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Powell NR, Shugg T, Leighty J, Martin M, Kreutz RP, Eadon MT, Lai D, Lu T, Skaar TC. Analysis of the combined effect of rs699 and rs5051 on angiotensinogen expression and hypertension. Chronic Dis Transl Med 2024; 10:102-117. [PMID: 38872760 PMCID: PMC11166681 DOI: 10.1002/cdt3.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 06/15/2024] Open
Abstract
Background Hypertension (HTN) involves genetic variability in the renin-angiotensin system and influences antihypertensive response. We previously reported that angiotensinogen (AGT) messenger RNA (mRNA) is endogenously bound by miR-122-5p and rs699 A > G decreases reporter mRNA in the microRNA functional-assay PASSPORT-seq. The AGT promoter variant rs5051 C > T is in linkage disequilibrium (LD) with rs699 A > G and increases AGT transcription. The independent effect of these variants is understudied due to their LD therefore we aimed to test the hypothesis that increased AGT by rs5051 C > T counterbalances AGT decreased by rs699 A > G, and when these variants occur independently, it translates to HTN-related phenotypes. Methods We used in silico, in vitro, in vivo, and retrospective models to test this hypothesis. Results In silico, rs699 A > G is predicted to increase miR-122-5p binding affinity by 3%. Mir-eCLIP results show rs699 is 40-45 nucleotides from the strongest microRNA-binding site in the AGT mRNA. Unexpectedly, rs699 A > G increases AGT mRNA in an AGT-plasmid-cDNA HepG2 expression model. Genotype-Tissue Expression (GTEx) and UK Biobank analyses demonstrate liver AGT expression and HTN phenotypes are not different when rs699 A > G occurs independently from rs5051 C > T. However, GTEx and the in vitro experiments suggest rs699 A > G confers cell-type-specific effects on AGT mRNA abundance, and suggest paracrine renal renin-angiotensin-system perturbations could mediate the rs699 A > G associations with HTN. Conclusions We found that rs5051 C > T and rs699 A > G significantly associate with systolic blood pressure in Black participants in the UK Biobank, demonstrating a fourfold larger effect than in White participants. Further studies are warranted to determine if altered antihypertensive response in Black individuals might be due to rs5051 C > T or rs699 A > G. Studies like this will help clinicians move beyond the use of race as a surrogate for genotype.
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Affiliation(s)
- Nicholas R. Powell
- Division of Clinical Pharmacology, Department of MedicineSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Tyler Shugg
- Division of Clinical Pharmacology, Department of MedicineSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Jacob Leighty
- Division of Clinical Pharmacology, Department of MedicineSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Matthew Martin
- Department of Pharmacology and ToxicologySchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Rolf P. Kreutz
- Department of CardiologySchool of Medicine, Krannert Institute of Cardiology, Indiana UniversityIndianapolisIndianaUSA
| | - Michael T. Eadon
- Division of Nephrology, Department of MedicineSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
- Department of Medical and Molecular GeneticsSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Dongbing Lai
- Department of Medical and Molecular GeneticsSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Tao Lu
- Department of Pharmacology and ToxicologySchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
| | - Todd C. Skaar
- Division of Clinical Pharmacology, Department of MedicineSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
- Department of Medical and Molecular GeneticsSchool of Medicine, Indiana UniversityIndianapolisIndianaUSA
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2
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Gao K, Wang PX, Mei X, Yang T, Yu K. Untapped potential of gut microbiome for hypertension management. Gut Microbes 2024; 16:2356278. [PMID: 38825779 PMCID: PMC11152106 DOI: 10.1080/19490976.2024.2356278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/13/2024] [Indexed: 06/04/2024] Open
Abstract
The gut microbiota has been shown to be associated with a range of illnesses and disorders, including hypertension, which is recognized as the primary factor contributing to the development of serious cardiovascular diseases. In this review, we conducted a comprehensive analysis of the progression of the research domain pertaining to gut microbiota and hypertension. Our primary emphasis was on the interplay between gut microbiota and blood pressure that are mediated by host and gut microbiota-derived metabolites. Additionally, we elaborate the reciprocal communication between gut microbiota and antihypertensive drugs, and its influence on the blood pressure of the host. The field of computer science has seen rapid progress with its great potential in the application in biomedical sciences, we prompt an exploration of the use of microbiome databases and artificial intelligence in the realm of high blood pressure prediction and prevention. We propose the use of gut microbiota as potential biomarkers in the context of hypertension prevention and therapy.
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Affiliation(s)
- Kan Gao
- Department of Pharmacy, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Pu Xiu Wang
- Department of Pharmacy, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xue Mei
- School of Pharmacy, Institute of Materia Medica, North Sichuan Medical College, Nanchang, Sichuan, China
| | - Tao Yang
- Department of Physiology and Pharmacology, Center for Hypertension and Precision Medicine, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Kai Yu
- Department of General Practice, The First Hospital of China Medical University, Shenyang, Liaoning, China
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3
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Umanath K, She R, Hassett C, Adrianto I, Levin AM, Savickas G, Yee J, Ortiz P. Urine Cell Transcriptomes Implicate Specific Renal Inflammatory Pathways Associated With Difficult-to-Control Hypertension. J Am Heart Assoc 2023; 12:e026242. [PMID: 36892045 PMCID: PMC10111524 DOI: 10.1161/jaha.122.026242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/19/2022] [Indexed: 03/10/2023]
Abstract
Background The renal mechanisms involved in the maintenance of human hypertension and resistance to treatment are not well understood. Animal studies suggest that chronic renal inflammation contributes to hypertension. We studied cells shed in first-morning urine samples from individuals who were hypertensive who exhibited difficult-to-control blood pressure (BP). We performed bulk RNA sequencing of these shed cells to develop transcriptome-wide associations with BP. We also analyzed nephron-specific genes and used an unbiased bioinformatic approach to find signaling pathways activated in difficult-to-control hypertension. Methods and Results Participants who completed the SPRINT (Systolic Blood Pressure Intervention Trial) at a single trial site were recruited, and cells shed in first-morning urine samples collected. A total of 47 participants were divided into 2 groups based on hypertension control. The BP-difficult group (n=29) had systolic BP>140 mm Hg, >120 mm Hg after intensive treatment for hypertension, or required more than the median number of antihypertensive drugs used in SPRINT. The easy-to-control BP group (n=18) comprised the remainder of the participants. A total of 60 differentially expressed genes were identified with a >2-fold change in the BP-difficult group. In BP-difficult participants, 2 of the most upregulated genes were associated with inflammation: Tumor Necrosis Factor Alpha Induced Protien 6 (fold change, 7.76; P=0.006) and Serpin Family B Member 9 (fold change, 5.10; P=0.007). Biological pathway analysis revealed an overrepresentation of inflammatory networks, including interferon signaling, granulocyte adhesion and diapedesis, and Janus Kinase family kinases in the BP-difficult group (P<0.001). Conclusions We conclude that transcriptomes from cells shed in first-morning urine identify a gene expression profile in difficult-to-control hypertension that associates with renal inflammation.
