アンチエイジングと骨・血管連関

Bone Metabolism and Cardiovascular Function Update. Cross link of hypertension, bone loss and vascular calcification - Common back grounds in renin angiotensin system with anti-aging aspect -.

　高齢化社会においてはさまざまな病気が複雑に絡み合って多様な病態を呈しており，これらの共有背景を検証することは人にも医療経済にもやさしい包括医療の基盤を築くものと考える。昇圧作用をもつレニン・アンジオテンシン系（RAS）は骨代謝にも密接に関わっており，破骨細胞活性を亢進して骨粗鬆症を増悪させる一方，血管平滑筋細胞を骨芽細胞様細胞に分化させて血管の石灰化にも関与していることがわかってきている。 　本稿では骨代謝におけるRASの作用機転について解説し，アンチエイジングの観点からアンジオテンシン受容体拮抗薬（ARB）の効用の多様性について検証したい。

　Hypertension, osteoporosis and vascular calcification are major diseases in the recent aging society and may share the same backgrounds genetically and environmentally. As treatments to prevent aging-related diseases simultaneously are desirable, we investigate common backgrounds underling these diseases. Renin- angiotensin system, which causes high blood pressure, is found to be involved in bone metabolism. Angiotensin II has been shown to accelerate osteoporosis through RANKL up-regulation in osteoblast. RANKL, in turn, contributes to vascular calcification by regulating bone morphogenetic protein-2 and MGP expression, as well as bone-related proteins. Angiotensin type 1 receptor blockers（ARBs）ameliorate osteoporosis and vascular calcification beyond their blood pressure lowering effects. These pleiotropic effects of antihypertensive drugs such as ARBs might benefit especially hypertensive postmenopausal women.