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Rossitto G, Bertoldi G, Rutkowski JM, Mitchell BM, Delles C. Sodium, Interstitium, Lymphatics and Hypertension-A Tale of Hydraulics. Hypertension 2024; 81:727-737. [PMID: 38385255 PMCID: PMC10954399 DOI: 10.1161/hypertensionaha.123.17942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Blood pressure is regulated by vascular resistance and intravascular volume. However, exchanges of electrolytes and water between intra and extracellular spaces and filtration of fluid and solutes in the capillary beds blur the separation between intravascular, interstitial and intracellular compartments. Contemporary paradigms of microvascular exchange posit filtration of fluids and solutes along the whole capillary bed and a prominent role of lymphatic vessels, rather than its venous end, for their reabsorption. In the last decade, these concepts have stimulated greater interest in and better understanding of the lymphatic system as one of the master regulators of interstitial volume homeostasis. Here, we describe the anatomy and function of the lymphatic system and focus on its plasticity in relation to the accumulation of interstitial sodium in hypertension. The pathophysiological relevance of the lymphatic system is exemplified in the kidneys, which are crucially involved in the control of blood pressure, but also hypertension-mediated cardiac damage. Preclinical modulation of the lymphatic reserve for tissue drainage has demonstrated promise, but has also generated conflicting results. A better understanding of the hydraulic element of hypertension and the role of lymphatics in maintaining fluid balance can open new approaches to prevent and treat hypertension and its consequences, such as heart failure.
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Affiliation(s)
- Giacomo Rossitto
- School of Cardiovascular and Metabolic Health, University of Glasgow, UK
- Emergency Medicine and Hypertension, DIMED; Università degli Studi di Padova, Italy
| | - Giovanni Bertoldi
- Emergency Medicine and Hypertension, DIMED; Università degli Studi di Padova, Italy
| | | | - Brett M. Mitchell
- Dept. of Medical Physiology, Texas A&M University School of Medicine, USA
| | - Christian Delles
- School of Cardiovascular and Metabolic Health, University of Glasgow, UK
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2
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Kou C, Zhao X, Fan X, Lin X, Wang Q, Yu J. Dietary sodium/potassium intake and cognitive impairment in older patients with hypertension: Data from NHANES 2011-2014. J Clin Hypertens (Greenwich) 2023. [PMID: 37183770 DOI: 10.1111/jch.14667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023]
Abstract
This study aimed to assess the relationship between dietary sodium/potassium intake and cognition in elderly individuals with hypertension. We designed a cross-sectional study based on the 2011-2014 National Health and Nutrition Examination Survey (NHANES) 2011-2014. A multivariable-logistic regression analysis was performed to analyze the relationship between sodium/potassium intake and cognitive impairment. Restricted cubic spline (RCS) based on regression analysis to assess the nonlinear dose-response relationship between dietary sodium intake and cognitive performance. Out of the 2276 participants included in this study, 1670 patients had hypertension. Compared with the lowest quartile of dietary sodium intake, the lowest weighted odds ratio of cognitive impairment in DSST was observed in Q4 (OR = 0.45, 0.29-0.70), and a similar trend was observed in AFT (OR = 0.34, 0.18-0.65). After adjusting the covariates, the lowest weighted multivariable-adjusted OR of cognitive impairment in DSST were also observed in Q4 (OR = 0.47, 0.26-0.84) compared with the lowest quartile of dietary sodium intake. The RCS results showed that dietary sodium intake was U-shaped and associated with the risk of cognitive impairment in the DSST (Pnon-linearity = 0.0067). In addition, no significant association was observed between dietary potassium intake and different dimensions of cognitive performance. In conclusion, excessively high and low low dietary sodium were associated with impairment of specific processing speed, sustained attention, and working memory for elderly patients with hypertension in the United States. However, no association was observed between dietary potassium intake and cognition.
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Affiliation(s)
- Chengkun Kou
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xu Zhao
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Fan
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xin Lin
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Qiongying Wang
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Jing Yu
- Hypertension Centre, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Ito Y, Sun T, Tanaka H, Yamaguchi M, Kinashi H, Sakata F, Kunoki S, Sakai Y, Ishimoto T. Tissue Sodium Accumulation Induces Organ Inflammation and Injury in Chronic Kidney Disease. Int J Mol Sci 2023; 24:ijms24098329. [PMID: 37176037 PMCID: PMC10179540 DOI: 10.3390/ijms24098329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
High salt intake is a primary cause of over-hydration in chronic kidney disease (CKD) patients. Inflammatory markers are predictors of CKD mortality; however, the pathogenesis of inflammation remains unclear. Sodium storage in tissues has recently emerged as an issue of concern. The binding of sodium to tissue glycosaminoglycans and its subsequent release regulates local tonicity. Many cell types express tonicity-responsive enhancer-binding protein (TonEBP), which is activated in a tonicity-dependent or tonicity-independent manner. Macrophage infiltration was observed in the heart, peritoneal wall, and para-aortic tissues in salt-loading subtotal nephrectomized mice, whereas macrophages were not prominent in tap water-loaded subtotal nephrectomized mice. TonEBP was increased in the heart and peritoneal wall, leading to the upregulation of inflammatory mediators associated with cardiac fibrosis and peritoneal membrane dysfunction, respectively. Reducing salt loading by a diuretic treatment or changing to tap water attenuated macrophage infiltration, TonEBP expression, and inflammatory marker expression. The role of TonEBP may be crucial during the cardiac fibrosis and peritoneal deterioration processes induced by sodium overload. Anti-interleukin-6 therapy improved cardiac inflammation and fibrosis and peritoneal membrane dysfunction. Further studies are necessary to establish a strategy to regulate organ dysfunction induced by TonEBP activation in CKD patients.
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Affiliation(s)
- Yasuhiko Ito
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Ting Sun
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Hiroya Tanaka
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Makoto Yamaguchi
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Hiroshi Kinashi
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Fumiko Sakata
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya 464-0813, Japan
| | - Shunnosuke Kunoki
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
- Department of Nephrology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Yukinao Sakai
- Department of Nephrology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Takuji Ishimoto
- Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute 480-1195, Japan
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Chen J, Chew K, Mary S, Boder P, Bagordo D, Rossi G, Touyz R, Delles C, Rossitto G. Skin-specific mechanisms of body fluid regulation in hypertension. Clin Sci (Lond) 2023; 137:239-250. [PMID: 36648486 PMCID: PMC10621731 DOI: 10.1042/cs20220609] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/18/2023]
Abstract
Increasing evidence suggests excess skin Na+ accumulation in hypertension; however, the role of skin-specific mechanisms of local Na+/water regulation remains unclear. We investigated the association between measures of sweat and trans-epidermal water loss (TEWL) with Na+ content in the skin ([Na+]skin) and clinical characteristics in consecutive hypertensive patients. We obtained an iontophoretic pilocarpine-induced sweat sample, a skin punch biopsy for chemical analysis, and measures of TEWL from the upper limbs. Serum vascular endothelial growth factor-c (VEGF-c) and a reflectance measure of haemoglobin skin content served as surrogates of skin microvasculature. In our cohort (n = 90; age 21-86 years; females = 49%), sweat composition was independent of sex and BMI. Sweat Na+ concentration ([Na+]sweat) inversely correlated with [K+]sweat and was higher in patients on ACEIs/ARBs (P < 0.05). A positive association was found between [Na+]sweat and [Na+]skin, independent of sex, BMI, estimated Na+ intake and use of ACEi/ARBs (Padjusted = 0.025); both closely correlated with age (P < 0.01). Office DBP, but not SBP, inversely correlated with [Na+]sweat independent of other confounders (Padjusted = 0.03). Total sweat volume and Na+ loss were lower in patients with uncontrolled office BP (Padjusted < 0.005 for both); sweat volume also positively correlated with serum VEGF-c and TEWL. Lower TEWL was paralleled by lower skin haemoglobin content, which increased less after vasodilatory pilocarpine stimulation when BMI was higher (P = 0.010). In conclusion, measures of Na+ and water handling/regulation in the skin were associated with relevant clinical characteristics, systemic Na+ status and blood pressure values, suggesting a potential role of the skin in body-fluid homeostasis and therapeutic targeting of hypertension.
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Affiliation(s)
- Jun Yu Chen
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Khai Syuen Chew
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Sheon Mary
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Philipp Boder
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Domenico Bagordo
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
| | - Gian Paolo Rossi
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
| | - Rhian M. Touyz
- Research Institute of McGill University Health Centre, McGill University, Montreal, Canada
| | - Christian Delles
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
| | - Giacomo Rossitto
- School of Cardiovascular & Metabolic Health, University of Glasgow, U.K
- Emergency Medicine and Hypertension, DIMED, Università degli Studi di Padova, Italy
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Yang Y, Wu Q, Lv Q, Li J, Li L, Wang S. Dietary sodium, potassium intake, sodium-to-potassium ratio and risk of hypertension: a protocol for systematic review and dose-response meta-analysis of cohort studies. BMJ Open 2023; 13:e065470. [PMID: 36754555 PMCID: PMC9923265 DOI: 10.1136/bmjopen-2022-065470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Hypertension (HTN) is the leading cause of disease and death on a global scale. Diet's sodium and potassium levels may synergistically affect blood pressure. Currently, the sodium-to-potassium (Na/K) ratio is becoming a more reliable indicator. There has not been a systematic investigation of the dose-response relationship between dietary sodium, potassium, the Na/K ratio and the incidence of HTN based on the same study criteria. This study will conduct a thorough dose-response meta-analysis of cohort studies to estimate the effects of dietary sodium, potassium, and the Na/K ratio on the incidence of HTN to provide the most accurate reference for sodium and potassium intake. METHODS AND ANALYSIS We will identify all relevant prospective and retrospective cohort studies by searching PubMed, Embase and Web of Science (from inception until December 2022). Exposures are 24 hours urinary excretions, and the outcome is the incidence of HTN. Two researchers will perform the literature selection and data extraction separately. The Newcastle-Ottawa Scale will be used to evaluate the quality of the included studies. We will use both linear and non-linear regression models to investigate the dose-response relationship among different levels (≥3) of sodium, potassium, Na/K ratio intake and the incidence of HTN (OR/RR/HR). Subgroup and sensitivity analyses will be applied to assess the potential heterogeneity sources and examine the stability of the results. We will also evaluate heterogeneity across studies and publication bias. Stata V.15.0 and RevMan V.5.0 will be used for statistical analyses. ETHICS AND DISSEMINATION According to the Institutional Review Board/Independent Ethics Committee of the Guang'anmen Hospital of the China Academy of Chinese Medical Science, this systematic meta-analysis protocol does not require ethical approval or informed consent. This meta-analysis will be published in a scientific journal with peer reviews. PROSPERO REGISTRATION NUMBER CRD42022331203.
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Affiliation(s)
- Yingtian Yang
- Faculty of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
| | - Qian Wu
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
| | - Qianyu Lv
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
| | - Junjia Li
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
| | - Lanlan Li
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
| | - Shihan Wang
- Department of Cardiovascular, China Academy of Chinese Medical Sciences Guang'anmen Hospital, Beijing, People's Republic of China
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Zheng X, Guan Q, Lin X. Changing trends of the disease burden of non-rheumatic valvular heart disease in China from 1990 to 2019 and its predictions: Findings from global burden of disease study. Front Cardiovasc Med 2023; 9:912661. [PMID: 36741848 PMCID: PMC9897059 DOI: 10.3389/fcvm.2022.912661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023] Open
Abstract
Objective China has an increasing burden of non-rheumatic valvular heart disease (NRVHD) as the aging of the population is deepening. The aim was to assess the age and sex-specific prevalence and DALYs of NRVHD in China from 1990 to 2019 and to predict the burden in the next 25 years. Methods The Global Burden of Disease Study (2019) was used to extract the data of age- and sex-specific incidence, mortality, and disability-adjusted life years (DALYs) of NRVHD in China, 1990-2019. We estimated the annual percentage change (EAPC) to access the temporal trends of the disease burden of NRVHD. The R package called Nordpred was used to perform an age-period-cohort analysis to predict the prevalence of NRVHD in the next 25 years. Results The number of incident cases of NRVHD increased from 93.16 thousand in 1990 to 325.05 thousand in 2019. Overall upward trends were observed in the age-standardized incidence rate (ASIR) from 1990 to 2019. Significant temporal trends in mortality and DALYs of NRVHD were observed. High systolic blood pressure, high sodium diet, and lead exposure were the main driving forces for NRVHD. In the next 25 years, the number of new cases and deaths of NRVHD should continue to increase to 390.64 thousand and 10.0 thousand, respectively. The ASIR should show an upward trend, while the ASMR should show a downward trend among men and women. Conclusion In China, the overall rates of NRVHD have increased over the past 30 years, and there has been a substantial increase in the burden of NRVHD due to population growth and aging and will continue to increase in the next 25 years. Our results can help shape a multifactorial approach and public policy to reduce the NRVHD burden throughout China.
