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  • Research Summary of Radu Iliescu, MD, PhD

    My current research focuses on understanding dynamic processes that occur in the cardiovascular system and their role in the regulation of blood pressure and kidney function in health and disease.

    Blood flow to the kidney and glomerular filtration rate are tightly controlled in the face of variations in systemic blood pressure (BP). This process, termed autoregulation, is achieved by active mechanisms, the myogenic response and the tubuloglomerular feedback, and is essential for the maintenance of body salt and fluid homeostasis and for the protection of the glomeruli from pressure-induced injury. Dysfunction of these mechanisms leads to reduced renal autoregulatory efficiency. Since BP normally fluctuates during daily activity, inadequate renal autoregulation would lead to transient increases in BP being transmitted to the glomerulus.

    Baroreceptor reflexes act to rapidly buffer normal fluctuations in BP through adaptive inhibition of sympathetic and stimulation of parasympathetic outflow. If baroreflexes are impaired, the kidneys may be exposed to larger and more frequent transient increases in systemic BP. We are currently investigating the importance of these renal and systemic hemodynamic alterations in mediating renal disease in obesity using an integrative physiological approach.

    Another long-standing interest in my research is the investigation of the role of sex hormones in the regulation of the cardiovascular-renal system function in health and disease. Recent and intriguing findings of both experimental and clinical studies demonstrate that men are more prone to develop hypertension and target-organ disease, and fare worse than age-matched women once affected by cardiovascular disease.

    Since large clinical trials called into question the generally-accepted protective role of estrogens in women, we have especially focused on the role of testosterone in promoting cardiovascular disease. We found that in a transgenic rat model of hypertension, the presence of androgens in females, albeit at reduced levels compared to males, contributes to exacerbation of hypertension and cardiac and renal injury.

    We are working under the hypothesis that testosterone promotes cardiovascular disease in both men and women via mechanisms other than the classical sex-differentiating pathways and development of molecular approaches to specifically blunt deleterious effects of testosterone on the cardiovascular system may be effective in the therapy of cardiovascular disease.