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Affiliation(s)
- Kausik Umanath
- Division of Nephrology and HypertensionHenry Ford HealthDetroitMI
- Division of Nephrology and HypertensionWayne State UniversityDetroitMI
- Department of MedicineMichigan State UniversityEast LansingMI
| | - Ruicong She
- Department of Public Health SciencesHenry Ford HealthDetroitMI
- Center for BioinformaticsHenry Ford HealthDetroitMI
| | - Clare Hassett
- Division of Nephrology and HypertensionHenry Ford HealthDetroitMI
| | - Indra Adrianto
- Department of Public Health SciencesHenry Ford HealthDetroitMI
- Center for BioinformaticsHenry Ford HealthDetroitMI
| | - Albert M. Levin
- Department of Public Health SciencesHenry Ford HealthDetroitMI
- Center for BioinformaticsHenry Ford HealthDetroitMI
| | - Gina Savickas
- Translation and Clinical Research CenterHenry Ford HospitalDetroitMI
| | - Jerry Yee
- Division of Nephrology and HypertensionHenry Ford HealthDetroitMI
- Division of Nephrology and HypertensionWayne State UniversityDetroitMI
| | - Pablo Ortiz
- Translation and Clinical Research CenterHenry Ford HospitalDetroitMI
- Division of Hypertension and Vascular ResearchHenry Ford HealthDetroitMI
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4
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Lai X, Wen H, Yang T, Qin F, Zhong X, Pan Y, Yu J, Huang J, Li J. Effects of renal denervation on endogenous ouabain in spontaneously hypertensive rats. Acta Cir Bras 2023; 37:e371102. [PMID: 36629529 PMCID: PMC9829196 DOI: 10.1590/acb371102] [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: 07/16/2022] [Accepted: 10/12/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To investigate the role of renal denervation (RDN) on endogenous ouabain (EO) secretion in spontaneously hypertensive rats (SHR). METHODS Sixteen 12-week-old male SHR were randomly separated into the renal denervation group (RDNX group) and sham operation group (sham group), and eight age-matched Wistar Kyoto rats (WKY) were served as control group. EO concentrations, the Na+- K+-ATPaseactivity, and the expression of Na+-K+-ATPase were assessed. RESULTS EO levels in serum, kidneys and hypothalamus of sham group were higher than in RDNX group (p < 0.05). Renal Na+-K+-ATPase activity subjected to denervation surgery showed significantly reduction when compared with the sham groups (p < 0.05). A positive correlation existed between norepinephrine (NE) content and Na+-K+-ATPase activity in the kidney (r2 = 0.579). Renal Na+-K+-ATPase α1 subunit mRNA expression was down-regulated in the RDNX group compared with the sham group (P < 0.05), while renal Na+-K+-ATPase α1 subunit mRNA expression was no statistical significance between the groups (P = 0.63). Immunohistochemical analysis showed that there were significant differences in the renal expression of Na+-K+-ATPasebetween the three groups (P < 0.05). CONCLUSIONS These experiments demonstrate that RDN exerted an anti-hypertensive effect with reduction of EO levels and Na+-K+-ATPase activity and Na+-K+-ATPase α1 subunit expression of kidney in SHR.
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Affiliation(s)
- Xiaomei Lai
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Hong Wen
- PhD. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Tingting Yang
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Fei Qin
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Xiaoge Zhong
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Yajin Pan
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Jie Yu
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Jing Huang
- Postgraduate. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China
| | - Jianling Li
- PhD, and Postdoctoral Mobile Station. Guangxi Medical University – First Affiliated Hospital – Department of Cardiology – Nanning, China.,Corresponding author:
- 13407710624
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5
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Crorkin P, Hao S, Ferreri NR. Responses to Ang II (Angiotensin II), Salt Intake, and Lipopolysaccharide Reveal the Diverse Actions of TNF-α (Tumor Necrosis Factor-α) on Blood Pressure and Renal Function. Hypertension 2022; 79:2656-2670. [PMID: 36129177 PMCID: PMC9649876 DOI: 10.1161/hypertensionaha.122.19464] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
TNF-α (tumor necrosis factor-alpha) is the best known as a proinflammatory cytokine; yet, this cytokine also has important immunomodulatory and regulatory functions. As the effects of TNF-α on immune system function were being revealed, the spectrum of its activities appeared in conflict with each other before investigators defined the settings and mechanisms by which TNF-α contributed to both host defense and chronic inflammation. These effects reflect self-protective mechanisms that may become harmful when dysregulated. The paradigm of physiological and pathophysiological effects of TNF-α has since been uncovered in the lung, colon, and kidney where its role has been identified in pulmonary edema, electrolyte reabsorption, and blood pressure regulation, respectively. Recent studies on the prohypertensive and inflammatory effects of TNF-α in the cardiovascular system juxtaposed to those related to NaCl and blood pressure homeostasis, the response of the kidney to lipopolysaccharide, and protection against bacterial infections are helping define the mechanisms by which TNF-α modulates distinct functions within the kidney. This review discusses how production of TNF-α by renal epithelial cells may contribute to regulatory mechanisms that not only govern electrolyte excretion and blood pressure homeostasis but also maintain the appropriate local hypersalinity environment needed for optimizing the innate immune response to bacterial infections in the kidney. It is possible that the wide range of effects mediated by TNF-α may be related to severity of disease, amount of inflammation and TNF-α levels, and the specific cell types that produce this cytokine, areas that remain to be investigated further.
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Affiliation(s)
- Patrick Crorkin
- Department of Pharmacology, New York Medical College, Valhalla, NY
| | - Shoujin Hao
- Department of Pharmacology, New York Medical College, Valhalla, NY
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Lansdell TA, Chambers LC, Dorrance AM. Endothelial Cells and the Cerebral Circulation. Compr Physiol 2022; 12:3449-3508. [PMID: 35766836 DOI: 10.1002/cphy.c210015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Endothelial cells form the innermost layer of all blood vessels and are the only vascular component that remains throughout all vascular segments. The cerebral vasculature has several unique properties not found in the peripheral circulation; this requires that the cerebral endothelium be considered as a unique entity. Cerebral endothelial cells perform several functions vital for brain health. The cerebral vasculature is responsible for protecting the brain from external threats carried in the blood. The endothelial cells are central to this requirement as they form the basis of the blood-brain barrier. The endothelium also regulates fibrinolysis, thrombosis, platelet activation, vascular permeability, metabolism, catabolism, inflammation, and white cell trafficking. Endothelial cells regulate the changes in vascular structure caused by angiogenesis and artery remodeling. Further, the endothelium contributes to vascular tone, allowing proper perfusion of the brain which has high energy demands and no energy stores. In this article, we discuss the basic anatomy and physiology of the cerebral endothelium. Where appropriate, we discuss the detrimental effects of high blood pressure on the cerebral endothelium and the contribution of cerebrovascular disease endothelial dysfunction and dementia. © 2022 American Physiological Society. Compr Physiol 12:3449-3508, 2022.
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Affiliation(s)
- Theresa A Lansdell
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - Laura C Chambers
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - Anne M Dorrance
- Department of Pharmacology and Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
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7
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Moeinafshar A, Razi S, Rezaei N. Interleukin 17, the double-edged sword in atherosclerosis. Immunobiology 2022; 227:152220. [PMID: 35452921 DOI: 10.1016/j.imbio.2022.152220] [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: 06/04/2021] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/05/2022]
Abstract
Cardiovascular diseases, including atherosclerosis, are the number one cause of death worldwide. These diseases have taken the place of pneumonia and other infectious diseases in the epidemiological charts. Thus, their importance should not be underestimated. Atherosclerosis is an inflammatory disease. Therefore, immunological signaling molecules and immune cells carry out a central role in its etiology. One of these signaling molecules is interleukin (IL)-17. This relatively newly discovered signaling molecule might have a dual role as acting both pro-atherogenic and anti-atherogenic depending on the situation. The majority of articles have discussed IL-17 and its action in atherosclerosis, and it may be a new target for the treatment of patients with this disease. In this review, the immunological basis of atherosclerosis with an emphasis on the role of IL-17 and a brief explanation of the role of IL-17 on atherosclerogenic disorders will be discussed.
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Affiliation(s)
- Aysan Moeinafshar
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sepideh Razi
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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8
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Lingli X, Wenfang X. Characteristics and molecular mechanisms through which SGLT2 inhibitors improve metabolic diseases: A mechanism review. Life Sci 2022; 300:120543. [PMID: 35421452 DOI: 10.1016/j.lfs.2022.120543] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/26/2022]
Abstract
Metabolic diseases, such as diabetes, gout and hyperlipidemia are global health challenges. Among them, diabetes has been extensively investigated. Type 2 diabetes mellitus (T2DM), which is characterized by hyperglycemia, is a complex metabolic disease that is associated with various metabolic disorders. The newly developed oral hypoglycemic agent, sodium-glucose cotransporter 2 (SGLT2) inhibitor, has been associated with glucose-lowering effects and it affects metabolism in various ways. However, the potential mechanisms of SGLT2 inhibitors in metabolic diseases have not fully reviewed. Many of the effects beyond glycemic control must be considered off-target effects. Therefore, we reviewed the effects of SGLT2 inhibition on metabolic diseases such as obesity, hypertension, hyperlipidemia, hyperuricemia, fatty liver disease, insulin resistance, osteoporosis and fractures. Moreover, we elucidated their molecular mechanisms to provide a theoretical basis for metabolic disease treatment.