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Affiliation(s)
- Xiaoxin Zheng
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, China,Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Cardiovascular Institute, Fujian Provincial Center for Geriatrics, Fujian Clinical Medical Research Center for Cardiovascular Diseases, Fuzhou, Fujian, China,Fujian Heart Failure Center Alliance, Fuzhou, Fujian, China,Xiaoxin Zheng,
| | - Qing Guan
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China,Qing Guan,
| | - Xiuquan Lin
- Department for Chronic and Non-Communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian, China,The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China,*Correspondence: Xiuquan Lin,
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Liu W, Xing S, Wei F, Yao Y, Zhang H, Li YC, Liu Z. Excessive Dietary Salt Intake Exacerbates Cognitive Impairment Progression and Increases Dementia Risk in Older Adults. J Am Med Dir Assoc 2023; 24:125-129.e4. [PMID: 36351463 DOI: 10.1016/j.jamda.2022.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/26/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate excessive dietary salt intake as an independent risk factor of cognitive impairment and dementia in older adults. DESIGN Prospective, population-based cohort study. SETTINGS AND PARTICIPANTS Two thousand forty-one community residents aged ≥60 years were recruited between April 2007 and August 2009 from the Shandong area of China. MEASUREMENTS Participants were classified into low, mild, moderate, and high salt intake groups according to urinary sodium measurements for 7 consecutive days. Global cognitive function was assessed at baseline and biennially thereafter using the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Dementia Rating Scale (DRS), and Informant Questionnaire on Cognitive Decline in the Elderly. Demographics and apolipoprotein E (APOE) genotype were also obtained for each participant. Participants were monitored for 11.4 ± 2.0 years. RESULTS During follow-up, MMSE, MoCA, and DRS scores decreased progressively faster with increasing salt intake (Padjustment < 0.05 among all intake groups). In total, 319 participants (13.74 per 1000 person-years) developed cognitive impairment. Compared with the low salt intake group, cognitive impairment risk was increased by 75% in the mild group (Padjustment = 0.027), 180% in the moderate group (Padjustment < 0.001), and 330% in the high group (Padjustment < 0.001) after adjustment for age, education, mean, and variability in visit-to-visit systolic and diastolic blood pressure, and APOE genotype. The hazard ratio for cognitive impairment increased by 1.59 (95% CI 1.40-1.79) with each 1-SD increment in salt intake after confounder adjustment (Padjustment < 0.001). CONCLUSIONS AND IMPLICATIONS Excessive dietary salt impairs cognitive function and increases cognitive impairment risk in older adults independently of known risk factors, including hypertension and APOE genotype.
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Affiliation(s)
- Weike Liu
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shasha Xing
- Department of Geriatrics, Third Hospital of Lixia District, Jinan, Shandong, China
| | - Fang Wei
- Department of Cardiology, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yanli Yao
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Hua Zhang
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yue-Chun Li
- Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhendong Liu
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; School of Basic Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China.
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Yang D, Chen J, Zhang T, Lin Y, Yao X, Meng L, Guo F, Chen K, Dai H, Tang M. Influencing factors of wide pulse pressure in an elderly Chinese population: A cross-sectional study. J Clin Hypertens (Greenwich) 2022; 24:1482-1490. [PMID: 36259250 DOI: 10.1111/jch.14582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
Blood pressure and pulse pressure (PP) had their own characteristics in the elderly population. This cross-sectional study including 5030 elderly participants was conducted to describe the distribution of blood pressure and wide PP in the elderly population and find influencing factors of wide PP. Wide PP was defined as PP equal to or more than 65 mmHg, and was classified three types as low systolic blood pressure (SBP) and low diastolic blood pressure (DBP) (LSLD), high SBP and low DBP (HSLD), and high SBP and high DBP (HSHD). Using multivariate logistic regression models to analyze the associations of demographic factors, health-related factors and lifestyle factors with different wide PP types. The associations of lifestyles with wide PP by gender were estimated by subgroup analyses. Among 5030 elderly participants, 2727 (54.2%) participants had wide PP. Logistic regression models showed older age (OR = 2.48, 95%CI: 2.14-2.88), female (OR = 1.31, 95%CI: 1.07-1.60), not married (OR = 1.26, 95%CI: 1.07-1.49), having chronic diseases (OR = 1.28, 95%CI: 1.09-1.50), current alcohol drinker (OR = 1.29, 95%CI: 1.11-1.50) were positively associated, and higher body height (OR = .78, 95%CI: .62-.99), higher education level (OR = .60, 95%CI: .43-.82), current smoker (OR = .79, 95%CI: .64-.97) were negatively associated with wide PP. Among three different types of wide PP including LSLD, HSLD, HSHD, these factors had different effects. Subgroup analyses found that only among male, current smoker was negatively associated and current alcohol drinker was positively associated with wide PP.
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Affiliation(s)
- Dandan Yang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Chen
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Tingting Zhang
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Yaoyao Lin
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuecheng Yao
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Meng
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fanjia Guo
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Honglei Dai
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Cui Y, Sun K, Xiao Y, Li X, Mo S, Yuan Y, Wang P, Yang L, Zhang R, Zhu X. High-salt diet accelerates bone loss accompanied by activation of ion channels related to kidney and bone tissue in ovariectomized rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 244:114024. [PMID: 36057202 DOI: 10.1016/j.ecoenv.2022.114024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Excessive salt intake can induce a variety of diseases, such as hypertension, cardiovascular disease, kidney disease and so on,it is also one of the factors promoting bone resorption. The mechanism of osteoporosis-induced exacerbations of high salt diet is not well-defined. In this study, we used ovariectomized 6-month-old Sprague Dawley rats to construct a high bone turnover model, and then administrated with high sodium chloride diet (2.0% w/w NaCl, 8.0% w/w NaCl) for 12 weeks to observe the effect of high salt diet on bone metabolism. The results showed that high salt diet could lead to the destruction of bone microstructure, promote the excretion of urinary calcium and phosphorus and accelerate the bone turnover, as well as cause the pathologic structural abnormalities in renal tubular. At the same time, it was accompanied by the up-regulated expression of the epithelial sodium channel (ENaCα), voltage-gated chloride channels (ClC)- 3 and the down-regulated expression of Na-Cl cotransporter (NCC), sodium calcium exchanger (NCX1) in femoral tissue and renal tubules. These findings confirm that high salt diet can destroy the microstructure of bone by increasing bone resorption and affect some ion channels of bone tissue and renal tubule in ovariectomized rats.
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Affiliation(s)
- Yan Cui
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Kehuan Sun
- The First Affiliated Hospital of Shenzhen University,Shenzhen Second People's Hospital, Shenzhen, Guangdong 518020, PR China
| | - Yawen Xiao
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Xiaoyun Li
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Shu Mo
- Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, Guangdong 518000, PR China
| | - Yihan Yuan
- School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Panpan Wang
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; Cancer research Institution, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Li Yang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China
| | - Ronghua Zhang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong 510630, PR China; Cancer research Institution, Jinan University, Guangzhou, Guangdong 510630, PR China; Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, Guangdong 510630, PR China.
| | - Xiaofeng Zhu
- The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, PR China; School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong 510630, PR China.
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10
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McDonough AA, Fenton RA. Potassium homeostasis: sensors, mediators, and targets. Pflugers Arch 2022; 474:853-867. [PMID: 35727363 PMCID: PMC10163916 DOI: 10.1007/s00424-022-02718-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 12/16/2022]
Abstract
Transmembrane potassium (K) gradients are key determinants of membrane potential that can modulate action potentials, control muscle contractility, and influence ion channel and transporter activity. Daily K intake is normally equal to the amount of K in the entire extracellular fluid (ECF) creating a critical challenge - how to maintain ECF [K] and membrane potential in a narrow range during feast and famine. Adaptations to maintain ECF [K] include sensing the K intake, sensing ECF [K] vs. desired set-point and activating mediators that regulate K distribution between ECF and ICF, and regulate renal K excretion. In this focused review, we discuss the basis of these adaptions, including (1) potential mechanisms for rapid feedforward signaling to kidney and muscle after a meal (before a rise in ECF [K]), (2) how skeletal muscles sense and respond to changes in ECF [K], (3) effects of K on aldosterone biosynthesis, and (4) how the kidney responds to changes in ECF [K] to modify K excretion. The concepts of sexual dimorphisms in renal K handling adaptation are introduced, and the molecular mechanisms that can account for the benefits of a K-rich diet to maintain cardiovascular health are discussed. Although the big picture of K homeostasis is becoming more clear, we also highlight significant pieces of the puzzle that remain to be solved, including knowledge gaps in our understanding of initiating signals, sensors and their connection to homeostatic adjustments of ECF [K].
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Affiliation(s)
- Alicia A McDonough
- Department of Physiology and Neuroscience, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | - Robert A Fenton
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
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11
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Nazari S, Moosavi SMS. Temporal patterns of alterations in obesity index, lipid profile, renal function and blood pressure during the development of hypertension in male, but not female, rats fed a moderately high-fat diet. Arch Physiol Biochem 2022; 128:897-909. [PMID: 32195603 DOI: 10.1080/13813455.2020.1739713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Male Sprague-Dawley rats consuming a moderately high-fat (MHF)-diet diverge into obesity-prone (OP) with hypertension and obesity-resistant. OBJECTIVES To study the temporal inter-relationships between body-weight, obesity-index, plasma lipid-profile, renal functional parameters and systolic-pressure alterations during 10-weeks feeding MHF or normal diet to male and female rats. METHODS Body-weight, obesity-index and systolic-pressure were measured weekly, while metabolic-cage and blood-sampling protocols were performed every other week. After 10-weeks, renal excretory responses to acute salt-loading and renal autoregulation were examined. RESULTS The male-OP group had progressively increased body-weight, plasma-triglyceride and systolic-pressure from Weeks 2, 4 and 5, respectively, lower renal sodium-excretion at weeks 4-8 and finally, delayed excretory response to salt-loading and rightward and downward shifts in renal autoregulatory curves compared to all other groups. CONCLUSION Feeding the MHF-diet in male-OP rats led to a greater weight-gain and adiposity followed by the development of atherogenic-hyperlipidaemia and persistently impaired pressure-natriuresis to induce hypertension.
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Affiliation(s)
- Somayeh Nazari
- Department of Physiology, The Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mostafa Shid Moosavi
- Department of Physiology, The Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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McMullan CJ, McHill AW, Hull JT, Wang W, Forman JP, Klerman EB. Sleep Restriction and Recurrent Circadian Disruption Differentially Affects Blood Pressure, Sodium Retention, and Aldosterone Secretion. Front Physiol 2022; 13:914497. [PMID: 35874530 PMCID: PMC9305384 DOI: 10.3389/fphys.2022.914497] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/03/2022] [Indexed: 12/14/2022] Open
Abstract
Prolonged exposure to chronic sleep restriction (CSR) and shiftwork are both associated with incident hypertension and cardiovascular disease. We hypothesized that the combination of CSR and shiftwork's rotating sleep schedule (causing recurrent circadian disruption, RCD) would increase blood pressure, renal sodium retention, potassium excretion, and aldosterone excretion. Seventeen healthy participants were studied during a 32-day inpatient protocol that included 20-h "days" with associated scheduled sleep/wake and eating behaviors. Participants were randomly assigned to restricted (1:3.3 sleep:wake, CSR group) or standard (1:2 sleep:wake, Control group) ratios of sleep:wake duration. Systolic blood pressure during circadian misalignment was ∼6% higher in CSR conditions. Renal sodium and potassium excretion showed robust circadian patterns; potassium excretion also displayed some influence of the scheduled behaviors (sleep/wake, fasting during sleep so made parallel fasting/feeding). In contrast, the timing of renal aldosterone excretion was affected predominately by scheduled behaviors. Per 20-h "day," total sodium excretion increased, and total potassium excretion decreased during RCD without a change in total aldosterone excretion. Lastly, a reduced total renal sodium excretion was found despite constant oral sodium consumption and total aldosterone excretion, suggesting a positive total body sodium balance independent of aldosterone excretion. These findings may provide mechanistic insight into the observed adverse cardiovascular and renal effects of shiftwork.
