Alterações cardiovasculares induzidas pela obesidade : envolvimento do sistema reninaangiotensina no núcleo do trato solitário
Speretta, Guilherme Fleury Fina
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In the last decades, obesity has become a worldwide epidemy. Excess of adipose tissue favors the development of associated diseases such as hypertension, obstructive sleep apnea and type II diabetes. Data from the literature have shown that obesity activates the reninangiotensin system (RAS), increases sympathetic nerve activity and pro-inflammatory cytokines levels, including in the central nervous system. However, the pathways and neural mechanisms involved in these responses are not yet fully elucidated. Therefore, the aim of this study was to evaluate the cardiovascular and metabolic responses in high-fat diet (HFD) feeding rats. We also study the possible participation of the RAS and the immune system in the nucleus of the solitary tract (NTS) in the obesity-induced cardiovascular changes. Finally, we tested if the resistance training (RT) performed at moderate intensity would be able to prevent obesityinduced cardiovascular changes. To achieve these goals, adult Holtzman rats (300-320 g) were fed with HFD (3.82 kcal/g and 26.4% total fat) or standard chow diet (SD; 2.25 kcal/g and 5.4% total fat) for 6 weeks. We observed higher blood levels of total cholesterol, triglycerides, leptin and glucose and decreased insulin sensitivity after 6 weeks of HFD. There was an increase in mean arterial pressure (MAP), the sympathetic modulation of systolic blood pressure (SBP), heart rate (HR) and sympathovagal balance of pulse interval (PI), and an impairment in the bradycardic response of the baroreflex in HFD feeding animals. After 6 weeks of HFD, there was an increase in the mRNA expression of the pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) and interleukine-6 (IL-6), an increase in the mRNA expression of the angiotensin converting enzyme (ACE) and AT1 receptor, and a decrease in the expression of AT2 and Mas receptors. In agreement with the increased expression of cytokines in the NTS we have demonstrated higher GFAP immunoreactivity (specific marker of astrocytes) and higher number of positive cells for Iba-1 (specific marker for microglia) in the NTS in rats fed with HFD. The blockade of AT1 receptor in the NTS in animals fed with HFD promoted a decrease in MAP, reduced the sympathetic modulation in SBP, reduced the sympathovagal balance of PI and restored the bradycardic response of the baroreflex. The overexpression of the AT2 receptors in the NTS in rats fed with HFD reestablished HR, baroreflex sensitivity and sympathovagal balance of PI, and partially attenuated the increase in sympathetic modulation of SBP. These responses were associated with increased Mas receptor mRNA expression and reduction in the TNF-α mRNA expression in the NTS. However, these effects were not sufficient to restore the MAP in HFD feeding rats with AT2 receptors overexpression in the NTS. Finally, the RT prevented cardiovascular changes induced by HFD, including increases in MAP, sympathetic modulation of SBP, HR, sympathovagal balance of PI, and reduced baroreflex sensitivity. These responses were associated with increased expression of mRNA for components of protective RAS axis (AT2 and Mas receptors and ACE2), and the antiinflammatory cytokine IL-10 as well as the reduction of pro-inflammatory cytokines (TNF-α and IL -1β) in the NTS. Together, our data suggest that HFD promotes increases in plasma levels of glucose and leptin, with dysfunction in insulin sensitivity. HFD also promotes increases in blood pressure associated with increased sympathetic modulation in SBP, sympathovagal balance of PI, HR and baroreflex dysfunction. The neuroinflammatory process and an imbalance between the pressor and protective RAS axis in the NTS seem to be involved with the development/maintenance of the cardiovascular alterations induced by HFD. The TF performed at moderate intensity seems to be an important tool in preventing cardiovascular changes induced by HFD.