Роль гиперактивации минералокортикоидных рецепторов в развитии кардиоренальных осложнений у пациентов с сахарным диабетом, перспективы применения селективных нестероидных антагонистов минералокортикоидных рецепторов

1. Remuzzi G, Perico N, Macia M, Ruggenenti P. The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease. Kidney Int Suppl. 2005;99:S57-65. DOI:10.1111/j.1523-1755.2005.09911.x 
2. Ferrario CM, Groban L, Wang H, et al. The renin-angiotensin system biomolecular cascade: a 2022 update of newer insights and concepts. Kidney Int Suppl. 2022;12(1):36. DOI:10.1016/j.kisu.2021.11.002
3. Parving HH, Andersen S, Jacobsen P, et al. Angiotensin receptor blockers in diabetic nephropathy: renal and cardiovascular end points. Semin Nephrol.
2004;24(2):147-57. DOI:10.1016/j.semnephrol.2003.11.003 
4. Hughes DB, Britton ML. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers for prevention and treatment of nephropathy associated with type 2 diabetes mellitus. Pharmacotherapy. 2005;25(11):1602-20. DOI:10.1592/phco.2005.25.11.1602
5. Chaudhuri A, Ghanim G, Arora P. Improving the residual risk of renal and cardiovascular outcomes in diabetic kidney disease: A review of pathophysiology, mechanisms, and evidence from recent trials. Diabetes Obes Metab. 2022;24:365-76. DOI:10.1111/dom.14601
6. Shunan F, Jiqing Y, Xue D. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on cardiovascular events in patients with diabetes and overt nephropathy: a meta-analysis of randomised controlled trials. J Renin Angiotensin Aldosterone Syst. 2018;19(4):1470320318803495. DOI:10.1177/1470320318803495
7. Tylicki L, Larczynski W, Rutkowski B. Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney Blood Press Res. 2005;28(4):230-42. DOI:10.1159/000087842
8. Tylicki L, Lizakowski S, Rutkowski B. Renin-angiotensin-aldosterone system blockade for nephroprotection: current evidence and future directions. J Nephrol. 2012;25(6):900-10. DOI:10.5301/jn.5000134
9. Bomback AS, Klemmer PJ. The incidence and implications of aldosterone breakthrough. Nat Clin Pract Nephrol. 2007;3(9):486-92. DOI:10.1038/ncpneph0575
10. Epstein M. Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: an extraordinary paradigm shift. Kidney Int Suppl. 2022;12:1-6. DOI:10.1016/j.kisu.2021.11.007
11. Bauersachs J, Lother A. Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms. Kidney Int Suppl. 2022;12:1-6. DOI:10.1016/j.kisu.2021.11.007 
12. Brown NJ. Contribution of aldosterone to cardiovascular and renal inflammation and fibrosis. Nat Rev Nephrol. 2013;9(8):459-69. DOI:10.1038/nrneph.2013.110
13. Wish JB, Pergola P. Evolution of mineralocorticoid receptor antagonists in the treatment of chronic kidney disease associated with type 2 diabetes mellitus. Mayo Clin Proc Inn Qual Out. 2022;6(6):536-51. Available at: http://creativecommons.org/licenses/by-nc-nd/4.0/ Accessed: 15.08.2023.
14. Rossing P. Clinical perspective – evolving evidence of mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes. Kidney Int Supl.
2022;12:27-35. DOI:10.1016/j.kisu.2021.11.005
15. Трубицына Н.П., Зайцева Н.В., Северина А.С., Шамхалова М.Ш. Хроническая болезнь почек у пациентов с сахарным диабетом 2 типа: новые мишени лекарственного воздействия. ­Сахарный диабет. 2022;25(5):492-8 [Trubitsyna NP, Zaitseva NV, Severinа AS, Shamkhalova MS. Chronic kidney disease in patients with type 2 diabetes: new targets of medicine action. Diabetes Mellitus. 2022;25(5):492-8 (in Russian)]. DOI:10.14341/DM12944