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Affiliation(s)
- Ciaran J. McMullan
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Andrew W. McHill
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States,Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland, OR, United States,*Correspondence: Andrew W. McHill,
| | - Joseph T. Hull
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - John P. Forman
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Elizabeth B. Klerman
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, United States,Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States,Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
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13
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Li Z, Hu L, Rong X, Luo J, Xu X, Zhao Y. Role of no table salt on hypertension and stroke based on large sample size from National Health and Nutrition Examination Survey database. BMC Public Health 2022; 22:1292. [PMID: 35788204 PMCID: PMC9254688 DOI: 10.1186/s12889-022-13722-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background To assess the associations between no table salt and hypertension or stroke. Methods The data of 15,352 subjects were collected from National Health and Nutrition Examination Survey (NHANES) database. All subjects were divided into no hypertension or stroke group (n = 10,894), hypertension group (n = 5888), stroke group (n = 164) and hypertension and stroke group (n = 511). Univariate and multivariate logistic regression analysis was used to measure the associations of salt type used with hypertension and stroke and co-variables were respectively adjusted in different models. Results After adjusting age and gender, other salt intake was associated with 1.88-fold risk of hypertension (OR = 1.88, 95%CI: 1.44–2.46) and no table salt was associated with 1.30-fold risk of hypertension (OR = 1.30, 95%CI: 1.15–1.47). After adjusting age, gender, race, BMI, PIR, marital status, CVDs, whether doctors’ told them to reduce salt, and diabetes, the risk of hypertension was 1.23-fold increase in no table salt group (OR = 1.23, 95%CI: 1.04–1.46). After the adjustment of age and gender, the risk of hypertension and stroke was 3.33-fold increase (OR = 3.33, 95%CI: 2.12–5.32) in other salt intake group and 1.43-fold increase (OR = 1.43, 95%CI:1.17–1.74) in no table salt group. Conclusion Other salt intake or no table salt were associated with a higher risk of hypertension or hypertension and stroke. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13722-8.
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Affiliation(s)
- Zongqin Li
- Department of Neurology, Sichuan Mianyang 404 Hospital, Mianyang, 621000, Sichuan, China
| | - Lan Hu
- Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Xiaoxia Rong
- Department of Operations Management Division, Sichuan Mianyang 404 Hospital, Mianyang, 621000, Sichuan, China
| | - Jun Luo
- Department of Neurology, Sichuan Mianyang 404 Hospital, Mianyang, 621000, Sichuan, China
| | - Xuejie Xu
- Department of Neurology, Sichuan Mianyang 404 Hospital, Mianyang, 621000, Sichuan, China
| | - Yonglong Zhao
- School of Pharmacy, and Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang, Guizhou, 550004, China.
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14
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Srugies F, Rump LC, Nitschmann S. [Effects of salt substitution]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2022; 63:684-688. [PMID: 35513607 DOI: 10.1007/s00108-022-01344-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 09/29/2022]
Affiliation(s)
- F Srugies
- Medizinische Fakultät, Universitätsklinikum Düsseldorf, Klinik für Nephrologie, Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - L C Rump
- Medizinische Fakultät, Universitätsklinikum Düsseldorf, Klinik für Nephrologie, Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
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Abstract
Purpose of Review The regulation of blood pressure is conventionally conceptualised into the product of “circulating blood volume” and “vasoconstriction components”. Over the last few years, however, demonstration of tissue sodium storage challenged this dichotomous view. Recent Findings We review the available evidence pertaining to this phenomenon and the early association made with blood pressure; we discuss open questions regarding its originally proposed hypertonic nature, recently challenged by the suggestion of a systemic, isotonic, water paralleled accumulation that mirrors absolute or relative extracellular volume expansion; we present the established and speculate on the putative implications of this extravascular sodium excess, in either volume-associated or -independent form, on blood pressure regulation; finally, we highlight the prevalence of high tissue sodium in cardiovascular, metabolic and inflammatory conditions other than hypertension. Summary We conclude on approaches to reduce sodium excess and on the potential of emerging imaging technologies in hypertension and other conditions.
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16
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Hunter RW, Dhaun N, Bailey MA. The impact of excessive salt intake on human health. Nat Rev Nephrol 2022; 18:321-335. [DOI: 10.1038/s41581-021-00533-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/19/2022]
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17
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Yokota H, Hayashi H, Hanaguri J, Yamagami S, Kushiyama A, Nakagami H, Nagaoka T. Effect of prorenin peptide vaccine on the early phase of diabetic retinopathy in a murine model of type 2 diabetes. PLoS One 2022; 17:e0262568. [PMID: 35041699 PMCID: PMC8765632 DOI: 10.1371/journal.pone.0262568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
Prorenin is viewed as an ideal target molecule in the prevention of diabetic retinopathy. However, no drugs are available for inhibiting activation of prorenin. Here, we tested the effect of a prorenin peptide vaccine (VP) in the retina of a murine model of type 2 diabetes (T2D). To choose the optimal vaccine, we selected three different epitopes of the prorenin prosegment (E1, E2, and E3) and conjugated them to keyhole limpet hemocyanin (KLH). We injected C57BL/6J mice twice with KLH only (as a control vaccine), E1 conjugated with KLH (E1-KLH), E2-KLH, or E3-KLH and compared antibody titers. E2-KLH showed the highest antibody titer and specific immunoreactivity of anti-sera against prorenin, so we used E2-KLH as VP. Then, we administered injections to the non-diabetic db/m and diabetic db/db mice, as follows: db/m + KLH, db/db + KLH, and db/db + VP. Retinal blood flow measurement with laser speckle flowgraphy showed that the impaired retinal circulation response to both flicker light and systemic hyperoxia in db/db mice improved with VP. Furthermore, the prolonged implicit time of b-wave and oscillatory potentials in electroretinography was prevented, and immunohistochemical analysis showed reduced microglial activation, gliosis, and vascular leakage. The enzyme-linked immunosorbent spot assay confirmed vaccinated mice had no auto-immune response against prorenin itself. The present data suggest that vaccination against prorenin is an effective and safe measure against the early pathological changes of diabetic retinopathy in T2D.
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Affiliation(s)
- Harumasa Yokota
- Division of Ophthalmology, Department of Visual Science, Nihon University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Hiroki Hayashi
- Department of Health Development and Medicine, Osaka University, Osaka, Japan
| | - Junya Hanaguri
- Division of Ophthalmology, Department of Visual Science, Nihon University School of Medicine, Tokyo, Japan
| | - Satoru Yamagami
- Division of Ophthalmology, Department of Visual Science, Nihon University School of Medicine, Tokyo, Japan
| | - Akifumi Kushiyama
- Department of Pharmacotherapy, Meiji Pharmaceutical University, Tokyo, Japan
| | - Hironori Nakagami
- Department of Health Development and Medicine, Osaka University, Osaka, Japan
| | - Taiji Nagaoka
- Division of Ophthalmology, Department of Visual Science, Nihon University School of Medicine, Tokyo, Japan
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Imig JD. Orally active epoxyeicosatrienoic acid analogs in hypertension and renal injury. ADVANCES IN PHARMACOLOGY 2022; 94:27-55. [PMID: 35659375 PMCID: PMC10105514 DOI: 10.1016/bs.apha.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Epoxyeicosatrienoic acids (EETs) are arachidonic acid metabolites synthesized by cytochrome P450 epoxygenases. Biological activities for EETs include vasodilation, decreasing inflammation, opposing apoptosis, and inhibiting renal sodium reabsorption. These actions are beneficial in lowering blood pressure and slowing kidney disease progression. Furthermore, evidence in human and experimental animal studies have found that decreased EET levels contribute to hypertension and kidney diseases. Consequently, EET mimics/analogs have been developed as a potential therapeutic for hypertension and acute and chronic kidney diseases. Their development has resulted in EET analogs that are orally active with favorable pharmacological profiles. Analogs for 8,9-EET, 11,12-EET, and 14,15-EET have been tested in several hypertension and kidney disease animal models. More recently, kidney targeted EET analogs have been synthesized and tested against drug-induced nephrotoxicity. Experimental evidence has demonstrated compelling therapeutic potential for EET analogs to oppose cardiovascular and kidney diseases. These EET analogs lower blood pressure, decrease kidney inflammation, improve vascular endothelial function, and decrease kidney fibrosis and apoptosis. Overall, these preclinical studies support the likelihood that EET analogs will advance to clinical trials for hypertension and associated comorbidities or acute and chronic kidney diseases.
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Affiliation(s)
- John D Imig
- Drug Discovery Center, Medical College of Wisconsin, Milwaukee, WI, United States.
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19
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Schrauben SJ, Inamdar A, Yule C, Kwiecien S, Krekel C, Collins C, Anderson C, Bailey-Davis L, Chang AR. Effects of Dietary App-Supported Tele-Counseling on Sodium Intake, Diet Quality, and Blood Pressure in Patients With Diabetes and Kidney Disease. J Ren Nutr 2022; 32:39-50. [PMID: 34649784 PMCID: PMC8727497 DOI: 10.1053/j.jrn.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/15/2021] [Accepted: 08/10/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The aim of this study is to examine the effect of a telehealth intervention that used a dietary app, educational website, and weekly dietitian tele-counseling on sodium intake, diet quality, blood pressure, and albuminuria among individuals with diabetes and early-stage chronic kidney disease. DESIGN AND METHODS We examined the effects of a dietary app-supported tele-counseling intervention in a single center, single arm study of 44 participants with type 2 diabetes and stage 1-3a chronic kidney disease. Participants recorded and shared dietary data via MyFitnessPal with registered dietitians, who used motivational interviewing to provide telephone counseling weekly for 8 weeks. After the 8-week intensive intervention, participants were followed at 6 and 12 months. Outcomes included 24-hour urine sodium (2 collections per timepoint), Healthy Eating Index 2015 score (three 24-hour dietary recalls per timepoint), 24-hour systolic blood pressure (SBP) and diastolic blood pressure (DBP), and 24-hour urine albumin excretion. RESULTS Out of 44 consented participants (mean age 60.3 ± 11.9 years, 43% female, 89% white, median estimated glomerular filtration rate was 78.5 mL/min/1.73 m2, median urine albumin excretion 52.9 mg/day, 84% hypertension), 32 (73%) completed 8-week follow-up, 27 (61%) completed 6-month follow-up, and 25 (57%) completed 12-month follow-up. Among participants who completed 12-month follow-up, reported sodium intake decreased by 638 mg/day from baseline of 2,919 mg/day (P < .001). The 24-hour mean urine sodium and albumin excretion did not decline over the study period. Healthy Eating Index 2015 score improved by 7.76 points at 12 months from a mean baseline of 54.6 (P < .001). Both 24-hour SBP and DBP declined at 12 months from baseline (SBP -5.7 mm Hg, 95% confidence interval -10.5 to -1.0, P = .02; DBP -4.1 mm Hg, 95% confidence interval -7.2 to -1.1, P = .01). CONCLUSIONS Overall, this study demonstrates that a short, intensive, remotely delivered dietary intervention for adults with type 2 diabetes and early chronic kidney disease at high risk for disease progression and cardiovascular complications led to improvement in blood pressure and self-reported sodium intake and diet quality, but no improvement in albuminuria. Future research studies are needed to examine whether remotely delivered dietary interventions can ultimately improve kidney health over time.
