SlideShare ist ein Scribd-Unternehmen logo
1 von 44
Endothelins?
“ Sorry, I don’t speak Greek”
 
Endothelin, one of the most potent vasoconstrictors Was first discovered by Yanagisawa and co-workers in 1988….. (Yanagisawa M, Kurihara H, Kimura S et al.  A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1988; 332: 411-5 .)  It was first isolated, characterised, and cloned in porcine aortic endothelial cells
Endothelin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Endothelin ,[object Object],[object Object],[object Object]
Endothelins and the kidney ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology Of Endothelins  ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Pathophysiology Of Endothelins
Synthesis And Secretion Of Endothelin
NO diffuses to smooth muscle cells and initiates (cGMP) by activating soluble  cytosolic guanylyl cyclase.  Elevation of cGMP levels causes vasodilation by decreasing intracellular calcium in smooth muscle cells Activation of ETA receptors results in calcium influx via phospholipase C (PLC) mediated diacylglycerol (DAG) and inositol trisphosphate (IP3) production.  DAG activates protein kinase C (PKC), which, alongside increased intracellular calcium, causes phosphorylation of myosin kinase and smooth muscle cell contraction .
Pathophysiology Of Endothelins  ,[object Object],[object Object],[object Object]
Pathophysiology Of Endothelins ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology Of Endothelins In Renal Disease  ,[object Object],[object Object],[object Object]
Pathophysiology Of Endothelins In Hypertension  ,[object Object]
[object Object],[object Object],[object Object],[object Object],Pathophysiology Of Endothelins In Ischaemic heart disease
[object Object],[object Object],Pathophysiology Of Endothelins In Heart Failure
[object Object],[object Object],[object Object],Pathophysiology Of Endothelins In Primary Pulmonary Hypertension
Pathophysiology Of Endothelins In Subarachnoid haemorrhage   ,[object Object],[object Object]
Endothelins regulates cell proliferation and extracellular matrix accumulation ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Evidence of Endothelins in pathophysiology of Diabetic Nephropathy ,[object Object],[object Object]
Are you still with me?
Role Of Endothelin Antagonism in Kidney diseases   Given the role of Endothelins  in several processes that lead to progression of chronic kidney disease, the possibility that Endothelin antagonism may be beneficial has been studied
Endothelin-A receptor antagonism reduces blood pressure and increases renal blood flow in hypertensive patients with chronic renal failure: a comparison of selective and combined endothelin receptor blockade .  Goddard, J, Johnston, NR, Hand, MF, et al. Circulation 2004; 109:1186.
The differences between selective Endothelin A, selective Endothelin B, and combined ETA/B receptor blockade was examined ,[object Object],[object Object],[object Object],[object Object],[object Object]
Results: ,[object Object],[object Object],[object Object],[object Object]
Interpretation of the results ,[object Object],[object Object],[object Object]
ASCENT Trial Avosentan on Doubling of Serum Creatinine, End Stage Renal Disease and Death in Diabetic Nephropathy
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Authority: Bulgaria: Bulgarian Drug Agency; Canada: Health Canada; China: State Food and Drug Administration; Columbia: Republica de Colombia, Ministerio de la Proteccion Social; Croatia:Ministry of Health; Czech Republic: State Institute for Drug Control; Estonia: The State Agency of Medicine; Finland: National Agency for Medicines; Germany: Federal Institute for Drugs and Medical Devices; Hungary: National Institute of Pharmacy; India: The Drugs Controller General; Indonesia: Badan Pom (NA-DFC); Italy: Ministry of Health; Israel: The Ministry of Health, Pharmaceutical Department;  Korea: Korea Food and Drug Administration; Latvia: State Agency of Medicines; Lithuania: State Medicine Control Agency - : National Pharmaceutical Bureau Control; Mexico: Federal Commission for Protection against Health Hazards; Peru: Instituto Nacional de Salud; Philippines: Bureau of Food and Drugs; Poland: Ministry of Health; Romania: State Institute for Drug Control; Russia: Federal Services for Supervision in the area of Healthcare and Social Development; Singapore: Health Sciences Authority; Slovakia: State Institute for Drug Control; South Africa: Medicines Control Council; Spain: Agencia del Medicamento y Productos Sanitaros; Sweden: Medical Products Agency; Thailand: Ministry of Publich Health; Head of Thai Drug Control Division; Taiwan: Bureau of Pharmaceutical, Department of Health; Turkey: Ministry of Health; United Kingdom: Medicines and Healthcare Products Regulatory Agency; United States: Food and Drug Administration Ministry of Health; Malaysia
[object Object],[object Object]
Role of ET-A receptor antagonism in Heart Failure Love MP, Haynes WG, Gary GA et al.  Vasodilator effects of endothelin-converting enzyme inhibition and ET-A receptor blockade in chronic heart failure patients treated with ACE inhibitors. Circulation 1996; 94: 2131-7.
[object Object],[object Object],[object Object]
Role of ET-A receptor antagonism in Cerebral Vasospasm ,[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],Role of ET-A receptor antagonism in Pulmonary Hypertension
[object Object],[object Object]
Bosentan (Tracleer®)  ,[object Object],[object Object],[object Object]
Side effects?/ Safety profile?
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object]
 

