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Schwartz L, Schwartz J, Henry M, Bakkar A. Metabolic Shift and Hyperosmolarity Underlie Age-Related Macular Degeneration. Life (Basel) 2024; 14:1189. [PMID: 39337971 PMCID: PMC11432886 DOI: 10.3390/life14091189] [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: 06/12/2024] [Revised: 07/30/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Age-related macular degeneration (AMD) is both a poorly understood and devastating disease. Here, we analyze the physico-chemical forces at stake, including osmolarity, redox shift, and pressure due to inflammation. Hyperosmolarity plays a key role in diseases of the anterior segment of the eye such as glaucoma, cataracts or dry eyes, and corneal ulceration. However, its role in macular degeneration has been largely overlooked. Hyperosmolarity is responsible for metabolic shifts such as aerobic glycolysis which increases lactate secretion by Muller cells. Increased osmolarity will also cause neoangiogenesis and cell death. Because of its unique energetic demands, the macula is very sensitive to metabolic shifts. As a proof of concept, subretinal injection of drugs increasing hyperosmolarity such as polyethylene glycol causes neoangiogenesis and drusen-like structures in rodents. The link between AMD and hyperosmolarity is reinforced by the fact that treatments aiming to restore mitochondrial activity, such as lipoic acid and/or methylene blue, have been experimentally shown to be effective. We suggest that metabolic shift, inflammation, and hyperosmolarity are hallmarks in the pathogenesis and treatment of AMD.
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Affiliation(s)
| | - Jules Schwartz
- Assistance Publique des Hôpitaux de Paris, 75610 Paris, France;
| | - Marc Henry
- Institut Le Bel, Université Louis Pasteur, 67070 Strasbourg, France;
| | - Ashraf Bakkar
- Faculty of Biotechnology, October University for Modern Sciences and Arts, Giza 12451, Egypt;
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2
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Xia C, Dai W, Carreno J, Rogando A, Wu X, Simmons D, Astraea N, Dalleska NF, Fonteh AN, Vasudevan A, Arakaki X, Kloner RA. Higher sodium in older individuals or after stroke/reperfusion, but not in migraine or Alzheimer's disease - a study in different preclinical models. Sci Rep 2024; 14:21636. [PMID: 39284837 PMCID: PMC11405707 DOI: 10.1038/s41598-024-72280-8] [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] [Received: 05/31/2024] [Accepted: 09/05/2024] [Indexed: 09/19/2024] Open
Abstract
Sodium serves as one of the primary cations in the central nervous system, playing a crucial role in maintaining normal brain function. In this study, we investigated alterations in sodium concentrations in the brain and/or cerebrospinal fluid across multiple models, including an aging model, a stroke model, a nitroglycerin (NTG)-induced rat migraine model, a familial hemiplegic migraine type 2 (FHM2) mouse model, and a transgenic mouse model of Alzheimer's disease (AD). Our results reveal that older rats exhibited higher sodium concentrations in cerebrospinal fluid (CSF), plasma, and various brain regions compared to their younger counterparts. Additionally, findings from the stroke model demonstrated a significant increase in sodium in the ischemic/reperfused region, accompanied by a decrease in potassium and an elevated sodium/potassium ratio. However, we did not detect significant changes in sodium in the NTG-induced rat migraine model or the FHM2 mouse model. Furthermore, AD transgenic mice showed no significant differences in sodium levels compared to wild-type mice in CSF, plasma, or the hippocampus. These results underscore the nuanced regulation of sodium homeostasis in various neurological conditions and aging, providing valuable insights into potential mechanisms underlying these alterations.
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Affiliation(s)
- Chenchen Xia
- Cognition and Brain Integration Laboratory, Neurosciences Department, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Wangde Dai
- Cardiovascular Department, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Juan Carreno
- Cardiovascular Department, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Andrea Rogando
- Cognition and Brain Integration Laboratory, Neurosciences Department, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Xiaomeng Wu
- Analytical Biochemistry Core, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Darren Simmons
- Analytical Biochemistry Core, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Natalie Astraea
- Analytical Biochemistry Core, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Nathan F Dalleska
- Water and Environment Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Alfred N Fonteh
- Biomarker and Neuro-Disease Mechanism Laboratory, Neurosciences Department, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Anju Vasudevan
- Angiogenesis and Brain Development Laboratory, Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, CA, USA
| | - Xianghong Arakaki
- Cognition and Brain Integration Laboratory, Neurosciences Department, Huntington Medical Research Institutes, Pasadena, CA, USA.