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Affiliation(s)
- Sarah J. Schrauben
- Renal, Electrolyte-Hypertension Division; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | | | - Cheryl Anderson
- Department of Family Medicine and Public Health, University of California San Diego
| | - Lisa Bailey-Davis
- Obesity Institute, Geisinger Health,Department of Population Health Sciences, Geisinger Health
| | - Alex R. Chang
- Kidney Health Research Institute, Geisinger Health,Department of Population Health Sciences, Geisinger Health
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Zhao K, Mao Y, Ye X, Ma J, Sun L, Li P, Li Y. MicroRNA-210-5p alleviates cardiac fibrosis via targeting transforming growth factor-beta type I receptor in rats on high sodium chloride (NaCl)-based diet. Eur J Pharmacol 2021; 912:174587. [PMID: 34678242 DOI: 10.1016/j.ejphar.2021.174587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
The present study was designed to explore whether high sodium chloride (NaCl)-based diet (HSD) caused cardiac fibrosis regardless of blood pressure in Sprague-Dawley (SD) rats, and to further determine the effects and the underlying mechanisms of microRNA (miR)-210-5p on HSD-induced cardiac fibrosis in rats or NaCl-induced cardiac fibroblast activation in neonatal rat cardiac fibroblasts (NRCFs). The SD rats received 8% HSD, and NRCFs were treated with NaCl. The levels of collagen I, alpha-smooth muscle actin (α-SMA) and transforming growth factor-beta 1 (TGF-β1) were increased in the heart of hypertension (HTN), hypertension-prone (HP) and hypertension-resistant (HR) rats on HSD in vivo. NaCl increased the levels of collagen I, α-SMA and TGF-β1 in NRCFs in vitro. The level of miR-210-5p was reduced in both NBD-induced rats' hearts and NaCl-treated NRCFs, which was consistent with the results of miR high-throughput sequencing in NRCFs. The HSD or NaCl-induced increases of collagen I, α-SMA and TGF-β1 were inhibited by miR-210-5p agomiR in vitro and in vivo, respectively. miR-210-5p antagomiR could mimic the pathological effects of NaCl in NRCFS. Bioinformatics analysis and luciferase reporter assays demonstrated that TGF-β type I receptor (TGFBR1) was a direct target gene of miR-210-5p. These results indicated that HSD resulted in cardiac fibrosis regardless of blood pressure. The upregulation of miR-210-5p could attenuate cardiac fibroblast activation in NRCFS via targeting TGFBR1. Thus, upregulating miR-210-5p might be a strategy for the treatment of cardiac fibrosis.
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Affiliation(s)
- Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yukang Mao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoman Ye
- Intensive Care Unit, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiazheng Ma
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Litao Sun
- SEU-FEI Nano-Pico Center, Key Laboratory of MEMS of Ministry of Education, Southeast University, Nanjing, 210096, China
| | - Peng Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yong Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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New Insights into the Critical Importance of Intratubular Na +/H + Exchanger 3 and Its Potential Therapeutic Implications in Hypertension. Curr Hypertens Rep 2021; 23:34. [PMID: 34110521 DOI: 10.1007/s11906-021-01152-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW The sodium (Na+) and hydrogen (H+) exchanger 3 (NHE3), known as solute carrier family 9 member 3 (SLC9A3), mediates active transcellular Na+ and bicarbonate reabsorption in the small intestine of the gut and proximal tubules of the kidney. The purpose of this article is to review and discuss recent findings on the critical roles of intestinal and proximal tubule NHE3 in maintaining basal blood pressure (BP) homeostasis and their potential therapeutic implications in the development of angiotensin II (Ang II)-dependent hypertension. RECENT FINDINGS Recently, our and other laboratories have generated or used novel genetically modified mouse models with whole-body, kidney-specific, or proximal tubule-specific deletion of NHE3 to determine the critical roles and underlying mechanisms of NHE3 in maintaining basal BP homeostasis and the development of Ang II-induced hypertension at the whole-body, kidney, or proximal tubule levels. The new findings demonstrate that NHE3 contributes to about 10 to 15 mmHg to basal blood pressure levels, and that deletion of NHE3 at the whole-kidney or proximal tubule level, or pharmacological inhibition of NHE3 at the kidney level with an orally absorbable NHE3 inhibitor AVE-0657, attenuates ~ 50% of Ang II-induced hypertension in mice. The results support the proof-of-concept hypothesis that NHE3 plays critical roles in physiologically maintaining normal BP and in the development of Ang II-dependent hypertension. Our results also strongly suggest that NHE3 in the proximal tubules of the kidney may be therapeutically targeted to treat poorly controlled hypertension in humans.
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Mullins L, Ivy J, Ward M, Tenstad O, Wiig H, Kitada K, Manning J, Rakova N, Muller D, Mullins J. Abnormal neonatal sodium handling in skin precedes hypertension in the SAME rat. Pflugers Arch 2021; 473:897-910. [PMID: 34028587 PMCID: PMC8164623 DOI: 10.1007/s00424-021-02582-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 12/03/2022]
Abstract
We discovered high Na+ and water content in the skin of newborn Sprague–Dawley rats, which reduced ~ 2.5-fold by 7 days of age, indicating rapid changes in extracellular volume (ECV). Equivalent changes in ECV post birth were also observed in C57Bl/6 J mice, with a fourfold reduction over 7 days, to approximately adult levels. This established the generality of increased ECV at birth. We investigated early sodium and water handling in neonates from a second rat strain, Fischer, and an Hsd11b2-knockout rat modelling the syndrome of apparent mineralocorticoid excess (SAME). Despite Hsd11b2−/− animals exhibiting lower skin Na+ and water levels than controls at birth, they retained ~ 30% higher Na+ content in their pelts at the expense of K+ thereafter. Hsd11b2−/− neonates exhibited incipient hypokalaemia from 15 days of age and became increasingly polydipsic and polyuric from weaning. As with adults, they excreted a high proportion of ingested Na+ through the kidney, (56.15 ± 8.21% versus control 34.15 ± 8.23%; n = 4; P < 0.0001), suggesting that changes in nephron electrolyte transporters identified in adults, by RNA-seq analysis, occur by 4 weeks of age. Our data reveal that Na+ imbalance in the Hsd11b2−/− neonate leads to excess Na+ storage in skin and incipient hypokalaemia, which, together with increased, glucocorticoid-induced Na+ uptake in the kidney, then contribute to progressive, volume contracted, salt-sensitive hypertension. Skin Na+ plays an important role in the development of SAME but, equally, may play a key physiological role at birth, supporting post-natal growth, as an innate barrier to infection or as a rudimentary kidney.
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Affiliation(s)
- Linda Mullins
- Molecular Physiology Laboratory, BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
| | - Jessica Ivy
- Molecular Physiology Laboratory, BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Mairi Ward
- Molecular Physiology Laboratory, BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Olav Tenstad
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Helge Wiig
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Kento Kitada
- Department of Pharmacology, Kagawa University, Takamatsu, Japan
| | - Jon Manning
- EMBL-EBI, Wellcome Genome Campus, Hinxton, UK
| | - Natalia Rakova
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitäts-Medizin Berlin, Berlin, Germany
| | - Dominik Muller
- Experimental and Clinical Research Center, a joint cooperation of Max Delbrück Center for Molecular Medicine and Charité-Universitäts-Medizin Berlin, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - John Mullins
- Molecular Physiology Laboratory, BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
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Yi B, Zeng W, Lv L, Hua P. Changing epidemiology of calcific aortic valve disease: 30-year trends of incidence, prevalence, and deaths across 204 countries and territories. Aging (Albany NY) 2021; 13:12710-12732. [PMID: 33973531 PMCID: PMC8148466 DOI: 10.18632/aging.202942] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/02/2021] [Indexed: 12/11/2022]
Abstract
Calcific aortic valve disease (CAVD) is associated with increased morbidity and mortality. We aimed to elucidate the 30-year epidemiology of CAVD globally. Global CAVD incidence, prevalence, and deaths increased 3.51-, 4.43-, and 1.38-fold from 1990 to 2019, respectively, without any decreasing trends, even after age standardization. In 2019, Slovenia had the highest age-standardized rate (ASR) of CAVD incidence (62.21/100,000 persons) and prevalence (1,080.06/100,000) whereas Cyprus had the highest ASR of deaths (8.20/100,000). Population aging was an important contributor to incidence. Compared with women, more men had CAVD and men had earlier peaks in disease prevalence. High systolic blood pressure, diet high in sodium, and lead exposure were the main risk factors for deaths owing to CAVD. The estimated annual percentage change, a measure to estimate the variation of ASR, was significantly associated with the ASR and sociodemographic index (SDI) in 2019 for incidence and prevalence across all 204 countries and territories (all p<0.0001). With increased lifespan and risk factors, the overall burden of CAVD is high and remains on the rise, with differences by sex, age, and SDI level. Our findings serve to sound the alarm for organizations, institutions, and resources whose primary purpose is to improve human health.
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Affiliation(s)
- Bin Yi
- Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Weike Zeng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Lei Lv
- Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Ping Hua
- Department of Cardiovascular Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
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Jobin K, Müller DN, Jantsch J, Kurts C. Sodium and its manifold impact on our immune system. Trends Immunol 2021; 42:469-479. [PMID: 33962888 DOI: 10.1016/j.it.2021.04.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022]
Abstract
The Western diet is rich in salt, and a high salt diet (HSD) is suspected to be a risk factor for cardiovascular diseases. It is now widely accepted that an experimental HSD can stimulate components of the immune system, potentially exacerbating certain autoimmune diseases, or alternatively, improving defenses against certain infections, such as cutaneous leishmaniasis. However, recent findings show that an experimental HSD may also aggravate other infections (e.g., pyelonephritis or systemic listeriosis). Here, we discuss the modulatory effects of a HSD on the microbiota, metabolic signaling, hormonal responses, local sodium concentrations, and their effects on various immune cell types in different tissues. We describe how these factors are integrated, resulting either in immune stimulation or suppression in various tissues and disease settings.
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Affiliation(s)
- Katarzyna Jobin
- Institute of Molecular Medicine and Experimental Immunology, University of Bonn, Bonn, Germany; Würzburg Institute of Systems Immunology, Max-Planck Research Group, University of Würzburg, Würzburg, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center (ECRC), a cooperation of Charité-Universitätsmedizin Berlin and Max Delbruck Center for Molecular Medicine, and Max Delbruck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Jonathan Jantsch
- Institute of Clinical Microbiology and Hygiene, University Hospital of Regensburg and University of Regensburg, Regensburg, Germany.
| | - Christian Kurts
- Institute of Molecular Medicine and Experimental Immunology, University of Bonn, Bonn, Germany; Department of Microbiology and Immunology, Doherty Institute for Infection and Immunity, University of Melbourne, Victoria, Australia.
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Metchi Donfack MF, Atsamo AD, Temdié Guemmogne RJ, Ngouateu Kenfack OB, Dongmo AB, Dimo T. Antihypertensive Effects of the Vitex cienkowskii (Verbenaceae) Stem-Bark Extract on L-NAME-Induced Hypertensive Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:6668919. [PMID: 33747111 PMCID: PMC7954626 DOI: 10.1155/2021/6668919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 02/06/2023]
Abstract
Vitex cienkowskii stem-bark is used in Cameroonian traditional medicine to treat cardiovascular diseases including hypertension. In previous studies, the methanol/methylene chloride stem-bark extract of Vitex cienkowskii (MMVC) showed a preventive activity in L-NAME-induced hypertension and improved blood pressure of spontaneously hypertensive rats. The present study investigated the curative effects in L-NAME-induced hypertensive rats (LNHR). Hypertension was induced in rats by oral administration of L-NAME (40 mg/kg/day) for 28 days. The animals were divided into 2 groups: one group of 5 rats receiving distilled water (10 ml/kg) and another 20 rats receiving L-NAME. At the end of 4 weeks of administration of L-NAME, the animals were divided into 4 groups of 5 rats each: one group of hypertensive rats receiving distilled water, another one receiving captopril (25 mg/kg), and two groups of hypertensive rats receiving MMVC at doses of 200 and 400 mg/kg, respectively. Body weight, food, and water intake were measured weekly. At the end of the treatment, blood pressure and heart rate were recorded by invasive method. Whole heart, left ventricle, kidneys, and liver were weighed. The effects of plant extract on lipid profile and oxidative stress markers, as well as markers of hepatic and renal functions were assessed spectrophotometrically according to well described protocols. Results show that L-NAME significantly increases the mean arterial blood pressure (MABP), atherogenic index, lipid profile, and creatinine and transaminase activities of normotensive rats. MMVC significantly reduced the blood pressure in LNHR. Body weight, food and water intake, left ventricular hypertrophy, antioxidant level, renal and hepatic markers, and lipid profile were improved by the treatment with MMVC. The curative effect of MMVC on L-NAME-induced hypertension is probably related to its antihypertensive, hypolipidemic, and antioxidant properties. These results confirmed the use of Vitex cienkowskii for the treatment of hypertension in traditional medicine.