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Affiliation(s)
- Xie Lingli
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China
| | - Xia Wenfang
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.
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9
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Paterson MR, Jackson KL, Dona MSI, Farrugia GE, Visniauskas B, Watson AMD, Johnson C, Prieto MC, Evans RG, Charchar F, Pinto AR, Marques FZ, Head GA. Deficiency of MicroRNA-181a Results in Transcriptome-Wide Cell-Specific Changes in the Kidney and Increases Blood Pressure. Hypertension 2021; 78:1322-1334. [PMID: 34538100 PMCID: PMC8573069 DOI: 10.1161/hypertensionaha.121.17384] [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: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Madeleine R. Paterson
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, Australia; Monash University, Melbourne, Australia
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Kristy L. Jackson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Drug Discovery Biology, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University Parkville, Australia
| | - Malathi S. I. Dona
- Cardiac Cellular Systems Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gabriella E. Farrugia
- Cardiac Cellular Systems Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Bruna Visniauskas
- Department of Physiology, School of Medicine, Tulane University, New Orleans, the USA
| | - Anna M. D. Watson
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - Chad Johnson
- Monash Micro Imaging, Monash University, Melbourne, Australia
| | - Minolfa C. Prieto
- Department of Physiology, School of Medicine, Tulane University, New Orleans, the USA
| | - Roger G. Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Australia
| | - Fadi Charchar
- Health Innovation and Transformation Centre, Federation University, Ballarat, Australia
- Department of Physiology, University of Melbourne, Melbourne, Australia
| | - Alexander R. Pinto
- Drug Discovery Biology, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University Parkville, Australia
- Centre for Cardiovascular Biology and Disease Research, La Trobe University, Melbourne, Australia
| | - Francine Z. Marques
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, Australia; Monash University, Melbourne, Australia
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Geoffrey A. Head
- Neuropharmacology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Pharmacology, Monash University, Melbourne, Australia
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Sparks MA, Dilmen E, Ralph DL, Rianto F, Hoang TA, Hollis A, Diaz EJ, Adhikari R, Chew G, Petretto EG, Gurley SB, McDonough AA, Coffman TM. Vascular control of kidney epithelial transporters. Am J Physiol Renal Physiol 2021; 320:F1080-F1092. [PMID: 33969697 PMCID: PMC8285646 DOI: 10.1152/ajprenal.00084.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/23/2021] [Accepted: 05/05/2021] [Indexed: 01/03/2023] Open
Abstract
A major pathway in hypertension pathogenesis involves direct activation of ANG II type 1 (AT1) receptors in the kidney, stimulating Na+ reabsorption. AT1 receptors in tubular epithelia control expression and stimulation of Na+ transporters and channels. Recently, we found reduced blood pressure and enhanced natriuresis in mice with cell-specific deletion of AT1 receptors in smooth muscle (SMKO mice). Although impaired vasoconstriction and preserved renal blood flow might contribute to exaggerated urinary Na+ excretion in SMKO mice, we considered whether alterations in Na+ transporter expression might also play a role; therefore, we carried out proteomic analysis of key Na+ transporters and associated proteins. Here, we show that levels of Na+-K+-2Cl- cotransporter isoform 2 (NKCC2) and Na+/H+ exchanger isoform 3 (NHE3) are reduced at baseline in SMKO mice, accompanied by attenuated natriuretic and diuretic responses to furosemide. During ANG II hypertension, we found widespread remodeling of transporter expression in wild-type mice with significant increases in the levels of total NaCl cotransporter, phosphorylated NaCl cotransporter (Ser71), and phosphorylated NKCC2, along with the cleaved, activated forms of the α- and γ-epithelial Na+ channel. However, the increases in α- and γ-epithelial Na+ channel with ANG II were substantially attenuated in SMKO mice. This was accompanied by a reduced natriuretic response to amiloride. Thus, enhanced urinary Na+ excretion observed after cell-specific deletion of AT1 receptors from smooth muscle cells is associated with altered Na+ transporter abundance across epithelia in multiple nephron segments. These findings suggest a system of vascular-epithelial in the kidney, modulating the expression of Na+ transporters and contributing to the regulation of pressure natriuresis.NEW & NOTEWORTHY The use of drugs to block the renin-angiotensin system to reduce blood pressure is common. However, the precise mechanism for how these medications control blood pressure is incompletely understood. Here, we show that mice lacking angiotensin receptors specifically in smooth muscle cells lead to alternation in tubular transporter amount and function. Thus, demonstrating the importance of vascular-tubular cross talk in the control of blood pressure.
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Affiliation(s)
- Matthew A Sparks
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Renal Section, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Emre Dilmen
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Donna L Ralph
- Department of Physiology and Neuroscience, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Fitra Rianto
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Thien A Hoang
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Alison Hollis
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Edward J Diaz
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Rishav Adhikari
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Gabriel Chew
- Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
| | - Enrico G Petretto
- Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
| | - Susan B Gurley
- Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon
| | - Alicia A McDonough
- Department of Physiology and Neuroscience, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Thomas M Coffman
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Renal Section, Durham Veterans Affairs Health Care System, Durham, North Carolina
- Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
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11
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Veiras LC, Shen JZY, Bernstein EA, Regis GC, Cao D, Okwan-Duodu D, Khan Z, Gibb DR, Dominici FP, Bernstein KE, Giani JF. Renal Inflammation Induces Salt Sensitivity in Male db/db Mice through Dysregulation of ENaC. J Am Soc Nephrol 2021; 32:1131-1149. [PMID: 33731332 PMCID: PMC8259671 DOI: 10.1681/asn.2020081112] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/21/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Hypertension is considered a major risk factor for the progression of diabetic kidney disease. Type 2 diabetes is associated with increased renal sodium reabsorption and salt-sensitive hypertension. Clinical studies show that men have higher risk than premenopausal women for the development of diabetic kidney disease. However, the renal mechanisms that predispose to salt sensitivity during diabetes and whether sexual dimorphism is associated with these mechanisms remains unknown. METHODS Female and male db/db mice exposed to a high-salt diet were used to analyze the progression of diabetic kidney disease and the development of hypertension. RESULTS Male, 34-week-old, db/db mice display hypertension when exposed to a 4-week high-salt treatment, whereas equivalently treated female db/db mice remain normotensive. Salt-sensitive hypertension in male mice was associated with no suppression of the epithelial sodium channel (ENaC) in response to a high-salt diet, despite downregulation of several components of the intrarenal renin-angiotensin system. Male db/db mice show higher levels of proinflammatory cytokines and more immune-cell infiltration in the kidney than do female db/db mice. Blocking inflammation, with either mycophenolate mofetil or by reducing IL-6 levels with a neutralizing anti-IL-6 antibody, prevented the development of salt sensitivity in male db/db mice. CONCLUSIONS The inflammatory response observed in male, but not in female, db/db mice induces salt-sensitive hypertension by impairing ENaC downregulation in response to high salt. These data provide a mechanistic explanation for the sexual dimorphism associated with the development of diabetic kidney disease and salt sensitivity.