| | - Robert A Kloner
- Cardiovascular Department, Huntington Medical Research Institutes, Pasadena, CA, USA
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Meid AD, Scherkl C, Metzner M, Czock D, Seidling HM. Real-World Application of a Quantitative Systems Pharmacology (QSP) Model to Predict Potassium Concentrations from Electronic Health Records: A Pilot Case towards Prescribing Monitoring of Spironolactone. Pharmaceuticals (Basel) 2024; 17:1041. [PMID: 39204148 PMCID: PMC11357243 DOI: 10.3390/ph17081041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 09/03/2024] Open
Abstract
Quantitative systems pharmacology (QSP) models are rarely applied prospectively for decision-making in clinical practice. We therefore aimed to operationalize a QSP model for potas-sium homeostasis to predict potassium trajectories based on spironolactone administrations. For this purpose, we proposed a general workflow that was applied to electronic health records (EHR) from patients treated in a German tertiary care hospital. The workflow steps included model exploration, local and global sensitivity analyses (SA), identifiability analysis (IA) of model parameters, and specification of their inter-individual variability (IIV). Patient covariates, selected parameters, and IIV then defined prior information for the Bayesian a posteriori prediction of individual potassium trajectories of the following day. Following these steps, the successfully operationalized QSP model was interactively explored via a Shiny app. SA and IA yielded five influential and estimable parameters (extracellular fluid volume, hyperaldosteronism, mineral corticoid receptor abundance, potassium intake, sodium intake) for Bayesian prediction. The operationalized model was validated in nine pilot patients and showed satisfactory performance based on the (absolute) average fold error. This provides proof-of-principle for a Prescribing Monitoring of potassium concentrations in a hospital system, which could suggest preemptive clinical measures and therefore potentially avoid dangerous hyperkalemia or hypokalemia.
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Affiliation(s)
- Andreas D. Meid
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Camilo Scherkl
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Michael Metzner
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - David Czock
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Hanna M. Seidling
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- Internal Medicine IX: Department of Clinical Pharmacology and Pharmacoepidemiology—Cooperation Unit Clinical Pharmacy, Medical Faculty Heidelberg/Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Cole NI, Swift PA, Suckling RJ, He FJ, Gallagher H, van Vlymen J, Byford R, de Lusignan S. The Relationship between Serum Sodium Concentration and Albuminuria: A Retrospective Cohort Study. Nephron Clin Pract 2024; 148:701-711. [PMID: 39038444 DOI: 10.1159/000538819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/04/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Lowering dietary salt intake reduces albuminuria, an early marker of renal damage and a sensitive predictor of adverse cardiovascular outcomes. The mechanisms underlying this effect are uncertain but small changes in serum sodium concentration may be important: this retrospective cohort study investigated the hypothesis that higher serum sodium concentration is a risk factor for albuminuria (defined as a urine albumin:creatinine ratio [UACR], ≥3 mg/mmol). METHODS Primary care data from the Royal College of General Practitioners Research and Surveillance Centre were used to identify 47,294 individuals with a UACR result available between April 2010 and March 2015, and no known albuminuria prior to this. Exclusion criteria were missing or abnormal serum sodium concentration at baseline (<135 or >146 mmol/L); age <18 years; diabetes mellitus; decompensated liver disease; heart failure; and stage 5 chronic kidney disease. RESULTS After adjustment for known risk factors, there was a significant "U-shaped" relationship between serum sodium concentration and albuminuria. The lowest risk was associated with a serum sodium of 138-140 mmol/L. In comparison, the risk of albuminuria was 18% higher with a serum sodium of 135-137 mmol/L and 19% higher with a serum sodium of 144-146 mmol/L. There was no association between serum sodium concentration and blood pressure. CONCLUSION The finding of a positive association between higher serum sodium concentration and albuminuria is in support of the hypothesis, but the inverse relationship between serum sodium concentration and albuminuria at lower concentrations warrants further explanation.
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Affiliation(s)
- Nicholas I Cole
- Renal Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | - Pauline A Swift
- Renal Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | - Rebecca J Suckling
- Renal Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | - Feng J He
- Wolfson Institute of Preventative Medicine, Queen Mary University of London, London, UK
| | - Hugh Gallagher
- Renal Department, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK
| | - Jeremy van Vlymen
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Soares AP, Rodrigues M, Padrão P, Gonçalves C, Moreira A, Moreira P. Association between Urinary Sodium Excretion and Body Fat in School-Aged Children: Insights from the ARIA Study. Nutrients 2024; 16:1197. [PMID: 38674887 PMCID: PMC11054948 DOI: 10.3390/nu16081197] [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] [Received: 03/19/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Childhood obesity has been associated with increased sodium intake. Nonetheless, evidence linking sodium intake to Body Mass Index (BMI) and Body Fat Mass Percentage (%BF) remains limited, especially in the pediatric age group. Therefore, this study aims to investigate whether there is an association between 24 h urinary sodium excretion with BMI and %BF in a sample group of children from the ARIA study. This cross-sectional analysis included 303 children aged 7 to 12 from across 20 public schools in Porto, Portugal. Weight and %BF were assessed using the Tanita™ BC-418 Segmental Body Analyzer. Children's Total Energy Intake (TEI) was estimated through a single 24 h Recall Questionnaire, and urinary sodium and potassium excretion was estimated by a 24 h urine collection. The association of %BF and BMI with 24 h sodium excretion was estimated by a binary logistic regression adjusted for sex, age, physical activity, total energy intake, parental education, and 24 h urinary excreted potassium. There was a significant positive association between higher levels of urinary sodium excretion and higher %BF values, even after adjusting for confounders. However, the same was not observed for BMI. Our findings suggest that higher sodium intake is associated with higher values of %BF among children, regardless of TEI and potassium intake.