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Affiliation(s)
- Mireille Flaure Metchi Donfack
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Albert Donatien Atsamo
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Roméo Joël Temdié Guemmogne
- Department of Biological Sciences, Faculty of Science, University of Ngaoundéré, P.O. Box 454, Ngaoundéré, Cameroon
| | - Omer Bébé Ngouateu Kenfack
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Alain Bertrand Dongmo
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Théophile Dimo
- Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
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Liu TH, Chen MH, Tu WQ, Liang QE, Tao WC, Jin Z, Xiao Y, Chen LG. Network and 16S rRNA Sequencing-Combined Approach Provides Insightal Evidence of Vitamin K 2 for Salt-Sensitive Hypertension. Front Nutr 2021; 8:639467. [PMID: 33718421 PMCID: PMC7943625 DOI: 10.3389/fnut.2021.639467] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/20/2021] [Indexed: 01/05/2023] Open
Abstract
Vitamin K2 (VK2), found to act to treat hypertension, has been widely used in the food and pharmaceutical industries nowadays. However, the potential targets and molecular mechanisms of VK2 for salt-sensitive hypertension have not been fully investigated. Therefore, the study aimed to investigate the potential molecular mechanisms of VK2 for salt-sensitive hypertension using network pharmacology and 16S rRNA sequencing strategy. The network pharmacology-based findings from KEGG enrichment analysis revealed that VK2-treated salt-sensitive hypertension was mechanically associated with the complement and coagulation cascades, calcium signaling pathway, renin–angiotensin system, etc. A total of 29 different bacteria in an animal experiment after VK2 supplementation were screened and functionally enriched using PICRUSt2. Additionally, 10 signaling pathways were identified in which the renin–angiotensin system was found to be the potential molecular mechanisms with the greatest change in multiple and statistical significance. Moreover, the results of the renin–angiotensin system-related protein expression exhibited VK2-inhibited renin–angiotensin system in salt-induced hypertensive mice, which significantly verified the previous biological and functional prediction analysis. Finally, spearman correlation analysis showed the different bacteria such as Dubosiella, Ileibacterium, etc., had a positive or negative correlation with renin–angiotensin system-related proteins in salt-induced mice. In conclusion, the potential molecular mechanisms of VK2 for salt-sensitive hypertension may be beneficially achieved by the specific inhibition of the renin–angiotensin system, contributing to the development for a new preventive strategy of salt-sensitive hypertension.
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Affiliation(s)
- Tian-Hao Liu
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Ming-Hao Chen
- College of medicine, Jinan University, Guangzhou, China
| | - Wan-Qing Tu
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Qiu-Er Liang
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Wen-Cong Tao
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Zhen Jin
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Ya Xiao
- College of Chinese medicine, Jinan University, Guangzhou, China
| | - Li-Guo Chen
- College of Chinese medicine, Jinan University, Guangzhou, China
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Wang Y, Zhang J, Wier WG, Chen L, Blaustein MP. NO-induced vasodilation correlates directly with BP in smooth muscle-Na/Ca exchanger-1-engineered mice: elevated BP does not attenuate endothelial function. Am J Physiol Heart Circ Physiol 2021; 320:H221-H237. [PMID: 33124883 PMCID: PMC7847073 DOI: 10.1152/ajpheart.00487.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 12/29/2022]
Abstract
Arterial smooth muscle Na+/Ca2+ exchanger-1 (SM-NCX1) promotes vasoconstriction or vasodilation by mediating, respectively, Ca2+ influx or efflux. In vivo, SM-NCX1 mediates net Ca2+ influx to help maintain myogenic tone (MT) and neuronally activated constriction. SM-NCX1-TG (overexpressing transgenic) mice have increased MT and mean blood pressure (MBP; +13.5 mmHg); SM-NCX1-KO (knockout) mice have reduced MT and MBP (-11.1 mmHg). Endothelium-dependent vasodilation (EDV) is often impaired in hypertension. We tested whether genetically engineered SM-NCX1 expression and consequent BP changes similarly alter EDV. Isolated, pressurized mesenteric resistance arteries with MT from SM-NCX1-TG and conditional SM-NCX1-KO mice, and femoral arteries in vivo from TG mice were studied. Acetylcholine (ACh)-dilated TG arteries with MT slightly more than control or KO arteries, implying that SM-NCX1 overexpression does not impair EDV. In preconstricted KO, but not TG mouse arteries, however, ACh- and bradykinin-triggered vasodilation was markedly attenuated. To circumvent the endothelium, phenylephrine-constricted resistance arteries were tested with Na-nitroprusside [SNP; nitric oxide (NO) donor] and cGMP. This endothelium-independent vasodilation was augmented in TG but attenuated in KO arteries that lack NCX1-mediated Ca2+ clearance. Baseline cytosolic Ca2+ ([Ca2+]cyt) was elevated in TG femoral arteries in vivo, supporting the high BP; furthermore, SNP-triggered [Ca2+]cyt decline and vasodilation were augmented as NO and cGMP promote myocyte polarization thereby enhancing NCX1-mediated Ca2+ efflux. The TG mouse data indicate that BP elevation does not attenuate endothelium-dependent vasodilation. Thus, in essential hypertension and many models the endothelial impairment that supports the hypertension apparently is not triggered by BP elevation but by extravascular mechanisms.NEW & NOTEWORTHY Endothelium-dependent, ACh-induced vasodilation (EDV) is attenuated, and arterial myocyte Na+/Ca2+ exchangers (NCX1) are upregulated in many forms of hypertension. Surprisingly, mildly hypertensive smooth muscle-specific (SM)-NCX1 transgenic mice exhibited modestly enhanced EDV and augmented endothelium-independent vasodilation (EIV). Conversely, mildly hypotensive SM-NCX1-knockout mice had greatly attenuated EIV. These adaptations help compensate for NCX1 expression-induced alterations in cytosolic Ca2+ and blood pressure (BP) and belie the view that elevated BP, itself, causes the endothelial dysregulation in hypertension.
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Affiliation(s)
- Youhua Wang
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
- Department of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Jin Zhang
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - W Gil Wier
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Ling Chen
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Mordecai P Blaustein
- Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
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Luzes R, Crisóstomo T, Silva PA, Iack R, de Abreu VG, Francischetti EA, Vieyra A. Angiotensin-(3-4) normalizes blood pressure, decreases Na + and energy intake, but preserves urinary Na + excretion in overweight hypertensive rats. Biochim Biophys Acta Mol Basis Dis 2020; 1867:166012. [PMID: 33212189 DOI: 10.1016/j.bbadis.2020.166012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 01/13/2023]
Abstract
Hypertension, one of the most common and severe comorbidities of obesity and overweight, is a worldwide epidemic affecting over 30% of the population. We induced overweight in young male rats (aged 58 days) by exposure to a hypercaloric high lipid (HL) diet in which 70% of the calories originated from fat. The HL diet also contained 33 or 57% higher Na+ than the control (CTR) diet. Over the following weeks the HL rats gradually became overweight (490 ± 12 g vs 427 ± 7 g in the CTR group after 15 weeks) with high visceral fat. They developed elevated systolic blood pressure (SBP) (141 ± 1.9 mmHg), which was fully restored to CTR values (128 ± 1.1 mmHg) by oral administration of Ang-(3-4) (Val-Tyr), the shortest renin-angiotensin-derived peptide. The overweight rats had lower plasma Na+ concentration that augmented to CTR values by Ang-(3-4) treatment. Na+ ingestion was depressed by 40% as result of the Ang-(3-4) treatment, whereas the urinary excretion of Na+ (UNaV) remained unmodified. The preservation of UNaV after Ang-(3-4) treatment - despite the sharp decrease in the dietary Na+ intake - can be ascribed to the normalization of renal type 1 angiotensin II receptors and Na+-transporting ATPases, both up-regulated in overweight rats. These renal effects complete a counterregulatory action on elevated renin-angiotensin activity that allows the high SBP to be normalized and body Na+ homeostasis to be restored concomitantly in overweight rats.
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Affiliation(s)
- Rafael Luzes
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Graduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil
| | - Thuany Crisóstomo
- Leopoldo de Meis Institute of Medical Biochemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paulo A Silva
- Graduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil
| | - Roxane Iack
- Graduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil
| | | | - Emílio A Francischetti
- Graduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil
| | - Adalberto Vieyra
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Graduate Program in Translational Biomedicine, University of Grande Rio, Duque de Caxias, Brazil; National Center of Structural Biology and Bioimaging/CENABIO, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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29
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Pinter J, Chazot C, Stuard S, Moissl U, Canaud B. Sodium, volume and pressure control in haemodialysis patients for improved cardiovascular outcomes. Nephrol Dial Transplant 2020; 35:ii23-ii30. [PMID: 32162668 PMCID: PMC7066545 DOI: 10.1093/ndt/gfaa017] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/12/2022] Open
Abstract
Chronic volume overload is pervasive in patients on chronic haemodialysis and substantially increases the risk of cardiovascular death. The rediscovery of the three-compartment model in sodium metabolism revolutionizes our understanding of sodium (patho-)physiology and is an effect modifier that still needs to be understood in the context of hypertension and end-stage kidney disease. Assessment of fluid overload in haemodialysis patients is central yet difficult to achieve, because traditional clinical signs of volume overload lack sensitivity and specificity. The highest all-cause mortality risk may be found in haemodialysis patients presenting with high fluid overload but low blood pressure before haemodialysis treatment. The second highest risk may be found in patients with both high blood pressure and fluid overload, while high blood pressure but normal fluid overload may only relate to moderate risk. Optimization of fluid overload in haemodialysis patients should be guided by combining the traditional clinical evaluation with objective measurements such as bioimpedance spectroscopy in assessing the risk of fluid overload. To overcome the tide of extracellular fluid, the concept of time-averaged fluid overload during the interdialytic period has been established and requires possible readjustment of a negative target post-dialysis weight. 23Na-magnetic resonance imaging studies will help to quantitate sodium accumulation and keep prescribed haemodialytic sodium mass balance on the radar. Cluster-randomization trials (e.g. on sodium removal) are underway to improve our therapeutic approach to cardioprotective haemodialysis management.
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Affiliation(s)
- Jule Pinter
- Renal Division, University Hospital of Würzburg, Würzburg, Germany
| | | | - Stefano Stuard
- Global Medical Office, FMC Deutschland, Bad Homburg, Germany
| | - Ulrich Moissl
- Global Medical Office, FMC Deutschland, Bad Homburg, Germany
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30
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Li Y, Wu W, Liu W, Zhou M. Roles and mechanisms of renalase in cardiovascular disease: A promising therapeutic target. Biomed Pharmacother 2020; 131:110712. [PMID: 32916539 DOI: 10.1016/j.biopha.2020.110712] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease (CVD) is prevalent worldwide and remains a leading cause of death. Although substantial progress has been made in the diagnosis and treatment of CVD, the prognosis remains unsatisfactory. Renalase is a newly discovered cytokine that is synthesized by the kidney and then secreted into blood. Numerous studies have suggested the efficacy of renalase in treating CVD by metabolizing catecholamines in the circulatory system. As a new biomarker of heart disease, renalase is normally recognized as a signalling molecule that activates cytoprotective intracellular signals to lower blood pressure, protect ischaemic heart muscle and promote atherosclerotic plaque stability in CVD, which subsequently improves cardiac function. Due to its important regulatory role in the circulatory system, renalase has gradually become a potential target in the treatment of CVD. This review summarizes the structure, mechanism and function of renalase in CVD, thereby providing preclinical evidence for alternative approaches and new prospects in the development of renalase-related drugs against CVD.
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Affiliation(s)
- Yue Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, 100010, China
| | - Weidong Wu
- London Metropolitan University, London, N7 8DB, United Kingdom
| | - Weihong Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, 100010, China
| | - Mingxue Zhou
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, 100010, China.