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Affiliation(s)
- Luciana C. Veiras
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Justin Z. Y. Shen
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ellen A. Bernstein
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Giovanna C. Regis
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - DuoYao Cao
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - Derick Okwan-Duodu
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zakir Khan
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California
| | - David R. Gibb
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Fernando P. Dominici
- Department of Biological Chemistry, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Kenneth E. Bernstein
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California,Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jorge F. Giani
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California,Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California
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12
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Cytokines and Water Distribution in Anorexia Nervosa. Mediators Inflamm 2021; 2021:8811051. [PMID: 33867858 PMCID: PMC8035023 DOI: 10.1155/2021/8811051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/03/2021] [Accepted: 03/27/2021] [Indexed: 01/02/2023] Open
Abstract
In patients with anorexia nervosa (AN), decreased intracellular (ICW), extracellular (ECW), and total body water (TBW) as well as changes in serum cytokine concentrations have been reported. In this exploratory study, we measured body composition and serum cytokine levels in patients with AN (n = 27) and healthy controls (HCs; n = 13). Eating disorder symptom severity was assessed using the Eating Disorder Examination-Questionnaire (EDE-Q). Body composition was determined by bioimpedance analysis (BIA) which provided information on ICW, ECW, and TBW. Following blood collection, 27 cytokines and chemokines were quantified using multiplex ELISA-based technology: Eotaxin, Eotaxin-3, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon- (IFN-) γ, interleukin- (IL-) 1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12/IL-23p40, IL-12p70, IL-13, IL-15, IL-16, IL-17A, interferon γ-induced protein- (IP-) 10, macrophage inflammatory protein- (MIP-) 1α, MIP-1β, monocyte chemoattractant protein- (MCP-) 1, MCP-4, thymus and activation-regulated chemokine (TARC), TNF-α, and TNF-β. ICW, ECW, and TBW volumes were significantly lower in patients with AN than in HCs. In the whole sample, GM-CSF, MCP-4, and IL-4 were positively, whereas IFN-γ, IL-6, and IL-10 were negatively associated with all three parameters of body water. In AN participants, we found a statistically significant negative correlation of IL-10 with ICW, ECW, and TBW. Our results suggest an interaction between body water and the cytokine system. Underlying mechanisms are unclear but may involve a loss of water from the gut, kidneys, or skin due to AN-associated inflammatory processes.
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13
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Madhur MS, Elijovich F, Alexander MR, Pitzer A, Ishimwe J, Van Beusecum JP, Patrick DM, Smart CD, Kleyman TR, Kingery J, Peck RN, Laffer CL, Kirabo A. Hypertension: Do Inflammation and Immunity Hold the Key to Solving this Epidemic? Circ Res 2021; 128:908-933. [PMID: 33793336 DOI: 10.1161/circresaha.121.318052] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Elevated cardiovascular risk including stroke, heart failure, and heart attack is present even after normalization of blood pressure in patients with hypertension. Underlying immune cell activation is a likely culprit. Although immune cells are important for protection against invading pathogens, their chronic overactivation may lead to tissue damage and high blood pressure. Triggers that may initiate immune activation include viral infections, autoimmunity, and lifestyle factors such as excess dietary salt. These conditions activate the immune system either directly or through their impact on the gut microbiome, which ultimately produces chronic inflammation and hypertension. T cells are central to the immune responses contributing to hypertension. They are activated in part by binding specific antigens that are presented in major histocompatibility complex molecules on professional antigen-presenting cells, and they generate repertoires of rearranged T-cell receptors. Activated T cells infiltrate tissues and produce cytokines including interleukin 17A, which promote renal and vascular dysfunction and end-organ damage leading to hypertension. In this comprehensive review, we highlight environmental, genetic, and microbial associated mechanisms contributing to both innate and adaptive immune cell activation leading to hypertension. Targeting the underlying chronic immune cell activation in hypertension has the potential to mitigate the excess cardiovascular risk associated with this common and deadly disease.
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Affiliation(s)
- Meena S Madhur
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
| | - Fernando Elijovich
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Matthew R Alexander
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ashley Pitzer
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jeanne Ishimwe
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Justin P Van Beusecum
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - David M Patrick
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Charles D Smart
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
| | - Thomas R Kleyman
- Departments of Medicine, Cell Biology, Pharmacology and Chemical Biology, University of Pittsburgh, PA (T.R.K.)
| | - Justin Kingery
- Center for Global Health, Weill Cornell Medical College, NY (J.K., R.N.P.).,Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania (J.K., R.N.P.)
| | - Robert N Peck
- Center for Global Health, Weill Cornell Medical College, NY (J.K., R.N.P.).,Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania (J.K., R.N.P.).,Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania (R.N.P.)
| | - Cheryl L Laffer
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Annet Kirabo
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
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14
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Interleukin 17A: Key Player in the Pathogenesis of Hypertension and a Potential Therapeutic Target. Curr Hypertens Rep 2021; 23:13. [PMID: 33666761 DOI: 10.1007/s11906-021-01128-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To summarize key advances in our understanding of the role of interleukin 17A (IL-17A) in the pathogenesis of hypertension and highlight important areas for future research and clinical translation. RECENT FINDINGS While T helper 17 (Th17) cells are major producers of IL-17A, there are several additional innate and adaptive immune cell sources including gamma-delta T cells, innate lymphoid cells, and natural killer cells. IL-17A promotes an increase in blood pressure through multiple mechanisms including inhibiting endothelial nitric oxide production, increasing reactive oxygen species formation, promoting vascular fibrosis, and enhancing renal sodium retention and glomerular injury. IL-17A production from Th17 cells is increased by high salt conditions in vitro and in vivo. There is also emerging data linking salt, the gut microbiome, and intestinal T cell IL-17A production. Novel therapeutics targeting IL-17A signaling are approved for the treatment of autoimmune diseases and show promise in both animal models of hypertension and human studies. Hypertensive stimuli enhance IL-17A production. IL-17A is a key mediator of renal and vascular dysfunction in hypertensive mouse models and correlates with hypertension in humans. Large randomized clinical trials are needed to determine whether targeting IL-17A might be an effective adjunct treatment for hypertension and its associated end-organ dysfunction.
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15
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Mattson DL, Dasinger JH, Abais-Battad JM. Amplification of Salt-Sensitive Hypertension and Kidney Damage by Immune Mechanisms. Am J Hypertens 2021; 34:3-14. [PMID: 32725162 DOI: 10.1093/ajh/hpaa124] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/27/2020] [Accepted: 07/23/2020] [Indexed: 12/13/2022] Open
Abstract
Humans with salt-sensitive (SS) hypertension demonstrate increased morbidity, increased mortality, and renal end-organ damage when compared with normotensive subjects or those with salt-resistant hypertension. Increasing evidence indicates that immune mechanisms play an important role in the full development of SS hypertension and associated renal damage. Recent experimental advances and studies in animal models have permitted a greater understanding of the mechanisms of activation and action of immunity in this disease process. Evidence favors a role of both innate and adaptive immune mechanisms that are triggered by initial, immune-independent alterations in blood pressure, sympathetic activity, or tissue damage. Activation of immunity, which can be enhanced by a high-salt intake or by alterations in other components of the diet, leads to the release of cytokines, free radicals, or other factors that amplify renal damage and hypertension and mediate malignant disease.
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Affiliation(s)
- David L Mattson
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - John Henry Dasinger
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Justine M Abais-Battad
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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16
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Abstract
Interstitial inflammation is an important feature of cystic kidney disease. Renal macrophages are the most well-studied inflammatory cell in the kidney, and their involvement in cyst formation has been reported in different animal models and patients with cystic kidney disease. Originally, it was believed that renal macrophages were maintained from a constant supply of bone marrow-derived circulating monocytes, and could be recruited to the kidney in response to local inflammation. However, this idea has been challenged using fate-mapping methods, by showing that at least two distinct developmental origins of macrophages are present in the adult mouse kidney. The first type, infiltrating macrophages, are recruited from circulating monocytes and gradually develop macrophage properties on entering the kidney. The second, resident macrophages, predominantly originate from embryonic precursors, colonize the kidney during its development, and proliferate in situ to maintain their population throughout adulthood. Infiltrating and resident macrophages work together to maintain homeostasis and properly respond to pathologic conditions, such as AKI, cystic kidney disease, or infection. This review will briefly summarize current knowledge of resident macrophages in cystic kidney disease.
