An Update on Actions of Mineralocorticoid Receptor in the Cardiovascular System: From Clinical Studies to Basic Research

Recent clinical studies continued to show beneficial outcome of mineralocorticoid receptor (MR) antagonists for treating heart failure. However, the side effects of these drugs, particularly in the kidney, justified more studies to explore the cell type-specific effects of this receptor. Experimental data from cell type-specific knockout mouse models revealed that deletion of MR in myeloid cells, cardiomyocytes, or vascular smooth muscle cells in general protected mice from cardiovascular disease. Overexpression of MR in cardiomyocytes or endothelial cells, on the other hand, exacerbated cardiovascular disease. These results indicated direct function of MR in these cells. In all these cell types, oxidative stress and inflammation may be unified mechanisms of MR actions. Future clinical trials may broaden the indications of MR antagonists and basic research may provide more insightful understanding of MR actions in the cardiovascular system. [N A J Med Sci. 2013;6(2):91-94.   DOI: 10.7156/najms.2013.0602091]