Weitere ähnliche Inhalte

Was ist angesagt?

Lecture 3 lipoproteins metabolism-
Lecture 3  lipoproteins metabolism-Lecture 3  lipoproteins metabolism-
Lecture 3 lipoproteins metabolism-
Dr Ramesh Krishnan
 
Gastric motility and secretion
Gastric motility and secretion Gastric motility and secretion
Gastric motility and secretion
Sana Lodhi
 

Was ist angesagt? (20)

Eicosanoids
EicosanoidsEicosanoids
Eicosanoids
 
Aldosterone by M.Pandian
Aldosterone by M.PandianAldosterone by M.Pandian
Aldosterone by M.Pandian
 
Drugs acting on Renin Angiotensin Aldosterone system
Drugs acting on Renin Angiotensin Aldosterone system Drugs acting on Renin Angiotensin Aldosterone system
Drugs acting on Renin Angiotensin Aldosterone system
 
Renin angiotensin system & drugs
Renin angiotensin system & drugsRenin angiotensin system & drugs
Renin angiotensin system & drugs
 
Alpha blockers
Alpha blockersAlpha blockers
Alpha blockers
 
Renin angiotensin-aldosterone system
Renin angiotensin-aldosterone systemRenin angiotensin-aldosterone system
Renin angiotensin-aldosterone system
 
Blood pressure & its regulation
Blood pressure & its regulationBlood pressure & its regulation
Blood pressure & its regulation
 
Aldersterone
AldersteroneAldersterone
Aldersterone
 
Regulation of sodium & water balance
Regulation of sodium & water  balanceRegulation of sodium & water  balance
Regulation of sodium & water balance
 
tubular diseases and analysis of urinary calculi
tubular diseases and analysis of urinary calculitubular diseases and analysis of urinary calculi
tubular diseases and analysis of urinary calculi
 
Mineralocorticoids & glucocorticoids
Mineralocorticoids & glucocorticoidsMineralocorticoids & glucocorticoids
Mineralocorticoids & glucocorticoids
 
Pcsk 9 inhibitors
Pcsk 9 inhibitorsPcsk 9 inhibitors
Pcsk 9 inhibitors
 
Cardiorenal syndrome
Cardiorenal syndromeCardiorenal syndrome
Cardiorenal syndrome
 
Renin-Angiotensin Aldeaterone System RAAS
Renin-Angiotensin Aldeaterone System RAASRenin-Angiotensin Aldeaterone System RAAS
Renin-Angiotensin Aldeaterone System RAAS
 
CONGESTIVE HEART FAILURE.pptx
CONGESTIVE HEART FAILURE.pptxCONGESTIVE HEART FAILURE.pptx
CONGESTIVE HEART FAILURE.pptx
 
Lecture 3 lipoproteins metabolism-
Lecture 3  lipoproteins metabolism-Lecture 3  lipoproteins metabolism-
Lecture 3 lipoproteins metabolism-
 
Role of the Renin–Angiotensin–Aldosterone System Inhibition Beyond BP Reduction
Role of the Renin–Angiotensin–Aldosterone System Inhibition Beyond BP ReductionRole of the Renin–Angiotensin–Aldosterone System Inhibition Beyond BP Reduction
Role of the Renin–Angiotensin–Aldosterone System Inhibition Beyond BP Reduction
 
Gastric motility and secretion
Gastric motility and secretion Gastric motility and secretion
Gastric motility and secretion
 
Prostaglandins presentation notes slideshare
Prostaglandins presentation notes slideshareProstaglandins presentation notes slideshare
Prostaglandins presentation notes slideshare
 