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Affiliation(s)
- Zhang Li
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kurt A. Zimmerman
- Division of Nephrology, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Bradley K. Yoder
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
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17
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Araos P, Figueroa S, Amador CA. The Role of Neutrophils in Hypertension. Int J Mol Sci 2020; 21:ijms21228536. [PMID: 33198361 PMCID: PMC7697449 DOI: 10.3390/ijms21228536] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
It is well accepted that the immune system and some cells from adaptive and innate immunity are necessary for the initiation/perpetuation of arterial hypertension (AH). However, whether neutrophils are part of this group remains debatable. There is evidence showing that the neutrophil/lymphocyte ratio correlates with AH and is higher in non-dipper patients. On the other hand, the experimental neutrophil depletion in mice reduces basal blood pressure. Nevertheless, their participation in AH is still controversial. Apparently, neutrophils may modulate the microenvironment in blood vessels by increasing oxidative stress, favoring endothelial disfunction. In addition, neutrophils may contribute to the tissue infiltration of immune cells, secreting chemoattractant chemokines/cytokines and promoting the proinflammatory phenotype, leading to AH development. In this work, we discuss the potential role of neutrophils in AH by analyzing different mechanisms proposed from clinical and basic studies, with a perspective on cardiovascular and renal damages relating to the hypertensive phenotype.
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18
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Farooqui Z, Mohammad RS, Lokhandwala MF, Banday AA. Nrf2 inhibition induces oxidative stress, renal inflammation and hypertension in mice. Clin Exp Hypertens 2020; 43:175-180. [PMID: 33070655 DOI: 10.1080/10641963.2020.1836191] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oxidative stress and renal inflammation play a pivotal role in the pathogenesis of hypertension. The redox-sensitive transcription factor, nuclear factor E2-related factor 2 (Nrf2) is the master regulator of phase II antioxidant enzymes that protects against oxidative stress and inflammation. This study aimed to investigate the effect of Nrf2 inhibition on oxidative stress-associated hypertension and renal dopamine 1 receptor (D1R) dysfunction in mice. Male C57BL/6 J mice were treated with a pro-oxidant, L-buthionine sulfoximine (BSO) (10 mmol/L in drinking water), and ML385 (10 kg body weight/kg body weight/day, intraperitoneally), a novel Nrf2 inhibitor that blocks Nrf2 regulated downstream target genes expression. Mice treated with BSO exhibited oxidative stress, renal functional impairment, inflammation, and elevated blood pressure. Also, BSO treatment increased the activity of phase II antioxidant enzyme, NAD(P)H: quinone oxidoreductase-1 (NQO-1). BSO and ML385 co-treatment exhibited a robust increase in blood pressure, oxidative stress and intensified the renal function deterioration as indicated by a significant increase in serum creatinine, urinary albumin excretion rate, and albumin to creatinine ratio and decreased glomerular filtration rate (GFR). Also, BSO and ML385 co-treatment downregulated NQO-1 and significantly altered the inflammatory cytokines, IL-1β and IL-10 levels. A D1R agonist SKF38393 failed to promote urinary sodium excretion indicating functional impairment in renal D1R. ML385 per se did not affect mean arterial pressure, GFR, and renal D1R function. Taken together, we concluded that the Nrf2 inhibition aggravated oxidative stress and inflammation by diminishing phase II antioxidant defense that deteriorates renal function and contributes to the development of hypertension in mice.
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Affiliation(s)
- Zeba Farooqui
- Heart and Kidney Institute, College of Pharmacy, University of Houston , Houston, Texas, USA
| | - Razia Sultana Mohammad
- Heart and Kidney Institute, College of Pharmacy, University of Houston , Houston, Texas, USA
| | - Mustafa F Lokhandwala
- Heart and Kidney Institute, College of Pharmacy, University of Houston , Houston, Texas, USA
| | - Anees Ahmad Banday
- Heart and Kidney Institute, College of Pharmacy, University of Houston , Houston, Texas, USA
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19
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Multiplex Bead Array Assay of a Panel of Circulating Cytokines and Growth Factors in Patients with Albuminuric and Non-AlbuminuricDiabetic Kidney Disease. J Clin Med 2020; 9:jcm9093006. [PMID: 32961903 PMCID: PMC7565054 DOI: 10.3390/jcm9093006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
A panel of cytokines and growth factors, mediating low-grade inflammation and fibrosis, was assessed in patients with type 2 diabetes (T2D) and different patterns of chronic kidney disease (CKD). Patients with long-term T2D (N = 130) were classified into four groups: no signs of CKD; estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 without albuminuria; albuminuria and eGFR ≥60 mL/min/1.73 m2; albuminuria and eGFR <60 mL/min/1.73 m2. Thirty healthy subjects were acted as control. Twenty-seven cytokines and growth factors were assessed in serum by multiplex bead array assay. Serum hs-CRP, urinary nephrin, podocine, and WFDC2 were measured by ELISA. Patients with T2D showed elevated IL-1Ra, IL-6, IL-17A, G-CSF, IP-10, MIP-1α, and bFGF levels; concentrations of IL-4, IL-12, IL-15, INF-γ, and VEGF were decreased. IL-6, IL-17A, G-CSF, MIP-1α, and bFGF correlated negatively with eGFR; IL-10 and VEGF demonstrated negative associations with WFDC2; no relationships with podocyte markers were found. Adjusted IL-17A and MIP-1α were predictors of non-albuminuric CKD, IL-13 predicted albuminuria with preserved renal function, meanwhile, IL-6 and hsCRP were predictors of albuminuria with eGFR decline. Therefore, albuminuric and non-albuminuric CKD in T2D patients are associated with different pro-inflammatory shifts in the panel of circulating cytokines.
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20
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Cianciolo G, De Pascalis A, Gasperoni L, Tondolo F, Zappulo F, Capelli I, Cappuccilli M, La Manna G. The Off-Target Effects, Electrolyte and Mineral Disorders of SGLT2i. Molecules 2020; 25:molecules25122757. [PMID: 32549243 PMCID: PMC7355461 DOI: 10.3390/molecules25122757] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/21/2022] Open
Abstract
The sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a relatively new class of antidiabetic drugs that, in addition to emerging as an effective hypoglycemic treatment, have been shown to improve, in several trials, both renal and cardiovascular outcomes. In consideration of the renal site of action and the associated osmotic diuresis, a negative sodium balance has been postulated during SGLT2i administration. Although it is presumable that sodium and water depletion may contribute to some positive actions of SGLT2i, evidence is far from being conclusive and the real physiologic effects of SGLT2i on sodium remain largely unknown. Indeed, no study has yet investigated how SGLT2i change sodium balance in the long term and especially the pathways through which the natriuretic effect is expressed. Furthermore, recently, several experimental studies have identified different pathways, not directly linked to tubular sodium handling, which could contribute to the renal and cardiovascular benefits associated with SGLT2i. These compounds may also modulate urinary chloride, potassium, magnesium, phosphate, and calcium excretion. Some changes in electrolyte homeostasis are transient, whereas others may persist, suggesting that the administration of SGLT2i may affect mineral and electrolyte balances in exposed subjects. This paper will review the evidence of SGLT2i action on sodium transporters, their off-target effects and their potential role on kidney protection as well as their influence on electrolytes and mineral homeostasis.
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Affiliation(s)
- Giuseppe Cianciolo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | | | - Lorenzo Gasperoni
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | - Francesco Tondolo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | - Fulvia Zappulo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | - Irene Capelli
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | - Maria Cappuccilli
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
| | - Gaetano La Manna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, 40100 Bologna, Italy; (G.C.); (L.G.); (F.T.); (F.Z.); (I.C.); (M.C.)
