II . Humoral regulation of cardiovascular system ??????????

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II . Humoral regulation of
cardiovascular system ??????????
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• 1. ??-?????-?????(RAAS)
• 2. ???????????
• 3. ?????
• 4. ???????????
• 5. ?????
• 6. ?????-????

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1. Renin-angiotension-aldosterone
system(RAA??-?????-?????(RAAS)
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• ??????
• ???
• Na?

??????????
??????
AI
ACE
AII
????????
?????
???
???
??
??????
ADH
??????
????
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(1)Angiotonin II ?????II (AII)

• angiotensinogen ( a2-globulin)
• renin (kidney )
• angiotensin?(decapeptide)
• converting enzyme (pneumoangiogram)
• angiotensin?(octapeptide) AT1 receptor
• angiotensinase A
• angiotensin ?(heptapeptide)

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• a. The formation of angiotonin
• ?????????
• ??????(???)
• ???(???????)
• ??????(10?)
• ?(???,??????)
• ??????(8?)AT1??
• ???????A
• ?????III(7?)

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b. Physiological function of angiotensin ?
???????????

• ? The systemic arterioles contracts and the
  peripheral
• resistance increases.
• ???????,??????
• ? The veins contracts and the returned blood
  increases.
• ????,??????

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• ? Prejunctional modulation, promote the
  sympathetic
• nerve ending to excrete NA.
• ?????,??????????NA?
• ? Action on the specific receptors of CNS , the
• sympathesis vasoconstrictor tone ?.
• ?????????,?????????
• ? Stimulate the formation and excretion of
  aldosterone, the reabsorption of sodium and
  fluid increases and thus the BP increases too.
• ?????????,??????,????

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• (2) Aldosterone ???
• Synthesis position adrenal cortex ZG cell
• ??????????????
• critical organ distal tubule ?collecting duct
• ???????????
• Function to keep Na and excrete K .
• ???Na?K???

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• mechanism of action
• ????
• 
  
• 
  
• 
  

• ????????Na ???
• ????????ATP
• ??????Na ???

???
????? ????

• K????
• ???(?K)

• ??Na?????? (?Na)

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• 2. Adrenaline(Adr) and noradrenaline (NA)
• ???????????
• Synthesis postion ????
• (1)adrenal medulla ?????
• Adr 80, NE 20
• ????80,?????? 20
• (2)adrenergic nerve ending ?????????
• Secrete NA only.
• ??????NA???

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???? ???
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?????? ???
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• 3. vasopressin (Antidiuretic hormone )
• ?????(?????)
• Synthesis position
• supraoptic nucleus and paraventricular
  nucleus.
• Store in posterior pituitary gland and
  release to
• blood stream.
• ???????????????????
• ?????????,???????????

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• V1 receptor constriction of blood vessel
  increase
• in blood pressure.
• ??V1??????,????
• V2 receptor reabsorption of H2O from
  collecting
• duct increases.
• ??V2??????????????

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• Physical function ????
• In normal condition , the increase in the
  level of ADH in plasma firstly induces the effect
  of antidiuresis,and only when its level increases
  definitely ,the BP increases. ADH plays an
  important role in the regulation of the volume of
  extracellular fluid .Under the condition of water
  bearing , water depletion and blood loss ,the
  secretion of ADH increases to keep the normal
  volume of body fluid and maintain the normal BP.

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• ?????,???ADH??????????????,???????????,????????
  ADH??????????????????????????????,ADH????,???????,
  ???????

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• 4. Endothelium-derived vasoactive substances
• ?????????????
• (1) Endothelium-derived relaxing substances
• ????????????
• Prostacyclin ????(PGI2)
• Endothelium-derived relaxing factor- NO
• ????????-????(NO)

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Endothelium-derived relaxing factor- NO
????????-????(NO)
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The finding process of NO

• In 1977 Murad
• Find glycerol trinitrate educe its
  endothelium-
• relaxing effect through NO.
• In 1980 Furchgott
• Presume Ach educe its its endothelium-
  relaxing effect through EDRF.
• In 1987 Moncada
• Certificate the EDRF is in fact NO through
  the
• way of waterfall-type shower .

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NO?????

• 1977? ???(Murad)
• ????????????????????NO????
• 1980? ????(Furchgott)
• ??Ach?????????EDRF??????????
• 1987? ???(Moncada)
• ???????????EDRF??NO?

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Physical function of NO NO?????
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???
AC
NOS
????
???
NO
cGMP?
Ca2i?
?NOS ??Ach,???,P??,5-HT,ATP ?NOS ??NA,ADH,AII
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(2) Endothelium-derived vasoconstrictor
substances ????????????