16. Мкртумян А.М., Подачина С.В., Соловьева И.В. Финеренон – новый высокоселективный нестероидный антагонист минералокортикоидных рецепторов для профилактики кардиоренальных осложнений у пациентов с хронической болезнью почек и сахарным диабетом 2 типа. Эффективная фармакотерапия. 2023;19(12):16‑28 [Mkrtumyan AM, Podachina SV, Solovyova IV. Finerenon is a new highly selective nonsteroidal antagonist of mineralocorticoid receptors for the prevention of cardiorenal complications in patients with chronic kidney disease and type 2 diabetes mellitus. Effectivnaja farmakoterapija. 2023;19(12):16-28 (in Russian)]. DOI:10.33978/2307-3586-2023-19-12-16-28
17. Epstein M. Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: from Hans Selye to the present. Am J Nephrol. 2021;52:209-16. DOI:10.1159/000515622
18. Funder JW. Minireview: Aldosterone and mineralocorticoid receptors: past, present, and future. Endocrinology. 2010;151(11):5098-102. DOI:10.1210/en.2010-0465
19. Luther JM, Fogo AB. The role of mineralocorticoid receptor activation in kidney inflammation and fibrosis. Kidney Int Sup. 2022;12:63-8. DOI:10.1016/j.kisu.2021.11.006
20. Nakamura T, Girerd S, Jaisser F, Barrera-Chimal J. Nonepithelial mineralocorticoid receptor activation as a determinant of kidney disease. Kidney Int Suppl. 2022;12(1):12-8. DOI:10.1016/j.kisu.2021.11.004
21. Lerma EV, Daniel J, Wilson DJ. Finerenone: a mineralocorticoid receptor antagonist for the treatment of chronic kidney disease associated with type 2 diabetes. Expert Rev Clin Pharmacol. 2022;15(5):501-13. DOI:10.1080/17512433.2022.2094770 
22. Lerma E, White WB, Bakris G. Effectiveness of nonsteroidal mineralocorticoid receptor antagonists in patients with diabetic kidney disease. Postgrad Med. 2023;135(3):224-33. DOI:10.1080/00325481.2022.2060598
23. Ong GSY, Young MJ. Mineralocorticoid regulation of cell function: the role of rapid signalling and gene transcription pathways. J Mol Endocrinol. 2017;58(1):R33-57. DOI:10.1530/JME-15-0318
24. Barrera-Chimal J, Bonnard B, Jaisser F. Roles of mineralocorticoid receptors in cardiovascular and cardiorenal diseases. Annu Rev Physiol. 2022;84:585610.
DOI:10.1146/annurev-physiol-060821-013950
25. Kolkhof P, Lawatscheck R, Filippatos G, Bakris GL. Nonsteroidal mineralocorticoid receptor antagonism by finerenone-translational aspects and clinical perspectives across multiple organ systems. Int J Mol Sci. 2022;23(16):9243. DOI:10.3390/ijms23169243
26. Bolignano D, Palmer SC, Navaneethan SD, Strippoli GFM. Aldosterone antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2014;4:CD007004. DOI:10.1002/14651858.CD007004.pub3
27. Chung EY, Ruospo M, Natale P, et al. Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2020;10(10):CD007004. DOI:10.1002/14651858.CD007004.pub4
28. Bakris GL, Agarwal R, Anker SD, et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med. 2020;383(23):2219-29. DOI:10.1056/NEJMoa2025845
29. Pitt B, Filippatos G, Agarwal R, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med. 2021;385(24):2252-63. DOI:10.1056/NEJMoa2110956
30. Tezuka Y, Ito S. The time to reconsider mineralocorticoid receptor blocking strategy: arrival of nonsteroidal mineralocorticoid receptor blockers. Curr Hypertens Rep.
2022;24:215-24. DOI:10.1007/s11906-022-01177-6
31. Kintscher U, Bakris GL, Kolkhof P. Novel non-steroidal mineralocorticoid receptor antagonists in cardiorenal disease. Br J Pharmacol. 2022;179(13):3220-34. DOI:10.1111/bph.15747
32. Bakris GL, Agarwal R, Chan JC, et al. Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial. JAMA. 2015;314(9):884-94. DOI:10.1001/jama.2015.10081
33. Rossing P, Filippatos G, Agarwal R, et al. Finerenone in Predominantly Advanced CKD and Type 2 Diabetes With or Without Sodium-Glucose Cotransporter-2 Inhibitor Therapy. Kidney Int Rep. 2021;7(1):36-45. DOI:10.1016/j.ekir.2021.10.008 
34. Blazek O, Bakris GL. The evolution of “pillars of therapy” to reduce heart failure risk and slow diabetic kidney disease progressiоn. Am Heart J Plus. 2022;19:100187. DOI:10.1016/j.ahjo.2022.100187 

