiovascular continuum. Furthermore, EGFR signaling may serve as a negative feedback loop to limit sodium retention. Overall, MR´s "misuse" of the EGFR is one possible explanation for the pathophysiological effects of aldosterone, making the EGFR a potential target for therapeutical interventions against reno-cardiovascular remodelling.
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Non-classical actions of aldosterone and EGFR 3
Classical and non-classical effects of the mineralocorticoid receptor and aldosteroneAldosterone is a steroid hormone and the main mineralocorticoid in humans. It is secreted by the zona glomerulosa of the adrenal cortex and for a long time was thought to be primarily involved in electrolyte and volume homeostasis. These classical actions of aldosterone have been mostly studied in the distal nephron and collecting duct of the kidney in the so-called principal cells, responsible for sodium reabsorption and potassium secretion. Aldosterone enters the principal cells presumably by diffusion and bind to its receptor, the mineralocorticoid receptor (MR), located mainly in the cytosol tethered to a heteromeric complex containing hsp90 and other chaperone molecules (Arriza et al., 1987;. Upon hormone binding, the MR dissociates from this complex, forms homodimers and translocates to the nucleus where it acts as a ligand-induced transcription factor, binding to response elements and modulating the expression of aldosterone-sensitive genes. So far, no mineralocorticoid receptor specific promoter elements have been described and the only binding sites known are shared between the glucocorticoid receptor and the mineralocorticoid receptor and are therefore called glucocorticoid response elements (GRE). In the case of principal cells, the epithelial sodium channel (ENaC), potassium channel ROMK, Na + /K + -ATPase and mitochondrial enzymes are known targets of MR regulation. The cellular response -sodium reabsorption and potassium secretion eventually leads to systemic alterations, like salt and water retention, enhanced blood pressure, hypokalemia and alkalosis. Similar mechanisms of action also occur in other tight epithelia, like the ...