AcE Inhibitors in Hypertension
AcE Inhibitors in HypertensionAcE Inhibitors in Hypertension
AcE Inhibitors in Hypertension
 

Andere mochten auch

Slideshare biological actions of endothelium aj
Slideshare  biological actions of endothelium aj Slideshare  biological actions of endothelium aj
Slideshare biological actions of endothelium aj
Anu Priya
 
Endothelial cell in health & disease seminar
Endothelial cell in health & disease seminarEndothelial cell in health & disease seminar
Endothelial cell in health & disease seminar
Sweety Kalantri
 

Andere mochten auch (15)

Vascular endothelium
Vascular endotheliumVascular endothelium
Vascular endothelium
 
Slideshare biological actions of endothelium aj
Slideshare  biological actions of endothelium aj Slideshare  biological actions of endothelium aj
Slideshare biological actions of endothelium aj
 
Endothelial cell in health & disease seminar
Endothelial cell in health & disease seminarEndothelial cell in health & disease seminar
Endothelial cell in health & disease seminar
 
Vascular Endothelium in Health and Disease
Vascular Endothelium in Health and DiseaseVascular Endothelium in Health and Disease
Vascular Endothelium in Health and Disease
 
Nitric oxide
Nitric oxideNitric oxide
Nitric oxide
 
Bipn105 Symposia Presentation- Slides
Bipn105 Symposia Presentation- SlidesBipn105 Symposia Presentation- Slides
Bipn105 Symposia Presentation- Slides
 
Final .-p.practise
Final .-p.practiseFinal .-p.practise
Final .-p.practise
 
Cours les ecosanoides
Cours les ecosanoides Cours les ecosanoides
Cours les ecosanoides
 
Lung carcinoid tumor
Lung carcinoid tumorLung carcinoid tumor
Lung carcinoid tumor
 
Resumen ciencias 9
Resumen ciencias 9Resumen ciencias 9
Resumen ciencias 9
 
Renal haemodynamics
Renal haemodynamicsRenal haemodynamics
Renal haemodynamics
 
Endothelial Dysfunction Y O U S R Y Y Yeasured
Endothelial  Dysfunction   Y O U S R Y Y YeasuredEndothelial  Dysfunction   Y O U S R Y Y Yeasured
Endothelial Dysfunction Y O U S R Y Y Yeasured
 
Lect 26 9th oct angiotensin system
Lect 26 9th oct angiotensin systemLect 26 9th oct angiotensin system
Lect 26 9th oct angiotensin system
 
Nuevos enfoques en seleccion de personal
Nuevos enfoques en seleccion de personalNuevos enfoques en seleccion de personal
Nuevos enfoques en seleccion de personal
 
Sistema de formación y gestión de empleo público
Sistema de formación y gestión de empleo públicoSistema de formación y gestión de empleo público
Sistema de formación y gestión de empleo público
 

Ähnlich wie Endothelins

33 ellabban care of the kidney during daily
33 ellabban   care of the kidney during daily33 ellabban   care of the kidney during daily
33 ellabban care of the kidney during daily
Dang Thanh Tuan
 
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
iosrjce
 
Eplerenone revised
Eplerenone revisedEplerenone revised
Eplerenone revised
lawfu
 

Ähnlich wie Endothelins (20)

ni3
ni3ni3
ni3
 
Fibrosis[1]
Fibrosis[1]Fibrosis[1]
Fibrosis[1]
 
Alcohol Induce Liver Injury
Alcohol Induce Liver InjuryAlcohol Induce Liver Injury
Alcohol Induce Liver Injury
 
Angiogenesis
AngiogenesisAngiogenesis
Angiogenesis
 
Angiogenesis
AngiogenesisAngiogenesis
Angiogenesis
 
Hidrocortisona en shock vasodilatado
Hidrocortisona en shock vasodilatadoHidrocortisona en shock vasodilatado
Hidrocortisona en shock vasodilatado
 
33 ellabban care of the kidney during daily
33 ellabban   care of the kidney during daily33 ellabban   care of the kidney during daily
33 ellabban care of the kidney during daily
 
Oxidation and Inflammation
Oxidation and InflammationOxidation and Inflammation
Oxidation and Inflammation
 
Cv risk puzzle in ckd
Cv risk puzzle in ckdCv risk puzzle in ckd
Cv risk puzzle in ckd
 
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
Bosentan Ameliorates Diabetic Angiopathy and Nephropathy in Streptozotocin-In...
 