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1. Remuzzi G, Perico N, Macia M, Ruggenenti P. The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease. Kidney Int Suppl. 2005;99:S57-65. DOI:10.1111/j.1523-1755.2005.09911.x 
2. Ferrario CM, Groban L, Wang H, et al. The renin-angiotensin system biomolecular cascade: a 2022 update of newer insights and concepts. Kidney Int Suppl. 2022;12(1):36. DOI:10.1016/j.kisu.2021.11.002
3. Parving HH, Andersen S, Jacobsen P, et al. Angiotensin receptor blockers in diabetic nephropathy: renal and cardiovascular end points. Semin Nephrol.
2004;24(2):147-57. DOI:10.1016/j.semnephrol.2003.11.003 
4. Hughes DB, Britton ML. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers for prevention and treatment of nephropathy associated with type 2 diabetes mellitus. Pharmacotherapy. 2005;25(11):1602-20. DOI:10.1592/phco.2005.25.11.1602
5. Chaudhuri A, Ghanim G, Arora P. Improving the residual risk of renal and cardiovascular outcomes in diabetic kidney disease: A review of pathophysiology, mechanisms, and evidence from recent trials. Diabetes Obes Metab. 2022;24:365-76. DOI:10.1111/dom.14601
6. Shunan F, Jiqing Y, Xue D. Effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on cardiovascular events in patients with diabetes and overt nephropathy: a meta-analysis of randomised controlled trials. J Renin Angiotensin Aldosterone Syst. 2018;19(4):1470320318803495. DOI:10.1177/1470320318803495
7. Tylicki L, Larczynski W, Rutkowski B. Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney Blood Press Res. 2005;28(4):230-42. DOI:10.1159/000087842
8. Tylicki L, Lizakowski S, Rutkowski B. Renin-angiotensin-aldosterone system blockade for nephroprotection: current evidence and future directions. J Nephrol. 2012;25(6):900-10. DOI:10.5301/jn.5000134
9. Bomback AS, Klemmer PJ. The incidence and implications of aldosterone breakthrough. Nat Clin Pract Nephrol. 2007;3(9):486-92. DOI:10.1038/ncpneph0575
10. Epstein M. Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: an extraordinary paradigm shift. Kidney Int Suppl. 2022;12:1-6. DOI:10.1016/j.kisu.2021.11.007
11. Bauersachs J, Lother A. Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms. Kidney Int Suppl. 2022;12:1-6. DOI:10.1016/j.kisu.2021.11.007 
12. Brown NJ. Contribution of aldosterone to cardiovascular and renal inflammation and fibrosis. Nat Rev Nephrol. 2013;9(8):459-69. DOI:10.1038/nrneph.2013.110
13. Wish JB, Pergola P. Evolution of mineralocorticoid receptor antagonists in the treatment of chronic kidney disease associated with type 2 diabetes mellitus. Mayo Clin Proc Inn Qual Out. 2022;6(6):536-51. Available at: http://creativecommons.org/licenses/by-nc-nd/4.0/ Accessed: 15.08.2023.
14. Rossing P. Clinical perspective – evolving evidence of mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes. Kidney Int Supl.
2022;12:27-35. DOI:10.1016/j.kisu.2021.11.005
15. Trubitsyna NP, Zaitseva NV, Severinа AS, Shamkhalova MS. Chronic kidney disease in patients with type 2 diabetes: new targets of medicine action. Diabetes Mellitus. 2022;25(5):492-8 (in Russian). DOI:10.14341/DM12944
16. Mkrtumyan AM, Podachina SV, Solovyova IV. Finerenon is a new highly selective nonsteroidal antagonist of mineralocorticoid receptors for the prevention of cardiorenal complications in patients with chronic kidney disease and type 2 diabetes mellitus. Effectivnaja farmakoterapija. 2023;19(12):16-28 (in Russian). 
DOI:10.33978/2307-3586-2023-19-12-16-28
17. Epstein M. Aldosterone and mineralocorticoid receptor signaling as determinants of cardiovascular and renal injury: from Hans Selye to the present. Am J Nephrol. 2021;52:209-16. DOI:10.1159/000515622