- Correspondence: ; Tel.: +39-051-214-3255; Fax: +39-051-340-871
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21
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Chakraborty S, Mandal J, Cheng X, Galla S, Hindupur A, Saha P, Yeoh BS, Mell B, Yeo JY, Vijay-Kumar M, Yang T, Joe B. Diurnal Timing Dependent Alterations in Gut Microbial Composition Are Synchronously Linked to Salt-Sensitive Hypertension and Renal Damage. Hypertension 2020; 76:59-72. [PMID: 32450738 DOI: 10.1161/hypertensionaha.120.14830] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alterations of diurnal rhythms of blood pressure (BP) and reshaping of gut microbiota are both independently associated with hypertension. However, the relationships between biorhythms of BP and gut microbial composition are unknown. We hypothesized that diurnal timing-associated alterations of microbial compositions are synchronous with diurnal rhythmicity, dip in BP, and renal function. To test this hypothesis, Dahl salt-sensitive (S) rats on low- and high-salt diets were examined for time of day effects on gut microbiota, BP, and indicators of renal damage. Major shifts in night and day patterns of specific groups of microbiota were observed between the dark (active) and light (rest) phases, which correlated with diurnal rhythmicity of BP. The diurnal abundance of Firmicutes, Bacteroidetes, and Actinobacteria were independently associated with BP. Discrete bacterial taxa were observed to correlate independently or interactively with one or more of the following 3 factors: (1) BP rhythm, (2) dietary salt, and (3) dip in BP. Phylogenetic Investigation of Communities revealed diurnal timing effects on microbial pathways, characterized by upregulated biosynthetic processes during the active phase of host, and upregulated degradation pathways of metabolites in the resting phase. Additional metagenomics functional pathways with rhythm variations were noted for aromatic amino acid metabolism and taurine metabolism. These diurnal timing dependent changes in microbiota, their functional pathways, and BP dip were associated with concerted effects of the levels of renal lipocalin 2 and kidney injury molecule-1 expression. These data provide evidence for a firm and concerted diurnal timing effects of BP, renal damage, and select microbial communities.
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Affiliation(s)
- Saroj Chakraborty
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Juthika Mandal
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Xi Cheng
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Sarah Galla
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Anay Hindupur
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Piu Saha
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Beng San Yeoh
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Blair Mell
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Ji-Youn Yeo
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Matam Vijay-Kumar
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Tao Yang
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
| | - Bina Joe
- From the Microbiome Consortium, Center for Hypertension and Precision Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH; and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH (S.J., J.M., X.C., S.G., A.H., P.S., B.S.Y., B.M., J.-Y.Y., M.V-K., T.Y., B.J.)
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22
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Abstract
Hypertension is an important risk factor for cardiovascular morbidity and mortality and for events such as myocardial infarction, stroke, heart failure and chronic kidney disease and is a major determinant of disability-adjusted life-years. Despite the importance of hypertension, the pathogenesis of essential hypertension, which involves the complex interaction of several mechanisms, is still poorly understood. Evidence suggests that interplay between bone marrow, microglia and immune mediators underlies the development of arterial hypertension, in particular through mechanisms involving cytokines and peptides, such as neuropeptide Y, substance P, angiotensin II and angiotensin-(1-7). Chronic psychological stress also seems to have a role in increasing the risk of hypertension, probably through the activation of neuroimmune pathways. In this Review, we summarize the available data on the possible role of neuroimmune crosstalk in the origin and maintenance of arterial hypertension and discuss the implications of this crosstalk for recovery and rehabilitation after cardiac and cerebral injuries.
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23
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Balasubbramanian D, Gelston CAL, Lopez AH, Iskander G, Tate W, Holderness H, Rutkowski JM, Mitchell BM. Augmenting Renal Lymphatic Density Prevents Angiotensin II-Induced Hypertension in Male and Female Mice. Am J Hypertens 2020; 33:61-69. [PMID: 31429865 DOI: 10.1093/ajh/hpz139] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Renal inflammation and immune cell infiltration are characteristic of several forms of hypertension. Our laboratory has previously demonstrated that renal-inflammation-associated lymphangiogenesis occurs in salt-sensitive and nitric-oxide-inhibition-induced hypertension. Moreover, enhancing renal lymphatic density prevented the development of these two forms of hypertension. Here, we investigated the effects of angiotensin II-induced hypertension on renal lymphatic vessel density in male and female mice. METHODS Wild-type and genetically engineered male and female mice were infused with angiotensin II for 2 or 3 weeks. Isolated splenocytes and peritoneal macrophages from mice, and commercially available mouse lymphatic endothelial cells were used for in vitro studies. RESULTS Compared to vehicle controls, angiotensin II-infused male and female mice had significantly increased renal lymphatic vessel density in association with pro-inflammatory immune cells in the kidneys of these mice. Direct treatment of lymphatic endothelial cells with angiotensin II had no effect as they lack angiotensin II receptors; however, angiotensin II treatment of splenocytes and peritoneal macrophages induced secretion of the lymphangiogenic growth factor VEGF-C in vitro. Utilizing our genetic mouse model of inducible renal lymphangiogenesis, we demonstrated that greatly augmenting renal lymphatic density prior to angiotensin II infusion prevented the development of hypertension in male and female mice and this was associated with a reduction in renal CD11c+F4/80- monocytes. CONCLUSION Renal lymphatics play a significant role in renal immune cell trafficking and blood pressure regulation, and represent a novel avenue of therapy for hypertension.
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Affiliation(s)
| | | | - Alexandra H Lopez
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Geina Iskander
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Winter Tate
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Haley Holderness
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Joseph M Rutkowski
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
| | - Brett M Mitchell
- Department of Medical Physiology, Texas A&M University Health Science Center, Bryan, Texas, USA
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24
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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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25
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Pavuk M, Serio TC, Cusack C, Cave M, Rosenbaum PF, Birnbaum LS. Hypertension in Relation to Dioxins and Polychlorinated Biphenyls from the Anniston Community Health Survey Follow-Up. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:127007. [PMID: 31858832 PMCID: PMC6957279 DOI: 10.1289/ehp5272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND In 2014, we conducted a longitudinal study [Anniston Community Health Survey (ACHS II)] 8 y after the baseline (ACHS I). OBJECTIVES We investigated the relationship between persistent chlorinated compounds and hypertension in residents living around the former polychlorinated biphenyl (PCB) production plant in Anniston, Alabama. We also examined the potential role of inflammatory cytokines in those with hypertension. METHODS A total of 338 participants had their blood pressure measured and medications recorded, gave a blood sample, and completed a questionnaire. Prevalent hypertension was defined as taking antihypertensive medication or having systolic blood pressure >140 mmHg and/or diastolic pressure >90 mmHg; incident hypertension used similar criteria in those who developed hypertension since the baseline in 2005-2007. PCB congeners were categorized into structure-activity groups, and toxic equivalencies (TEQs) were calculated for dioxin-like compounds. Descriptive statistics, logistic and linear regressions, as well as Cox proportional hazard models, were used to analyze the associations between exposures and hypertension. RESULTS Prevalent hypertension (78%) in ACHS II showed statistically significant adjusted odds ratios (ORs) for PCBs 74, 99, 138, 153, 167, 177, 183, and 187, ranging from 2.18 [95% confidence interval (CI): 1.10, 4.33] to 2.76 (95% CI: 1.14, 6.73), as well as for two estrogenic-like PCB groups, and the thyroid-like group [ORs ranging from 2.25 (95% CI: 1.07, 4.75) to 2.54 (95% CI: 1.13, 5.74)]. Furthermore, analysis of quartiles demonstrated a monotonic relationship for dioxin-like non-ortho (non-o)-PCB TEQs [fourth vs. first quartile: 3.66 (95% CI: 1.40, 9.56)]. Longitudinal analyses of incident hypertension supported those positive associations. The results were strongest for the di-o-PCBs [hazard ratio (HR)=1.93 (95% CI: 0.93, 4.00)] and estrogenic II PCB group [HR=1.90 (95% CI: 0.96, 3.78)] but were weaker for the dioxin TEQs. DISCUSSION Findings supportive of positive associations were reported for dioxin-like mono-o- and non-o-PCBs as well as for nondioxin-like estrogenic and thyroid-like congeners with prevalent and incident hypertension, suggesting that multiple pathways may be involved in hypertension development. https://doi.org/10.1289/EHP5272.