ARB + Statin
ARB + StatinARB + Statin
ARB + Statin
 
Angiogenesis
AngiogenesisAngiogenesis
Angiogenesis
 
Blood And Its Clinical Aspects - Dr. Gunjan Barot.pptx
Blood And Its Clinical Aspects - Dr. Gunjan Barot.pptxBlood And Its Clinical Aspects - Dr. Gunjan Barot.pptx
Blood And Its Clinical Aspects - Dr. Gunjan Barot.pptx
 
Case presentatio 8 10-2012 (2)
Case presentatio 8 10-2012 (2)Case presentatio 8 10-2012 (2)
Case presentatio 8 10-2012 (2)
 
Angiogenesis in health and disease
Angiogenesis in health and diseaseAngiogenesis in health and disease
Angiogenesis in health and disease
 
drug poisoning
drug poisoningdrug poisoning
drug poisoning
 
Yang{JMCC_2009]
Yang{JMCC_2009]Yang{JMCC_2009]
Yang{JMCC_2009]
 
DIABETIC NEUROPATHY
DIABETIC NEUROPATHYDIABETIC NEUROPATHY
DIABETIC NEUROPATHY
 
Eplerenone revised
Eplerenone revisedEplerenone revised
Eplerenone revised
 
ANEMIA_IN_CKD.pptx
ANEMIA_IN_CKD.pptxANEMIA_IN_CKD.pptx
ANEMIA_IN_CKD.pptx
 

Mehr von edwinchowyw

Mehr von edwinchowyw (20)

Focal Glomerulosclerosis
Focal GlomerulosclerosisFocal Glomerulosclerosis
Focal Glomerulosclerosis
 
MPGN/MCGN
MPGN/MCGNMPGN/MCGN
MPGN/MCGN
 
Membranous GN
Membranous GNMembranous GN
Membranous GN
 
Nodular GN
Nodular GNNodular GN
Nodular GN
 
Tubulointerstitial diseases
Tubulointerstitial diseasesTubulointerstitial diseases
Tubulointerstitial diseases
 
Minimal Light Microscopic Changes
Minimal Light Microscopic ChangesMinimal Light Microscopic Changes
Minimal Light Microscopic Changes
 
Crescentic GN
Crescentic GNCrescentic GN
Crescentic GN
 
Diffuse Proliferative GN
Diffuse Proliferative GNDiffuse Proliferative GN
Diffuse Proliferative GN
 
Mesangial proliferative GN
Mesangial proliferative GNMesangial proliferative GN
Mesangial proliferative GN
 
Focalproliferative Glomerulonephritis
Focalproliferative GlomerulonephritisFocalproliferative Glomerulonephritis
Focalproliferative Glomerulonephritis
 
Basement Membrane Abnormalities
Basement Membrane AbnormalitiesBasement Membrane Abnormalities
Basement Membrane Abnormalities
 
Humoral Immunity
Humoral ImmunityHumoral Immunity
Humoral Immunity
 
Introduction to Renal Pathology
Introduction to Renal PathologyIntroduction to Renal Pathology
Introduction to Renal Pathology
 
Intro Immune
Intro ImmuneIntro Immune
Intro Immune
 
Nephrotic Syndrome
Nephrotic SyndromeNephrotic Syndrome
Nephrotic Syndrome
 
Screening
ScreeningScreening
Screening
 
Dry Weight Dr Rosna
Dry Weight Dr RosnaDry Weight Dr Rosna
Dry Weight Dr Rosna
 
Bartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S SyndromesBartter’S And Gittleman’S Syndromes
Bartter’S And Gittleman’S Syndromes
 
Mycophenolate Mofetil in Primary Glomerulonephritis
Mycophenolate Mofetil in Primary GlomerulonephritisMycophenolate Mofetil in Primary Glomerulonephritis
Mycophenolate Mofetil in Primary Glomerulonephritis
 
Mycophenolate Mofetil In Relapsing Lupus Nephritis
Mycophenolate Mofetil In Relapsing Lupus NephritisMycophenolate Mofetil In Relapsing Lupus Nephritis
Mycophenolate Mofetil In Relapsing Lupus Nephritis
 

Kürzlich hochgeladen

Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
adilkhan87451
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
Sheetaleventcompany
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
chetankumar9855
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
adilkhan87451
 

Kürzlich hochgeladen (20)

Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Avai...
 
