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The incidence rate and mortality of hypertension increase every year. Hypothalamic paraventricular nucleus (PVN) plays a critical role on the pathophysiology of hypertension. It has been demonstrated that the imbalance of neurotransmitters including norepinephrine (NE), glutamate (Glu) and γ-aminobutyric acid (GABA) are closely related to sympathetic overactivity and pathogenesis of hypertension. N-methyl-D-aspartate receptor (NMDAR), consisting of GluN1 and GluN2 subunits, is considered to be a glutamate-gated ion channel, which binds to Glu, and activates neuronal activity. Studies have found that the synthesis of respiratory chain enzyme complex was affected and mitochondrial function was impaired in spontaneously hypertensive rats (SHR), further indicating that mitochondria is associated with hypertension. Nuclear respiratory factor 1 (Nrf1) is a transcription factor that modulates mitochondrial respiratory chain and is related to GluN1, GluN2A, and GluN2B promoters. However, the brain mechanisms underlying PVN Nrf1 modulating sympathoexcitation and blood pressure during the development of hypertension remains unclear. In this study, an adeno-associated virus (AAV) vector carrying the shRNA targeting rat Nrf1 gene (shNrf1) was injected into bilateral PVN of male rats underwent two kidneys and one clip to explore the role of Nrf1 in mediating the development of hypertension and sympathoexcitation. Administration of shNrf1 knocked down the expression of Nrf1 and reduced the expression of excitatory neurotransmitters, increased the expression of inhibitory neurotransmitters, and reduced the production of reactive oxygen species (ROS), and attenuated sympathoexcitation and hypertension. The results indicate that knocking down Nrf1 suppresses sympathoexcitation in hypertension by reducing PVN transcription of NMDAR subunits (GluN1, GluN2A, and GluN2B), rebalancing PVN excitatory and inhibitory neurotransmitters, inhibiting PVN neuronal activity and oxidative stress, and attenuating sympathetic activity.
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http://dx.doi.org/10.3389/fnins.2021.805070 | DOI Listing |
Interv Neuroradiol
September 2025
Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
IntroductionVenous sinus stenting (VSS) is an effective, less invasive alternative to ventriculoperitoneal shunting (VPS) for idiopathic intracranial hypertension (IIH). While efficacy is comparable, with some evidence favoring VSS for headache control, perioperative costs remain under-characterized due to reliance on reimbursement rates rather than actual expenditures.ObjectiveTo compare the perioperative cost of elective VSS and VPS for IIH, including outpatient workup and follow-up costs, using detailed institutional cost data.
View Article and Find Full Text PDFJAMA
September 2025
Department of Cardiology, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, China.
JAMA
September 2025
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
High Blood Press Cardiovasc Prev
September 2025
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Blood pressure variability (BPV), independent of mean BP, is an emerging predictor of cardiovascular risk and hypertension-mediated organ damage. However, its clinical utility remains limited due to the lack of clear guideline recommendations, leading to variability in physician practices. Using the modified Delphi method, this is the first Egyptian consensus to provide expert recommendations for integrating BPV in Egypt's resource-limited settings.
View Article and Find Full Text PDFEndocrine
September 2025
Otorhinolaryngology, Head and Neck Surgery, Candiolo Cancer Institute, FPO-IRCCS Turin, Turin, Italy.
Background: While osteoporosis in primary hyperparathyroidism (PHPT) is widely studied, PHPT patients with osteopenia remain less characterized. This study aimed to evaluate the prevalence, biochemical features, and estimated fracture risk of osteopenic PHPT patients in a real-life cohort.
Methods: We retrospectively analyzed a consecutive series of PHPT patients with available densitometric data at three sites.