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31
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Tissue sodium excess is not hypertonic and reflects extracellular volume expansion. Nat Commun 2020; 11:4222. [PMID: 32839436 PMCID: PMC7445299 DOI: 10.1038/s41467-020-17820-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/17/2020] [Indexed: 01/10/2023] Open
Abstract
Our understanding of Na+ homeostasis has recently been reshaped by the notion of skin as a depot for Na+ accumulation in multiple cardiovascular diseases and risk factors. The proposed water-independent nature of tissue Na+ could induce local pathogenic changes, but lacks firm demonstration. Here, we show that tissue Na+ excess upon high Na+ intake is a systemic, rather than skin-specific, phenomenon reflecting architectural changes, i.e. a shift in the extracellular-to-intracellular compartments, due to a reduction of the intracellular or accumulation of water-paralleled Na+ in the extracellular space. We also demonstrate that this accumulation is unlikely to justify the observed development of experimental hypertension if it were water-independent. Finally, we show that this isotonic skin Na+ excess, reflecting subclinical oedema, occurs in hypertensive patients and in association with aging. The implications of our findings, questioning previous assumptions but also reinforcing the importance of tissue Na+ excess, are both mechanistic and clinical. Na+ has been suggested to accumulate in tissues, particularly skin, in a hypertonic manner and to exert local pathogenic effects. Here, we reappraise this phenomenon which is systemic in nature and reflects isotonic changes in the relative extracellular volume in tissues, e.g. subclinical oedema; as such, it occurs in human hypertension and aging.
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Minegishi S, Luft FC, Titze J, Kitada K. Sodium Handling and Interaction in Numerous Organs. Am J Hypertens 2020; 33:687-694. [PMID: 32198504 DOI: 10.1093/ajh/hpaa049] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/10/2020] [Accepted: 03/17/2020] [Indexed: 12/27/2022] Open
Abstract
Salt (NaCl) is a prerequisite for life. Excessive intake of salt, however, is said to increase disease risk, including hypertension, arteriosclerosis, heart failure, renal disease, stroke, and cancer. Therefore, considerable research has been expended on the mechanism of sodium handling based on the current concepts of sodium balance. The studies have necessarily relied on relatively short-term experiments and focused on extremes of salt intake in humans. Ultra-long-term salt balance has received far less attention. We performed long-term salt balance studies at intakes of 6, 9, and 12 g/day and found that although the kidney remains the long-term excretory gate, tissue and plasma sodium concentrations are not necessarily the same and that urinary salt excretion does not necessarily reflect total-body salt content. We found that to excrete salt, the body makes a great effort to conserve water, resulting in a natriuretic-ureotelic principle of salt excretion. Of note, renal sodium handling is characterized by osmolyte excretion with anti-parallel water reabsorption, a state-of-affairs that is achieved through the interaction of multiple organs. In this review, we discuss novel sodium and water balance concepts in reference to our ultra-long-term study. An important key to understanding body sodium metabolism is to focus on water conservation, a biological principle to protect from dehydration, since excess dietary salt excretion into the urine predisposes to renal water loss because of natriuresis. We believe that our research direction is relevant not only to salt balance but also to cardiovascular regulatory mechanisms.
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Affiliation(s)
- Shintaro Minegishi
- Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Friedrich C Luft
- Experimental & Clinical Research Center, a joint collaboration between Max-Delbrück Center for Molecular Medicine and Charité Universitätsmedizin, Berlin, Germany
| | - Jens Titze
- Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
- Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA
- Division of Nephrology and Hypertension, University Clinic Erlangen, Erlangen, Germany
| | - Kento Kitada
- Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
- JSPS Overseas Research Fellow, Japan Society for the Promotion of Science, Tokyo, Japan
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Himmerkus N, Svendsen SL, Quintanova C, Bleich M, Von Schwerdtner O, Benzing T, Welling PA, Leipziger J, Rinschen MM. Viewing Cortical Collecting Duct Function Through Phenotype-guided Single-Tubule Proteomics. FUNCTION (OXFORD, ENGLAND) 2020; 1:zqaa007. [PMID: 35330743 PMCID: PMC8788781 DOI: 10.1093/function/zqaa007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 01/06/2023]
Abstract
The revolution of the omics technologies has enabled profiling of the molecules of any sample. However, the heterogeneity of the kidney with highly specialized nephron segments like the cortical collecting duct (CCD) poses a challenge regarding integration of omics data and functional analysis. We examined function and proteome from the same single CCDs of C57Bl6 mice by investigating them in a double-barreled perfusion system before targeted mass spectrometry. Transepithelial voltage (Vte), transepithelial resistance, as well as amiloride-sensitive voltage (ΔVteamil) were recorded. CCDs were of 400-600 µm of length, showed lumen negative Vte between -8.5 and -32.5 mV and an equivalent short circuit current I'sc between 54 and 192 µA/cm2. On a single-tubule proteome level, intercalated cell (IC) markers strongly correlated with other intercalated cell markers and negatively with principal cell markers. Integration of proteome data with phenotype data revealed that tubular length correlated with actin and Na+-K+-ATPase expression. ΔVte(amil) reflected the expression level of the β-subunit of the epithelial sodium channel. Intriguingly, ΔVte(amil) correlated inversely with the water channel AQP2 and the negative regulator protein NEDD4L (NEDD4-2). In pendrin knockout (KO) mice, the CCD proteome was accompanied by strong downregulation of other IC markers like CLCNKB, BSND (Barttin), and VAA (vH+-ATPase), a configuration that may contribute to the salt-losing phenotype of Pendred syndrome. Proteins normally coexpressed with pendrin were decreased in pendrin KO CCDs. In conclusion, we show that functional proteomics on a single nephron segment scale allows function-proteome correlations, and may potentially help predicting function from omics data.
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Affiliation(s)
- Nina Himmerkus
- Institute of Physiology, Christian Albrechts University Kiel, Kiel, Germany
| | | | | | - Markus Bleich
- Institute of Physiology, Christian Albrechts University Kiel, Kiel, Germany
| | | | - Thomas Benzing
- Center for Molecular Medicine, University of Cologne, Cologne, Germany,Department II of Internal Medicine, University of Cologne, Cologne, Germany
| | - Paul A Welling
- Departments of Physiology and Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jens Leipziger
- Department of Biomedicine, Aarhus University, Aarhus, Denmark,Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Markus M Rinschen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark,Center for Molecular Medicine, University of Cologne, Cologne, Germany,Department II of Internal Medicine, University of Cologne, Cologne, Germany,Scripps Center for Metabolomics, Scripps Research, San Diego, CA, USA,III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany,Corresponding author. E-mail:
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Jafree DJ, Long DA. Beyond a Passive Conduit: Implications of Lymphatic Biology for Kidney Diseases. J Am Soc Nephrol 2020; 31:1178-1190. [PMID: 32295825 DOI: 10.1681/asn.2019121320] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The kidney contains a network of lymphatic vessels that clear fluid, small molecules, and cells from the renal interstitium. Through modulating immune responses and via crosstalk with surrounding renal cells, lymphatic vessels have been implicated in the progression and maintenance of kidney disease. In this Review, we provide an overview of the development, structure, and function of lymphatic vessels in the healthy adult kidney. We then highlight the contributions of lymphatic vessels to multiple forms of renal pathology, emphasizing CKD, transplant rejection, and polycystic kidney disease and discuss strategies to target renal lymphatics using genetic and pharmacologic approaches. Overall, we argue the case for lymphatics playing a fundamental role in renal physiology and pathology and treatments modulating these vessels having therapeutic potential across the spectrum of kidney disease.
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Affiliation(s)
- Daniyal J Jafree
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.,MB/PhD Programme, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - David A Long
- Developmental Biology and Cancer Programme, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Huang YQ, Liu L, Lo K, Huang JY, Zhang B, Feng YQ. The relationship between mean telomere length and blood pressure: results from the National Health and Nutrition Examination Surveys. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:535. [PMID: 32411758 PMCID: PMC7214907 DOI: 10.21037/atm.2020.03.205] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Recent studies have shown that telomere length has significantly relationship with different age-related diseases. However, the relationship between mean telomere length (MTL) and elevated blood pressure (BP) has been unclear. Therefore, the aim of the recent study was tried to explore the association of MLT with BP. Methods There were 5,981 subjects from the National Health and Nutrition Examination Surveys (NHANES, 1999–2002) was included in analysis. The MTL was measured using the quantitative polymerase chain reaction (PCR) method and expressed in telomere-to-single copy gene (T/S) ratio and grouped into quartiles. Multivariate linear [expressed in beta and 95% confidence interval (CI)], logistic regression [odds ratios (ORs) and 95% CI] analyses and smooth curve fitting were performed to evaluate the relationship between MTL, BPs and the likelihood of hypertension. Results The mean age of the participants was 45.2±17.3 years, including 2,923 (48.9%) males. After adjusting for potential confounders, MLT was significantly related to the prevalence of hypertension (OR: 0.12, 95% CI: 0.02, 0.94; P=0.04). Smooth curve fitting found a non-linear relationship between MTL, the levels of systolic and diastolic blood pressure (SBP/DBP) and the prevalence of hypertension. The inflection points for the smooth curve of MLT were at 0.86, 1.02 and 0.80 (T/S ratio) respectively. The betas (95% CIs) for SBP [–12.58 (–20.07, –5.09), P<0.01 and 2.25 (0.07, 4.43), P=0.04] and DBP [4.88 (1.29, 8.47), P<0.01 and –3.30 (–5.54, –1.06), P<0.01], and ORs (95% CIs) for the prevalence of hypertension [0.02 (0.001, 9.71), P=0.15 and 0.26 (0.026, 2.60), P=0.25] on the left and right of the inflection point, respectively. Conclusions Our findings revealed that MTL was related with SBP, DBP and the odds of hypertension in a non-linear manner.
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Affiliation(s)
- Yu-Qing Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China
| | - Lin Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China
| | - Kenneth Lo
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China.,Center for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Jia-Yi Huang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China
| | - Bin Zhang
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, China
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Canaud B, Kooman J, Selby NM, Taal M, Francis S, Kopperschmidt P, Maierhofer A, Kotanko P, Titze J. Sodium and water handling during hemodialysis: new pathophysiologic insights and management approaches for improving outcomes in end-stage kidney disease. Kidney Int 2020; 95:296-309. [PMID: 30665570 DOI: 10.1016/j.kint.2018.09.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 02/07/2023]
Abstract
Space medicine and new technology such as magnetic resonance imaging of tissue sodium stores (23NaMRI) have changed our understanding of human sodium homeostasis and pathophysiology. It has become evident that body sodium comprises 3 main components. Two compartments have been traditionally recognized, namely one that is circulating and systemically active via its osmotic action, and one slowly exchangeable pool located in the bones. The third, recently described pool represents sodium stored in skin and muscle interstitium, and it is implicated in cell and biologic activities via local hypertonicity and sodium clearance mechanisms. This in-depth review provides a comprehensive view on the pathophysiology and existing knowledge gaps of systemic hemodynamic and tissue sodium accumulation in dialysis patients. Furthermore, we discuss how the combination of novel technologies to quantitate tissue salt accumulation (e.g., 23NaMRI) with devices to facilitate the precise attainment of a prescribed hemodialytic sodium mass balance (e.g., sodium and water balancing modules) will improve our therapeutic approach to sodium management in dialysis patients. While prospective studies are required, we think that these new diagnostic and sodium balancing tools will enhance our ability to pursue more personalized therapeutic interventions on sodium and water management, with the eventual goal of improving dialysis patient outcomes.