18. Funder JW. Minireview: Aldosterone and mineralocorticoid receptors: past, present, and future. Endocrinology. 2010;151(11):5098-102. DOI:10.1210/en.2010-0465
19. Luther JM, Fogo AB. The role of mineralocorticoid receptor activation in kidney inflammation and fibrosis. Kidney Int Sup. 2022;12:63-8. DOI:10.1016/j.kisu.2021.11.006
20. Nakamura T, Girerd S, Jaisser F, Barrera-Chimal J. Nonepithelial mineralocorticoid receptor activation as a determinant of kidney disease. Kidney Int Suppl. 2022;12(1):12-8. DOI:10.1016/j.kisu.2021.11.004
21. Lerma EV, Daniel J, Wilson DJ. Finerenone: a mineralocorticoid receptor antagonist for the treatment of chronic kidney disease associated with type 2 diabetes. Expert Rev Clin Pharmacol. 2022;15(5):501-13. DOI:10.1080/17512433.2022.2094770 
22. Lerma E, White WB, Bakris G. Effectiveness of nonsteroidal mineralocorticoid receptor antagonists in patients with diabetic kidney disease. Postgrad Med. 2023;135(3):224-33. DOI:10.1080/00325481.2022.2060598
23. Ong GSY, Young MJ. Mineralocorticoid regulation of cell function: the role of rapid signalling and gene transcription pathways. J Mol Endocrinol. 2017;58(1):R33-57. DOI:10.1530/JME-15-0318
24. Barrera-Chimal J, Bonnard B, Jaisser F. Roles of mineralocorticoid receptors in cardiovascular and cardiorenal diseases. Annu Rev Physiol. 2022;84:585610.
DOI:10.1146/annurev-physiol-060821-013950
25. Kolkhof P, Lawatscheck R, Filippatos G, Bakris GL. Nonsteroidal mineralocorticoid receptor antagonism by finerenone-translational aspects and clinical perspectives across multiple organ systems. Int J Mol Sci. 2022;23(16):9243. DOI:10.3390/ijms23169243
26. Bolignano D, Palmer SC, Navaneethan SD, Strippoli GFM. Aldosterone antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2014;4:CD007004. DOI:10.1002/14651858.CD007004.pub3
27. Chung EY, Ruospo M, Natale P, et al. Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2020;10(10):CD007004. DOI:10.1002/14651858.CD007004.pub4
28. Bakris GL, Agarwal R, Anker SD, et al. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med. 2020;383(23):2219-29. DOI:10.1056/NEJMoa2025845
29. Pitt B, Filippatos G, Agarwal R, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med. 2021;385(24):2252-63. DOI:10.1056/NEJMoa2110956
30. Tezuka Y, Ito S. The time to reconsider mineralocorticoid receptor blocking strategy: arrival of nonsteroidal mineralocorticoid receptor blockers. Curr Hypertens Rep.
2022;24:215-24. DOI:10.1007/s11906-022-01177-6
31. Kintscher U, Bakris GL, Kolkhof P. Novel non-steroidal mineralocorticoid receptor antagonists in cardiorenal disease. Br J Pharmacol. 2022;179(13):3220-34. DOI:10.1111/bph.15747
32. Bakris GL, Agarwal R, Chan JC, et al. Effect of finerenone on albuminuria in patients with diabetic nephropathy: a randomized clinical trial. JAMA. 2015;314(9):884-94. DOI:10.1001/jama.2015.10081
33. Rossing P, Filippatos G, Agarwal R, et al. Finerenone in Predominantly Advanced CKD and Type 2 Diabetes With or Without Sodium-Glucose Cotransporter-2 Inhibitor Therapy. Kidney Int Rep. 2021;7(1):36-45. DOI:10.1016/j.ekir.2021.10.008 
34. Blazek O, Bakris GL. The evolution of “pillars of therapy” to reduce heart failure risk and slow diabetic kidney disease progressiоn. Am Heart J Plus. 2022;19:100187. DOI:10.1016/j.ahjo.2022.100187 

И.Н. Бобкова*

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*bobkova_i_n@staff.sechenov.ru

________________________________________________

Irina N. Bobkova*

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*bobkova_i_n@staff.sechenov.ru