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Affiliation(s)
- Marian Pavuk
- Agency for Toxic Substances and Disease Registry (ATSDR), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Tara C. Serio
- Oak Ridge Institute for Science and Education (ORISE), ATSDR, CDC, Atlanta, Georgia, USA
| | - Caroline Cusack
- Agency for Toxic Substances and Disease Registry (ATSDR), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Matt Cave
- University of Louisville, Louisville, Kentucky, USA
| | - Paula F. Rosenbaum
- State University of New York (SUNY) Upstate Medical University, Syracuse, New York, USA
| | - Linda S. Birnbaum
- National Cancer Institute at National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, North Carolina, USA
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26
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Seong HY, Cho HM, Kim M, Kim I. Maternal High-Fructose Intake Induces Multigenerational Activation of the Renin-Angiotensin-Aldosterone System. Hypertension 2019; 74:518-525. [PMID: 31327271 DOI: 10.1161/hypertensionaha.119.12941] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although maternal high-fructose intake induces cardiometabolic syndrome in adult offspring, whether it induces hypertension in successive multiple generations has not yet been studied. We hypothesized that maternal high-fructose intake induces multigenerational activation of the renin-angiotensin-aldosterone system. Pregnant mice were offered 20% fructose in drinking water, of which subsequent first to fourth generation offspring were raised without being offered fructose. Blood pressure was measured via the tail-cuff method, mRNA expression was determined using the quantitative polymerase chain reaction, and fibrosis was evaluated using trichrome staining. Maternal high-fructose intake statistically significantly increased blood pressure in the first and second, but not the third and fourth, generation offspring as compared to the control group, with maximal increases in serum renin, angiotensin II, and aldosterone in the third generation offspring. It increased the mRNA expression of renin-angiotensin-aldosterone system genes as well as the expression of renin in the kidneys in the first to third generation offspring, with the exception of the vasodilatory Mas1 gene, the mRNA expression of which was the lowest in the second generation offspring. Moreover, it maximally increased fibrosis and the mRNA expression of inflammatory cytokines in the second generation offspring and increased the mRNA expression of oxidative factors in the first to third generation offspring, but maximally decreased the mRNA expression of antioxidant-encoding Sod1 in the second generation offspring. Maternal high-fructose intake induces multigenerational activation of renin-angiotensin-aldosterone system, and the results of this study implicate that it epigenetically induces cardiometabolic syndrome in multiple generations of offspring.
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Affiliation(s)
- Ho Yeong Seong
- From the Department of Pharmacology (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Cardiovascular Research Institute (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hyun Min Cho
- From the Department of Pharmacology (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Cardiovascular Research Institute (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Department of Life Science, College of Natural Science (H.Y.S.)
| | - Mina Kim
- From the Department of Pharmacology (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Cardiovascular Research Institute (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - InKyeom Kim
- From the Department of Pharmacology (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- Cardiovascular Research Institute (H.Y.S., H.M.C., M.K., I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- BK21 Plus KNU Biomedical Convergence program, Department of Biomedical Science (I.K.), School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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27
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Abstract
PURPOSE OF REVIEW Despite enhanced screening and therapeutic management, hypertension remains the most prevalent chronic disease in the United States and the leading cause of heart disease, chronic kidney disease, and stroke in both men and women. It is widely accepted that hypertension is a pro-inflammatory disease and that the immune system plays a vital role in mediating hypertensive outcomes and end organ damage. Despite known discrepancies in the risk of hypertension development between men and women, preclinical models of immune-mediated hypertension were historically developed solely in male animals, leading to a lack of sex-specific clinical practice guidelines or therapeutic targets. RECENT FINDINGS Following the NIH policy on the consideration of sex as a biological variable in 2015, significant advancements have been made into sex-specific disease mechanisms in inflammation and hypertension. This review article serves to critically evaluate recent advancements in the field of sex-specific immune-mediated hypertension.
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Affiliation(s)
- Megan A Sylvester
- Department of Physiology, College of Medicine, University of Arizona, 1656 E. Mabel St/Rm 417, P.O. Box 245218, Tucson, AZ, 85724-5218, USA
| | - Heddwen L Brooks
- Department of Physiology, College of Medicine, University of Arizona, 1656 E. Mabel St/Rm 417, P.O. Box 245218, Tucson, AZ, 85724-5218, USA. .,Sarver Heart Center, University of Arizona, Tucson, AZ, USA.
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28
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Dale BL, Pandey AK, Chen Y, Smart CD, Laroumanie F, Ao M, Xiao L, Dikalova AE, Dikalov SI, Elijovich F, Foss JD, Barbaro NR, Van Beusecum JP, Deger SM, Alsouqi A, Itani HA, Norlander AE, Alexander MR, Zhao S, Ikizler TA, Algood HMS, Madhur MS. Critical role of Interleukin 21 and T follicular helper cells in hypertension and vascular dysfunction. JCI Insight 2019; 5:129278. [PMID: 31013256 DOI: 10.1172/jci.insight.129278] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
T and B cells have been implicated in hypertension, but the mechanisms by which they produce a coordinated response is unknown. T follicular helper (Tfh) cells that produce interleukin 21 (IL21) promote germinal center (GC) B cell responses leading to immunoglobulin (Ig) production. Here we investigate the role of IL21 and Tfh cells in hypertension. In response to angiotensin (Ang) II-induced hypertension, T cell IL21 production is increased, and Il21-/- mice develop blunted hypertension, attenuated vascular end-organ damage, and decreased interleukin 17A (IL17A) and interferon gamma production. Tfh-like cells and GC B cells accumulate in the aorta and plasma IgG1 is increased in hypertensive WT but not Il21-/-mice. Furthermore, Tfh cell deficient mice develop blunted hypertension and vascular hypertrophy in response to Ang II infusion. Importantly, IL21 neutralization reduces blood pressure (BP) and reverses endothelial dysfunction and vascular inflammation. Moreover, recombinant IL21 impairs endothelium-dependent relaxation ex vivo and decreases nitric oxide production from cultured endothelial cells. Finally, we show in humans that peripheral blood T cell production of IL21 correlates with systolic BP and IL17A production. These data suggest that IL21 may be a novel therapeutic target for the treatment of hypertension and its micro- and macrovascular complications.
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Affiliation(s)
- Bethany L Dale
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Yuhan Chen
- Department of Medicine, Division of Clinical Pharmacology
| | - Charles D Smart
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | | | - Mingfang Ao
- Department of Medicine, Division of Clinical Pharmacology
| | - Liang Xiao
- Department of Medicine, Division of Clinical Pharmacology
| | | | | | | | - Jason D Foss
- Department of Medicine, Division of Clinical Pharmacology
| | | | | | | | | | - Hana A Itani
- Department of Medicine, Division of Clinical Pharmacology
| | - Allison E Norlander
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA
| | | | | | | | - Holly M Scott Algood
- Department of Medicine, Division of Infectious Disease, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, Tennessee, USA.,Vanderbilt Digestive Diseases Research Center, Nashville, Tennessee, USA
| | - Meena S Madhur
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee, USA.,Department of Medicine, Division of Cardiovascular Medicine.,Department of Medicine, Division of Clinical Pharmacology.,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, Tennessee, USA
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29
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Wenzel UO, Bode M, Kurts C, Ehmke H. Salt, inflammation, IL-17 and hypertension. Br J Pharmacol 2018; 176:1853-1863. [PMID: 29767465 DOI: 10.1111/bph.14359] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/08/2018] [Accepted: 04/17/2018] [Indexed: 12/18/2022] Open
Abstract
Traditionally, arterial hypertension and subsequent end-organ damage have been attributed to haemodynamic factors, but increasing evidence indicates that inflammation also contributes to the deleterious consequences of this disease. The immune system has evolved to prevent invasion of foreign microorganisms and to promote tissue healing after injury. However, this beneficial activity comes at a cost of collateral damage when the immune system overreacts to internal injury, such as prehypertension. Over the past few years, important findings have revolutionized hypertension research. Firstly, in 2007, a seminal paper showed that adaptive immunity is involved in the pathogenesis of hypertension. Secondly, salt storage in the skin and its consequences for cardiovascular physiology were discovered. Thirdly, after the discovery that salt promotes the differentiation of CD4+ T cells into TH 17 cells, it was demonstrated that salt directly changes several cells of the innate and adaptive immune system and aggravates autoimmune disease but may improve antimicrobial defence. Herein, we will review pathways of activation of immune cells by salt in hypertension as the framework for understanding the multiple roles of salt and immunity in arterial hypertension and autoimmune disease. LINKED ARTICLES: This article is part of a themed section on Immune Targets in Hypertension. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.12/issuetoc.