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510Kollam call girls Mallu aunty service 7877702510
Kollam call girls Mallu aunty service 7877702510
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mumbai Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
 
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Mysore Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Ahmedabad Just Call 9630942363 Top Class Call Girl Service Available
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...
 
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
Low Rate Call Girls Bangalore {7304373326} ❤️VVIP NISHA Call Girls in Bangalo...
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available
 
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...
 
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...Top Rated  Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
Top Rated Hyderabad Call Girls Chintal ⟟ 9332606886 ⟟ Call Me For Genuine Se...
 
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
8980367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 

Endothelins

  • 2. “ Sorry, I don’t speak Greek”
  • 3.  
  • 4. Endothelin, one of the most potent vasoconstrictors Was first discovered by Yanagisawa and co-workers in 1988….. (Yanagisawa M, Kurihara H, Kimura S et al. A novel potent vasoconstrictor peptide produced by vascular endothelial cells. Nature 1988; 332: 411-5 .) It was first isolated, characterised, and cloned in porcine aortic endothelial cells
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. Synthesis And Secretion Of Endothelin
  • 11. NO diffuses to smooth muscle cells and initiates (cGMP) by activating soluble cytosolic guanylyl cyclase. Elevation of cGMP levels causes vasodilation by decreasing intracellular calcium in smooth muscle cells Activation of ETA receptors results in calcium influx via phospholipase C (PLC) mediated diacylglycerol (DAG) and inositol trisphosphate (IP3) production. DAG activates protein kinase C (PKC), which, alongside increased intracellular calcium, causes phosphorylation of myosin kinase and smooth muscle cell contraction .
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23. Are you still with me?
  • 24. Role Of Endothelin Antagonism in Kidney diseases Given the role of Endothelins in several processes that lead to progression of chronic kidney disease, the possibility that Endothelin antagonism may be beneficial has been studied
  • 25. Endothelin-A receptor antagonism reduces blood pressure and increases renal blood flow in hypertensive patients with chronic renal failure: a comparison of selective and combined endothelin receptor blockade . Goddard, J, Johnston, NR, Hand, MF, et al. Circulation 2004; 109:1186.
  • 26.
  • 27.
  • 28.
  • 29. ASCENT Trial Avosentan on Doubling of Serum Creatinine, End Stage Renal Disease and Death in Diabetic Nephropathy
  • 30.
  • 31. Health Authority: Bulgaria: Bulgarian Drug Agency; Canada: Health Canada; China: State Food and Drug Administration; Columbia: Republica de Colombia, Ministerio de la Proteccion Social; Croatia:Ministry of Health; Czech Republic: State Institute for Drug Control; Estonia: The State Agency of Medicine; Finland: National Agency for Medicines; Germany: Federal Institute for Drugs and Medical Devices; Hungary: National Institute of Pharmacy; India: The Drugs Controller General; Indonesia: Badan Pom (NA-DFC); Italy: Ministry of Health; Israel: The Ministry of Health, Pharmaceutical Department; Korea: Korea Food and Drug Administration; Latvia: State Agency of Medicines; Lithuania: State Medicine Control Agency - : National Pharmaceutical Bureau Control; Mexico: Federal Commission for Protection against Health Hazards; Peru: Instituto Nacional de Salud; Philippines: Bureau of Food and Drugs; Poland: Ministry of Health; Romania: State Institute for Drug Control; Russia: Federal Services for Supervision in the area of Healthcare and Social Development; Singapore: Health Sciences Authority; Slovakia: State Institute for Drug Control; South Africa: Medicines Control Council; Spain: Agencia del Medicamento y Productos Sanitaros; Sweden: Medical Products Agency; Thailand: Ministry of Publich Health; Head of Thai Drug Control Division; Taiwan: Bureau of Pharmaceutical, Department of Health; Turkey: Ministry of Health; United Kingdom: Medicines and Healthcare Products Regulatory Agency; United States: Food and Drug Administration Ministry of Health; Malaysia
  • 32.
  • 33. Role of ET-A receptor antagonism in Heart Failure Love MP, Haynes WG, Gary GA et al. Vasodilator effects of endothelin-converting enzyme inhibition and ET-A receptor blockade in chronic heart failure patients treated with ACE inhibitors. Circulation 1996; 94: 2131-7.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 41.
  • 42.
  • 43.
  • 44.