Zusammenfassung
Die Charakterisierung der ANG-II-Rezeptorsubtypen hat uns mit neuen Werkzeugen ausgestattet, mit denen wir unser Wissen um die verschiedenen Funktionen von ANG II erweitern konnten. Mit der Entwicklung der nicht-peptidergen AT1-Antagonisten, der Sartane, konnte ein neues therapeutisches Prinzip zur Behandlung der Hypertonie in die klinische Praxis eingeführt werden. Die Sartane blockieren den AT1-Rezeptor und bieten dabei hohe therapeutische Sicherheit verbunden mit niedriger Toxizität. Weiterhin konnte für die AT1-Rezeptorantagonisten gezeigt werden, daß sie, ähnlich den ACE-Hemmem, Herz- und Gefäßmorphologie und -funktion verbessern können. Die Mechanismen, die diesen zusätzlichen Wirkungen der AT1-Blocker zugrunde liegen, werden noch nicht vollständig verstanden. Da alle AT1-Antagonisten basierend auf den initial beschriebenen Imidazolderivaten entwickelt wurden und alle über eine hoch selektive Blockade des AT1-Rezeptors wirken, könnte man erwarten, daß sie sich auch klinisch ähnlich verhalten. Dennoch kann man bezüglich ihrer pharmakologischen Eigenschaften und bei einigen der neueren Antagonisten auch bezüglich der chemischen Struktur Unterschiede finden. Inwieweit sich diese Unterschiede tatsächlich auf die klinische Praxis auswirken, wird aber erst mit dem wachsenden Einsatz der AT1-Antagonisten und weiterführenden Studien endgültig zu beantworten sein.
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Chung, O., Unger, T. (1999). Pharmakologische Aspekte von Angiotensin-II-Rezeptoren und AT1-Rezeptorantagonisten. In: Dominiak, P., Heusch, G. (eds) AT1-Rezeptorblockade. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-93701-9_3
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