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Affiliation(s)
- Bernard Canaud
- Centre for Medical Excellence, Fresenius Medical Care Deutschland, Bad Homburg, Germany; Montpellier University, Montpellier, France.
| | - Jeroen Kooman
- Maastricht Universitair Medisch Centrum - Maastricht, Netherlands
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, University of Nottingham, Royal Derby Hospital Campus, Derby, UK
| | - Maarten Taal
- Centre for Kidney Research and Innovation, University of Nottingham, Royal Derby Hospital Campus, Derby, UK
| | - Susan Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, UK
| | | | | | - Peter Kotanko
- Renal Research Institute, New York, New York, USA; Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jens Titze
- Division of Cardiovascular and Metabolic Disease, Duke-NUS, Singapore; Division of Nephrology, Duke University Medical Center, Durham, North Carolina, USA; Division of Nephrology and Hypertension, University Clinic Erlangen, Germany
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Abstract
Background Oxidative stress and high salt intake could be independent or intertwined risk factors in the origin of hypertension. Kidneys are the major organ to regulate sodium homeostasis and blood pressure and the renal dopamine system plays a pivotal role in sodium regulation during sodium replete conditions. Oxidative stress has been implicated in renal dopamine dysfunction and development of hypertension, especially in salt‐sensitive animal models. Here we show the nexus between high salt intake and oxidative stress causing renal tubular dopamine oxidation, which leads to mitochondrial and lysosomal dysfunction and subsequently causes renal inflammation and hypertension. Methods and Results Male Sprague Dawley rats were divided into the following groups, vehicle (V)—tap water, high salt (HS)—1% NaCl, L‐buthionine‐sulfoximine (BSO), a prooxidant, and HS plus BSO without and with antioxidant resveratrol (R) for 6 weeks. Oxidative stress was significantly higher in BSO and HS+BSO–treated rat compared with vehicle; however, blood pressure was markedly higher in the HS+BSO group whereas an increase in blood pressure in the BSO group was modest. HS+BSO–treated rats had significant renal dopamine oxidation, lysosomal and mitochondrial dysfunction, and increased renal inflammation; however, HS alone had no impact on organelle function or inflammation. Resveratrol prevented oxidative stress, dopamine oxidation, organelle dysfunction, inflammation, and hypertension in BSO and HS+BSO rats. Conclusions These data suggest that dopamine oxidation, especially during increased sodium intake and oxidative milieu, leads to lysosomal and mitochondrial dysfunction and renal inflammation with subsequent increase in blood pressure. Resveratrol, while preventing oxidative stress, protects renal function and mitigates hypertension.
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Affiliation(s)
- Anees A Banday
- Heart and Kidney Institute College of Pharmacy University of Houston TX
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38
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Zhang Y, Wei W, Shilova V, Petrashevskaya NN, Zernetkina VI, Grigorova YN, Marshall CA, Fenner RC, Lehrmann E, Wood WH, Becker KG, Lakatta EG, Bagrov AY, Fedorova OV. Monoclonal Antibody to Marinobufagenin Downregulates TGFβ Profibrotic Signaling in Left Ventricle and Kidney and Reduces Tissue Remodeling in Salt-Sensitive Hypertension. J Am Heart Assoc 2019; 8:e012138. [PMID: 31576777 PMCID: PMC6818028 DOI: 10.1161/jaha.119.012138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Elevated levels of an endogenous Na/K-ATPase inhibitor marinobufagenin accompany salt-sensitive hypertension and are implicated in cardiac fibrosis. Immunoneutralization of marinobufagenin reduces blood pressure in Dahl salt-sensitive (Dahl-S) rats. The effect of the anti-marinobufagenin monoclonal antibody on blood pressure, left ventricular (LV) and renal remodeling, and gene expression were investigated in hypertensive Dahl-S rats. Methods and Results Dahl-S rats were fed high NaCl (8%, HS; n=14) or low NaCl (0.1%, LS; n=14) diets for 8 weeks. Animals were administered control antibody (LS control antibody, LSC; HS control antibody, HSC; n=7 per group) or anti-marinobufagenin antibody once on week 7 of diet intervention (n=7 per group). Levels of marinobufagenin, LV, and kidney mRNAs and proteins implicated in profibrotic signaling were assessed. Systolic blood pressure was elevated (211±8 versus 133±3 mm Hg, P<0.01), marinobufagenin increased 2-fold in plasma (P<0.05) and 5-fold in urine (P<0.01), LV and kidney weights increased, and levels of LV collagen-1 rose 3.5-fold in HSC versus LSC. Anti-marinobufagenin antibody treatment decreased systolic blood pressure by 24 mm Hg (P<0.01) and reduced organ weights and level of LV collagen-1 (P<0.01) in hypertensive Dahl salt-sensitive rats with anti-marinobufagenin antibody versus HSC. The expression of genes related to transforming growth factor-β-dependent signaling was upregulated in the left ventricles and kidneys in HSC versus LSC groups and became downregulated following administration of anti-marinobufagenin antibody to hypertensive Dahl-S rats. Marinobufagenin also activated transforming growth factor-β signaling in cultured ventricular myocytes from Dahl-S rats. Conclusions Immunoneutralization of heightened marinobufagenin levels in hypertensive Dahl-S rats resulted in a downregulation of genes implicated in transforming growth factor-β pathway, which indicates that marinobufagenin is an activator of profibrotic transforming growth factor-β-dependent signaling in salt-sensitive hypertension.
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Affiliation(s)
- Yongqing Zhang
- Laboratory of Genetics and Genomics National Institute on Aging NIH Baltimore MD
| | - Wen Wei
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Victoria Shilova
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | | | | | - Yulia N Grigorova
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Courtney A Marshall
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Rachel C Fenner
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Elin Lehrmann
- Laboratory of Genetics and Genomics National Institute on Aging NIH Baltimore MD
| | - William H Wood
- Laboratory of Genetics and Genomics National Institute on Aging NIH Baltimore MD
| | - Kevin G Becker
- Laboratory of Genetics and Genomics National Institute on Aging NIH Baltimore MD
| | - Edward G Lakatta
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Alexei Y Bagrov
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
| | - Olga V Fedorova
- Laboratory of Cardiovascular Science National Institute on Aging NIH Baltimore MD
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Polychronopoulou E, Braconnier P, Burnier M. New Insights on the Role of Sodium in the Physiological Regulation of Blood Pressure and Development of Hypertension. Front Cardiovasc Med 2019; 6:136. [PMID: 31608291 PMCID: PMC6756190 DOI: 10.3389/fcvm.2019.00136] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/29/2019] [Indexed: 01/08/2023] Open
Abstract
A precise maintenance of sodium and fluid balance is an essential step in the regulation of blood pressure and alterations of this balance may lead to the development of hypertension. In recent years, several new advances were made in our understanding of the interaction between sodium and blood pressure regulation. The first is the discovery made possible with by new technology, such as 23Na-MRI, that sodium can be stored non-osmotically in tissues including the skin and muscles particularly when subjects are on a high sodium diet or have a reduced renal capacity to excrete sodium. These observations prompted the refinement of the original model of regulation of sodium balance from a two-compartment model comprising the extracellular fluid within the intravascular and interstitial spaces to a three-compartment model that includes the intracellular space of some tissues, most prominently the skin. In this new model, the immune system plays a role, thereby supporting many previous studies indicating that the immune system is a crucial co-contributor to the maintenance of hypertension through pro-hypertensive effects in the kidney, vasculature, and brain. Lastly, there is now evidence that sodium can affect the gut microbiome, and induce pro-inflammatory and immune responses, which might contribute to the development of salt-sensitive hypertension.
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Affiliation(s)
- Erietta Polychronopoulou
- Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Philippe Braconnier
- Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Michel Burnier
- Service of Nephrology and Hypertension, Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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40
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Poulsen SB, Fenton RA. K
+
and the renin–angiotensin–aldosterone system: new insights into their role in blood pressure control and hypertension treatment. J Physiol 2019; 597:4451-4464. [DOI: 10.1113/jp276844] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Søren B. Poulsen
- Department of BiomedicineAarhus University Aarhus DK‐8000 Denmark
| | - Robert A. Fenton
- Department of BiomedicineAarhus University Aarhus DK‐8000 Denmark
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41
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Strauss M, Smith W, Kruger R, van der Westhuizen B, Schutte AE. Large artery stiffness is associated with salt intake in young healthy black but not white adults: the African-PREDICT study. Eur J Nutr 2018; 57:2649-2656. [PMID: 30032457 DOI: 10.1007/s00394-018-1791-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE There is global consensus on the benefits of reducing excessive salt intake. Indeed, lower salt intake associates with reduced arterial stiffness, a well-established predictor of cardiovascular risk, in older populations. Whether high habitual salt intake in healthy normotensive youth may already contribute to increased arterial stiffness is unknown. We, therefore, determined whether estimated salt intake is associated with large artery stiffness in young healthy black and white adults. METHODS We included 693 black and white adults (51% black; 42% men), aged 20-30 years. Participants were normotensive based on clinic blood pressure, and no previous diagnosed chronic illnesses. We measured carotid femoral pulse wave velocity (cfPWV) and determined estimated salt intake based on 24 h urinary sodium excretion. RESULTS We found estimated salt consumption of > 5 g/day in 47% of our population, whereas 21% consumed > 10 g/day. In multivariable-adjusted regression analyses a positive association existed between estimated salt intake and cfPWV in the total group (Adj. R2 = 0.32; std. β = 0.10; p = 0.007), and black adults (Adj. R2 = 0.37; std. β = 0.12; p = 0.029). This was independent of age, sex, mean arterial pressure, and other covariates. No association was evident in white individuals (p = 0.19). CONCLUSION Excessive salt intake is positively associated with large artery stiffness-independent of blood pressure-in young adults, especially in black individuals. Our results suggest a potential contributory role of salt consumption towards early vascular aging.
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Affiliation(s)
- Michél Strauss
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Wayne Smith
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.,MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.,MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Bianca van der Westhuizen
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa. .,MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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Wiig H, Luft FC, Titze JM. The interstitium conducts extrarenal storage of sodium and represents a third compartment essential for extracellular volume and blood pressure homeostasis. Acta Physiol (Oxf) 2018; 222. [PMID: 29193764 DOI: 10.1111/apha.13006] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/31/2017] [Accepted: 11/23/2017] [Indexed: 12/15/2022]
Abstract
The role of salt in the pathogenesis of arterial hypertension is not well understood. According to the current understanding, the central mechanism for blood pressure (BP) regulation relies on classical studies linking BP and Na+ balance, placing the kidney at the very centre of long-term BP regulation. To maintain BP homeostasis, the effective circulating fluid volume and thereby body Na+ content has to be maintained within very narrow limits. From recent work in humans and rats, the notion has emerged that Na+ could be stored somewhere in the body without commensurate water retention to buffer free extracellular Na+ and that previously unidentified extrarenal, tissue-specific regulatory mechanisms are operative regulating the release and storage of Na+ from a kidney-independent reservoir. Moreover, immune cells from the mononuclear phagocyte system not only function as local on-site sensors of interstitial electrolyte concentration, but also, together with lymphatics, act as systemic regulators of body fluid volume and BP. These studies have established new and unexpected targets in studies of BP control and thus the pathophysiology of hypertension: the interstitium/extracellular matrix of the skin, its inherent interstitial fluid and the lymphatic vasculature forming a vessel network in the interstitium. Aspects of the interstitium in relation to Na+ balance and hypertension are the focus of this review. Taken together, observations of salt storage in the skin to buffer free extracellular Na+ and macrophage modulation of the extracellular matrix and lymphatics suggest that electrolyte homeostasis in the body cannot be achieved by renal excretion alone, but also relies on extrarenal regulatory mechanisms.
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Affiliation(s)
- H. Wiig
- Department of Biomedicine; University of Bergen; Bergen Norway
| | - F. C. Luft
- Experimental and Clinical Research Center; Max-Delbrück Center for Molecular Medicine; Charité Medical Faculty; Berlin Germany
- Division of Clinical Pharmacology; Department of Medicine; Vanderbilt University School of Medicine; Nashville TN USA
| | - J. M. Titze
- Division of Clinical Pharmacology; Department of Medicine; Vanderbilt University School of Medicine; Nashville TN USA
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Kopp C, Linz P, Maier C, Wabel P, Hammon M, Nagel AM, Rosenhauer D, Horn S, Uder M, Luft FC, Titze J, Dahlmann A. Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by 23Na magnetic resonance imaging. Kidney Int 2018; 93:1191-1197. [PMID: 29455909 DOI: 10.1016/j.kint.2017.11.021] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 12/25/2022]
Abstract
Long-term elevated blood sugar levels result in tissue matrix compositional changes in patients with diabetes mellitus type 2 (T2DM). We hypothesized that hemodialysis patients with T2DM might accumulate more tissue sodium than control hemodialysis patients. To test this, 23Na magnetic resonance imaging (23Na MRI) was used to estimate sodium in skin and muscle tissue in hemodialysis patients with or without T2DM. Muscle fat content was estimated by 1H MRI and tissue sodium content by 23Na MRI pre- and post-hemodialysis in ten hemodialysis patients with T2DM and in 30 matched control hemodialysis patients. We also assessed body fluid distribution with the Body Composition Monitor. 1H MRI indicated a tendency to higher muscle fat content in hemodialysis patients with T2DM compared to non-diabetic hemodialysis patients. 23Na MRI indicated increased sodium content in muscle and skin tissue of hemodialysis patients with T2DM compared to control hemodialysis patients. Multi-frequency bioimpedance was used to estimate extracellular water (ECW), and excess ECW in T2DM hemodialysis patients correlated with HbA1c levels. Sodium mobilization during hemodialysis lowered muscle sodium content post-dialysis to a greater degree in T2DM hemodialysis patients than in control hemodialysis patients. Thus, our findings provide evidence that increased sodium accumulation occurs in hemodialysis patients with T2DM and that impaired serum glucose metabolism is associated with disturbances in tissue sodium and water content.