• Endothelin ???(ET) 21?
• Vascular endothelial cell excretes , strong
  vasoconstrictor.
• ????????????????
• Endothelin causes first decrease in BP and
  followed by
• long-term of the increase in BP.
• ???????????????????

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5. Atrial natriuretic peptide (ANP)
?????(ANP)

• Synthesis positionatrial muscle cell (28
  peptides)
• ?????????,28? Target organ heart, blood
  vessels, kidney, CNS
• ?????,??,??,??
• The blood volume increases, the atrium wall
  stretches
• ?ANP? .
• ?????,????????ANP? ?

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Physiological function ????

• HR ?,CO ?
• ???,??????
• The blood vessel dilates and the peripheral
• resistance increases.
• ????,??????
• To inhibit the activity of RAAS system,the
  secretion of water and sodium increases.
• ??RAAS?????,???????
• To inhibit the secretion of ADH . ???????????

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• 6. Kallikrein-kinin system
• ?????-????(KKS)

???????
??????
??????
????
???I
??
???II
??????
???
???????
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• Callidin and kallidin is the most intensive
  vessel-
• relaxing substances. Kinin can relax the VSM
  and
• improve the capillary permeability ,but as to
  other
• SM elicit contraction.
• ??????????(?????)???????????????????????????????
  ????,?????????????

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• III . Local regulation of blood flow
• ????????
• 1. Active hyperemia
• ????
• 2. Blood flow autoregulation
• ???????

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• The local regulation of blood flow is the
  organs and tissues to regulate its arteriole
  resistance and the blood flow depending on the
  factors of the organs and tissues but neural an
  hormonal mechanism.
• ???????????????????????????????????????,????????
  ????????

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1. Active hyperemia ????

• The phenomenon of the increase in the blood
  flow in most organs and tissues when their
  metabolism activity strengthen is called active
  hyperemia.It is caused by the relaxation of
  arterioles as a result of the activity of organs
  and tissues strengthen.
• ???????????????????????,??????????????????????
  ???????????

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• The relaxation of arteriole is the result of
  the change
• of the concentration of the chemical
  reconstituent in extracellular fluid,which
  includes the decrease in OPP,
• the increase in the concentration of CO2, H,
  adenosine, ATP etc.
• ??????????????????????
• ??????????????????????
• ?? CO2???H??????ATP????

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2. Blood flow autoregulation ????????

• When the organ perfusion pressure changes, the
  arteriole resistance also change to keep the
  organ blood flow at a constant level, which is
  called the autoregulation of the blood flow.
• ???????????,??????????????,????????????????????
  ???????
• ?????????

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The mechanism of the blood flow
autoregulation??????????

• ????? metabolism mechanism
• ????? muscle-derived mechanism

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metabolism mechanism?????
BP ? ??????
???? CO2, H?
?????
?????
??????????????????????? ?????????????????
??????
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muscle-derived mechanism?????

• ?????????????????????
• ?????????????????????

??? ??
??????????????????????
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• IV. Blood volume and long term regulation of
  blood pressure
• ????????????
• Neural regulation mainly plays a role in the
  regulation
• of BP under the condition of the transient
  fluctuation of BP ,and the blood volume is the
  major factor influencing the long term regulation
  of BP .
• ???????????????????????
• ???????????????????????

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Renal-body fluid control system ?-?????? (RAAS)

• The long term regulation of blood pressure is
  carrying
• out through the kidney to regulate the
  extracellular fluid
• volume, which is called Renal-body fluid control
  system .
• ??????????????????????
• ????????????-???????
• ?????????????Na??????
• ?????????????Na??????

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Essential hypertension
salt
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• The efficacy of renal-body fluid control system
  to regulate the BP is determined by the
  influence of the fluctuation of BP to the
  excretion of sodium and water of kidney.
• ?-???????????????????????????????
• From the normal level (100mmHg),the BP
  increased by 10mmHg, the excretion blood volume
  of kidney will increase by several times.
• ???????(100mmHg)???10mmHg,??????????

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Influencing factor????

• 1.Vasopressin (ADH)
• ????? (?????)
• ????? ?ADH??? ? ????????
• ??????? ?BP?
• 
  
• 2.RAAS??
• ????,BP ?
• AII
• ????????????????????
• 
  ? BP ?

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• In summarize,the regulation of BP is an
  intricate process which relates to many
  mechanisms.The neural regulation is quick and
  short-term which is carried out through the
  regulation of the diameter of resistance vessels
  and cardiac activation.However the long term
  regulation of BP is mainly undertaken through
  the regulation of kidney to the circulation blood
  volume.
• ??,???????????????????????????????????????,????
  ????????????????????,????????????????????????

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Thank you