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Affiliation(s)
- Ulrich O Wenzel
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marlies Bode
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Kurts
- Institute of Molecular Medicine and Experimental Immunology, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | - Heimo Ehmke
- Department of Cellular and Integrative Physiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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30
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Frame AA, Wainford RD. Mechanisms of altered renal sodium handling in age-related hypertension. Am J Physiol Renal Physiol 2018; 315:F1-F6. [PMID: 29442548 DOI: 10.1152/ajprenal.00594.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The prevalence of hypertension rises with age to approximately two out of three adults over the age of 60 in the United States. Although the mechanisms underlying age-related hypertension are incompletely understood, sodium homeostasis is critical to the long-term regulation of blood pressure and there is strong evidence that aging is associated with alterations in renal sodium handling. This minireview focuses on recent advancements in our understanding of the vascular, neurohumoral, and renal mechanisms that influence sodium homeostasis and promote age-related hypertension.
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Affiliation(s)
- Alissa A Frame
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine and The Whitaker Cardiovascular Institute , Boston, Massachusetts
| | - Richard D Wainford
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine and The Whitaker Cardiovascular Institute , Boston, Massachusetts
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31
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Hevia D, Araos P, Prado C, Fuentes Luppichini E, Rojas M, Alzamora R, Cifuentes-Araneda F, Gonzalez AA, Amador CA, Pacheco R, Michea L. Myeloid CD11c + Antigen-Presenting Cells Ablation Prevents Hypertension in Response to Angiotensin II Plus High-Salt Diet. Hypertension 2018; 71:709-718. [PMID: 29378857 DOI: 10.1161/hypertensionaha.117.10145] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/18/2017] [Accepted: 11/30/2017] [Indexed: 01/07/2023]
Abstract
Increasing evidence shows that antigen-presenting cells (APCs) are involved in the development of inflammation associated to hypertension. However, the potential role of APCs in the modulation of renal sodium transport has not been addressed. We hypothesized that APCs participate in renal sodium transport and, thus, development of high blood pressure in response to angiotensin II plus a high-salt diet. Using transgenic mice that allow the ablation of CD11chigh APCs, we studied renal sodium transport, the intrarenal renin-angiotensin system components, blood pressure, and cardiac/renal tissue damage in response to angiotensin II plus a high-salt diet. Strikingly, we found that APCs are required for the development of hypertension and that the ablation/restitution of APCs produces rapid changes in the blood pressure in mice with angiotensin II plus a high-salt diet. Moreover, APCs were necessary for the induction of intrarenal renin-angiotensin system components and affected the modulation of natriuresis and tubular sodium transporters. Consistent with the prevention of hypertension, the ablation of APCs also prevented cardiac hypertrophy and the induction of several indicators of renal and cardiac damage. Thus, our findings indicate a prominent role of APCs as modulators of blood pressure by mechanisms including renal sodium handling, with kinetics that suggest the involvement of tubular cell functions in addition to the modulation of inflammation and adaptive immune response.
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Affiliation(s)
- Daniel Hevia
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Patricio Araos
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Carolina Prado
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Eugenia Fuentes Luppichini
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Macarena Rojas
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Rodrigo Alzamora
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Flavia Cifuentes-Araneda
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Alexis A Gonzalez
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Cristian A Amador
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Rodrigo Pacheco
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.)
| | - Luis Michea
- From the Instituto de Ciencias Biomédicas (D.H., P.A., E.F.L., M.R., R.A., L.M.) and Millennium Institute on Immunology and Immunotherapy (D.H., P.A., E.F.L., M.R., L.M.), Facultad de Medicina, Universidad de Chile, Santiago; Laboratorio de Neuroinmunología, Fundación Ciencia & Vida, Santiago, Chile (C.P., R.P.); Millenium Nucleus of Ion Channels-Associated Diseases (MiNICAD), Santiago, Chile (R.A.); Instituto de Química, Pontificia Universidad Católica de Valparaíso, Chile (F.C.-A., A.A.G.); Centro de Investigación Biomédica, Universidad Autónoma de Chile, Santiago (C.A.A.); and Departamento de Ciencias Biológicas, Facultad de Ciencias Biológicas, Universidad Andres Bello, Santiago, Chile (R.P.).
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Norlander AE, Madhur MS, Harrison DG. The immunology of hypertension. J Exp Med 2017; 215:21-33. [PMID: 29247045 PMCID: PMC5748862 DOI: 10.1084/jem.20171773] [Citation(s) in RCA: 238] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/01/2017] [Accepted: 12/05/2017] [Indexed: 12/28/2022] Open
Abstract
Emerging evidence indicates that both innate and adaptive immunity contribute to hypertension. Efforts to understand mechanisms of immune activation in hypertension are defining not only new mechanisms of disease but also new therapeutic options for its treatment. Although systemic hypertension affects a large proportion of the population, its etiology remains poorly defined. Emerging evidence supports the concept that immune cells become activated and enter target organs, including the vasculature and the kidney, in this disease. Mediators released by these cells, including reactive oxygen species, metalloproteinases, cytokines, and antibodies promote dysfunction of the target organs and cause damage. In vessels, these factors enhance constriction, remodeling, and rarefaction. In the kidney, these mediators increase expression and activation of sodium transporters, and cause interstitial fibrosis and glomerular injury. Factors common to hypertension, including oxidative stress, increased interstitial sodium, cytokine production, and inflammasome activation promote immune activation in hypertension. Recent data suggest that isolevuglandin-modified self-proteins in antigen-presenting cells are immunogenic, promoting cytokine production by the cells in which they are formed and T cell activation. Efforts to prevent and reverse immune activation may prove beneficial in preventing the long-term sequelae of hypertension and its related cardiovascular diseases.
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Affiliation(s)
- Allison E Norlander
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN
| | - Meena S Madhur
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN
| | - David G Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN .,Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN
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Affiliation(s)
- Sean P. Didion
- From the Department of Pharmacology and Department of Neurology, University of Mississippi Medical Center, Jackson
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Bartoloni E, Alunno A, Gerli R. Hypertension as a cardiovascular risk factor in autoimmune rheumatic diseases. Nat Rev Cardiol 2017; 15:33-44. [PMID: 28836617 DOI: 10.1038/nrcardio.2017.118] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Evidence for the increased risk of cardiovascular morbidity and mortality in patients with chronic inflammatory and systemic autoimmune diseases has accumulated during the past 15 years. In these patients, an interplay between several mechanisms, including premature acceleration of subclinical atherosclerotic damage, inflammation, and dysregulation of the immune system, is involved in the induction and progression of atherosclerosis. Moreover, traditional cardiovascular risk factors are also likely to contribute, at least in part, to the excess cardiovascular risk. Among traditional cardiovascular risk factors, hypertension is an important predictor of cardiovascular events in the general population and in patients with chronic inflammatory and autoimmune diseases. Evidence supports the idea that the pathogenic mechanisms underlying the increased blood pressure in these diseases are multifactorial and not only related to the mechanical injury of the arterial wall. In particular, chronic inflammation and immune-mediated mechanisms have been demonstrated to affect blood-pressure control in patients with systemic autoimmune disease. In this Review, we discuss the available evidence on the relationship between hypertension and autoimmune diseases, and describe the multiple factors that might affect blood-pressure control in patients with chronic inflammatory and systemic autoimmune diseases. We also discuss the effect of hypertension and antirheumatic therapies on cardiovascular outcome.
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Affiliation(s)
- Elena Bartoloni
- Rheumatology Unit, Department of Medicine, University of Perugia, P.le Menghini 1, Perugia 06129, Italy
| | - Alessia Alunno
- Rheumatology Unit, Department of Medicine, University of Perugia, P.le Menghini 1, Perugia 06129, Italy
| | - Roberto Gerli
- Rheumatology Unit, Department of Medicine, University of Perugia, P.le Menghini 1, Perugia 06129, Italy
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