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Affiliation(s)
- Christoph Kopp
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
| | - Peter Linz
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Carolin Maier
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Wabel
- Fresenius Medical Care, Bad Homburg, Germany
| | - Matthias Hammon
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Daniela Rosenhauer
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | | | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Friedrich C Luft
- Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany; Department of Clinical Pharmacology, Vanderbilt University, Nashville, Tennessee, USA
| | - Jens Titze
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; Department of Clinical Pharmacology, Vanderbilt University, Nashville, Tennessee, USA
| | - Anke Dahlmann
- Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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Osborn JW, Banek CT. Catheter-Based Renal Nerve Ablation as a Novel Hypertension Therapy: Lost, and Then Found, in Translation. Hypertension 2018; 71:383-388. [PMID: 29295850 DOI: 10.1161/hypertensionaha.117.08928] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- John W Osborn
- From the Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis.
| | - Christopher T Banek
- From the Department of Integrative Biology and Physiology, University of Minnesota Medical School, Minneapolis
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45
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Steffensen IL, Frølich W, Dahl KH, Iversen PO, Lyche JL, Lillegaard ITL, Alexander J. Benefit and risk assessment of increasing potassium intake by replacement of sodium chloride with potassium chloride in industrial food products in Norway. Food Chem Toxicol 2018; 111:329-340. [DOI: 10.1016/j.fct.2017.11.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 10/20/2017] [Accepted: 11/20/2017] [Indexed: 12/28/2022]
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46
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Takagi Y, Sugimoto T, Kobayashi M, Shirai M, Asai F. High-Salt Intake Ameliorates Hyperglycemia and Insulin Resistance in WBN/Kob- Leprfa/fa Rats: A New Model of Type 2 Diabetes Mellitus. J Diabetes Res 2018; 2018:3671892. [PMID: 29744365 PMCID: PMC5884204 DOI: 10.1155/2018/3671892] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/08/2017] [Accepted: 01/31/2018] [Indexed: 02/06/2023] Open
Abstract
High-salt intake is a major risk factor for developing hypertension in type 2 diabetes mellitus, but its effects on glucose homeostasis are controversial. We previously found that high-salt intake induces severe hypertension in WBN/Kob diabetic fatty (WBKDF) rats. In the present study, we examined the effects of a high-salt intake on glucose homeostasis in WBKDF rats. Male WBKDF rats and age-matched Wistar rats at 6 weeks of age were each divided into two groups and fed either a normal-sodium (NS, 0.26%) diet or high-sodium (HS, 8%) diet for 7 weeks. Systolic blood pressure and urine volume were increased in WBKDF-HS and Wistar-HS. Body weight gain and food consumption were comparable between NS and HS in both strains. Plasma and urine glucose levels were significantly increased in WBKDF-NS but not in WBKDF-HS. HOMA-IR in WBKDF-HS was significantly lower compared with that in WBKDF-NS. The high plasma adiponectin level in WBKDF-NS compared with that in Wistar-NS was further enhanced in WBKDF-HS. Glycogen deposits and fat droplets in the livers of WBKDF-HS were reduced compared with those of WBKDF-NS. The present study demonstrated that HS intake ameliorated hyperglycemia and insulin resistance in WBKDF rats, which may be due to increased plasma levels of adiponectin.
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Affiliation(s)
- Yoshiichi Takagi
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Taichi Sugimoto
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Masaya Kobayashi
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Mitsuyuki Shirai
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Fumitoshi Asai
- Laboratory of Veterinary Pharmacology, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
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Francis S, Buchanan CE, Prestwich B, Taal MW. Sodium MRI: a new frontier in imaging in nephrology. Curr Opin Nephrol Hypertens 2017; 26:435-441. [PMID: 28877041 DOI: 10.1097/mnh.0000000000000370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW This review focuses on the recent technological advances in quantitative sodium (Na) MRI to provide a noninvasive measure of tissue viability for use in clinical studies of patients with kidney disease. Na MRI is the only noninvasive imaging technique that allows for the absolute spatial quantification of tissue sodium concentration (TSC), providing assessment of the corticomedullary sodium gradient (CMSG) in the kidney, and allowing measures of TSC in the skin and muscle. RECENT FINDINGS Na MRI of the kidney has demonstrated the sensitivity to measure the CMSG, providing the normal range in healthy individuals and demonstrating a reduction in CMSG in kidney disease and transplanted kidneys. Studies using Na and H MRI have shown that in humans, skeletal muscle and skin can store sodium without water retention, and that sodium concentrations in muscle and skin increase with advancing age. Recent studies have shown that TSC can be mobilised during haemodialysis, and that skin sodium content links closely to left ventricular mass in patients with chronic kidney disease. SUMMARY Na MRI is currently a research technique, but with future advances, Na MRI has potential to become a noninvasive renal biomarker and a measure of tissue sodium storage for clinical studies.
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Affiliation(s)
- Susan Francis
- aSir Peter Mansfield Imaging Centre, School of Physics and Astronomy bCentre for Kidney Research and Innovation, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Nottingham, United Kingdom
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Kurtz TW, Morris RC. What abnormalities initiate salt-induced increases in blood pressure according to the autoregulation and vasodysfunction theories for salt sensitivity? Kidney Int 2017; 92:1015-1016. [PMID: 28938938 DOI: 10.1016/j.kint.2017.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Theodore W Kurtz
- Department of Laboratory Medicine, University of California, San Francisco, California, USA.
| | - R Curtis Morris
- Department of Medicine, University of California, San Francisco, California, USA
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Pathak CM, Ix JH, Anderson CAM, Woodell TB, Smits G, Persky MS, Block GA, Rifkin DE. Variation in Sodium Intake and Intra-individual Change in Blood Pressure in Chronic Kidney Disease. J Ren Nutr 2017; 28:125-128. [PMID: 28866091 DOI: 10.1053/j.jrn.2017.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE In the kidney disease clinic setting, higher-than-usual blood pressure is often ascribed to recent dietary sodium indiscretion. While clinical trials demonstrate a clear relationship between salt intake and blood pressure on the population level, it is uncertain whether real-world variation in sodium intake within individual chronic kidney disease (CKD) patients is associated with fluctuations in blood pressure. METHODS We analyzed data from the Phosphorus Normalization Trial, in which participants with CKD eating their usual diets completed at least three 24-hour urine collections over 9 months, from which we measured sodium. Blood pressure was measured at the time of 24-hour urine collections. For each individual participant, we assessed the slope of the relationship between sodium intake and mean arterial blood pressure (MAP). RESULTS Among 119 participants (mean age 67 years and mean estimated glomerular filtration rate 31 mL/minute/1.73 m2), there was substantial variation in sodium intake as measured by 24-hour urine collections (mean intake 3,903 mg/day, standard deviation 1037 mg/day). Individual participants had highly variable associations between their sodium intake and their MAP; 47% (n = 56) had inverse associations between sodium and MAP, whereas the remainder had positive (salt-sensitive) associations. CONCLUSIONS Among CKD patients, there is substantial variation in sodium intake but no predictable relationship between dietary sodium and blood pressure in individuals. The frequent dismissal of elevated blood pressure readings as related to recent sodium intake in clinic may be a misapplication of large-scale population data to explain individual variability and may contribute to clinical inertia regarding high blood pressure treatment.
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Affiliation(s)
- Chetna M Pathak
- School of Medicine, University of California San Diego, San Diego, California
| | - Joachim H Ix
- School of Medicine, University of California San Diego, San Diego, California; Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California; Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Cheryl A M Anderson
- School of Medicine, University of California San Diego, San Diego, California; Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California
| | - Tyler B Woodell
- Division of Nephrology, Oregon Health Sciences University, Portland, Oregon
| | | | | | | | - Dena E Rifkin
- School of Medicine, University of California San Diego, San Diego, California; Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, San Diego, California; Department of Family Medicine and Public Health, University of California San Diego, San Diego, California; Veterans Affairs San Diego Healthcare System, San Diego, California.
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Dikalova AE, Itani HA, Nazarewicz RR, McMaster WG, Flynn CR, Uzhachenko R, Fessel JP, Gamboa JL, Harrison DG, Dikalov SI. Sirt3 Impairment and SOD2 Hyperacetylation in Vascular Oxidative Stress and Hypertension. Circ Res 2017; 121:564-574. [PMID: 28684630 DOI: 10.1161/circresaha.117.310933] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/01/2017] [Accepted: 07/05/2017] [Indexed: 01/21/2023]
Abstract
RATIONALE Clinical studies have shown that Sirt3 (Sirtuin 3) expression declines by 40% by 65 years of age paralleling the increased incidence of hypertension and metabolic conditions further inactivate Sirt3 because of increased NADH (nicotinamide adenine dinucleotide, reduced form) and acetyl-CoA levels. Sirt3 impairment reduces the activity of a key mitochondrial antioxidant enzyme, superoxide dismutase 2 (SOD2) because of hyperacetylation. OBJECTIVE In this study, we examined whether the loss of Sirt3 activity increases vascular oxidative stress because of SOD2 hyperacetylation and promotes endothelial dysfunction and hypertension. METHODS AND RESULTS Hypertension was markedly increased in Sirt3-knockout (Sirt3-/-) and SOD2-depleted (SOD2+/-) mice in response to low dose of angiotensin II (0.3 mg/kg per day) compared with wild-type C57Bl/6J mice. Sirt3 depletion increased SOD2 acetylation, elevated mitochondrial O2· -, and diminished endothelial nitric oxide. Angiotensin II-induced hypertension was associated with Sirt3 S-glutathionylation, acetylation of vascular SOD2, and reduced SOD2 activity. Scavenging of mitochondrial H2O2 in mCAT mice expressing mitochondria-targeted catalase prevented Sirt3 and SOD2 impairment and attenuated hypertension. Treatment of mice after onset of hypertension with a mitochondria-targeted H2O2 scavenger, mitochondria-targeted hydrogen peroxide scavenger ebselen, reduced Sirt3 S-glutathionylation, diminished SOD2 acetylation, and reduced blood pressure in wild-type but not in Sirt3-/- mice, whereas an SOD2 mimetic, (2-[2,2,6,6-tetramethylpiperidin-1-oxyl-4-ylamino]-2-oxoethyl) triphenylphosphonium (mitoTEMPO), reduced blood pressure and improved vasorelaxation both in Sirt3-/- and wild-type mice. SOD2 acetylation had an inverse correlation with SOD2 activity and a direct correlation with the severity of hypertension. Analysis of human subjects with essential hypertension showed 2.6-fold increase in SOD2 acetylation and 1.4-fold decrease in Sirt3 levels, whereas SOD2 expression was not affected. CONCLUSIONS Our data suggest that diminished Sirt3 expression and redox inactivation of Sirt3 lead to SOD2 inactivation and contributes to the pathogenesis of hypertension.
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Affiliation(s)
- Anna E Dikalova
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Hana A Itani
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Rafal R Nazarewicz
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - William G McMaster
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Charles R Flynn
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Roman Uzhachenko
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Joshua P Fessel
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Jorge L Gamboa
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - David G Harrison
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN
| | - Sergey I Dikalov
- From the Division of Clinical Pharmacology (A.E.D., H.A.I., R.R.N., W.G.M., R.U., J.P.F., J.L.G., D.G.H., S.I.D.) and Department of Surgery (C.R.F.), Vanderbilt University Medical Center, Nashville, TN.
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