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Affiliation(s)
- Ana Patrícia Soares
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
| | - Mónica Rodrigues
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
| | - Carla Gonçalves
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - André Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Immuno-Allergology Department, São João Hospital Center, 4200-319 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (A.P.S.); (P.P.); (A.M.)
- Epidemiology Research Unit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; (M.R.); (C.G.)
- Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
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Sakir NAI, Hwang SB, Park HJ, Lee BH. Associations between food consumption/dietary habits and the risks of obesity, type 2 diabetes, and hypertension: a cross-sectional study in Jakarta, Indonesia. Nutr Res Pract 2024; 18:132-148. [PMID: 38352217 PMCID: PMC10861337 DOI: 10.4162/nrp.2024.18.1.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/20/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to assess the current mean daily intake of 10 food groups, analyze the sociodemographic factors associated with food consumption, and determine the associations between food consumption/dietary intake and the prevalence rates of obesity, type 2 diabetes (T2D), and hypertension (HTN) in Jakarta, Indonesia. SUBJECTS/METHODS A total of 600 participants aged 20-85 yrs were included in this cross-sectional study. Food consumption and dietary habits were assessed using a food frequency questionnaire. To determine the association between food consumption/dietary habits and the abovementioned diseases, logistic regression analysis was performed. RESULTS The average vegetable and fruit intake was lower, while sugar and salt consumption were higher than that recommended by Indonesia's national dietary guidelines. A high intake of ultra-processed foods (UPFs) was associated with young age, men, "single" status, a high education level, and employment with a high monthly income. Obesity and T2D were positively correlated with high intakes of cereals and tubers, UPFs, sugars, fats, and oils. Conversely, an inverse association was found between legume, vegetable, and fruit consumption and obesity risk. An inverse correlation was also observed between vegetable consumption and T2D risk. Moreover, a high salt intake was inversely correlated with fruit consumption in terms of HTN risk. Non-indulgence in habitual late-night snacking and refrainment from consuming more than one dish at each meal were also negatively related to the prevalence of obesity, T2D, and HTN. Inverse correlations were also observed between the prevalence rates of T2D and HTN and abstaining from adding sugar to beverages. CONCLUSION Foods high in fat, sugar, and sodium were strongly associated with the risks of obesity, T2D, and HTN. Additionally, poor eating habits were also associated with disease development.
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Affiliation(s)
| | | | - Hyeon Ju Park
- Department of Food and Nutrition, Chung-Ang University, Anseong 17546, Korea
| | - Bog-Hieu Lee
- Department of Food and Nutrition, Chung-Ang University, Anseong 17546, Korea
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Sheriff MM, Abusabah HH, Sindi HB, Alaidrous AO, Moemen AH, Alshalawi SF, Alshalawi BF, Aljaoser NY, Alghamdi LK, Badri RM, Gadi LA, Alotaibi SD, Alharbi GH, Aljadani NM. A Study on the Awareness and Perceptions Regarding Monosodium Glutamate and its Potential Health Effects Amongst the Urban Population of Saudi Arabia. Cureus 2023; 15:e51094. [PMID: 38274916 PMCID: PMC10808944 DOI: 10.7759/cureus.51094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Monosodium glutamate (MSG), a common global food additive in processed foods, influences flavors and textures due to its chemical complexity and nutritional intricacy. Despite an annual production of 1.9 million tons and historical safety concerns, the multifaceted impact on health, ranging from metabolic disorders to neurological and cardiovascular implications, necessitates ongoing research for informed consumption and balanced dietary practices. Materials and methods This cross-sectional study investigates MSG-associated intricacies among Saudi Arabia's urban population. The research included questionnaire development, translation, and cultural adaptation, and was validated by nutrition experts. A sample size of 420 was calculated for a 95% confidence level. Data collection occurred from September 13 to October 31, 2023, and ethical considerations were ensured. Statistical analysis, including chi-square tests, regression analysis, and SPSS, explored intricacy relationships. Results The MSG intricacy study in Saudi Arabia's urban population, involving 420 respondents, showed statistically significant correlations (P < 0.05) in demographics. The key findings indicate an awareness of the impact of MSG on health, its associations with various conditions, and strong support for its exclusion from foods. Region, gender, age, and social status correlations highlighted diverse perspectives. The Western province showed the highest response rate at 42.61%, prompting regional awareness questions. Gender dynamics showed that 90.47% of the respondents were females, emphasizing potential gender-specific concerns. Concentration among ages 20-30 (61.9%) underscored generational factors. While commendable baseline awareness was noted, 73.09% of the participants believing MSG is harmful prompts further investigation. Emotional responses, including happiness (25.95%) and frustration (18.33%), highlight the complexity of the individuals' experiences, emphasizing the need for tailored communication strategies. Conclusion The MSG intricacy study in Saudi Arabia's urban population reveals insights into knowledge, attitudes, and behaviors, emphasizing the need for nuanced interventions considering regional and emotional differences. The findings underscore health concerns, supporting regulations, and knowledge impact on behavior. This survey serves as a valuable tool for informed public discourse and decision-making in the unique socio-cultural context of urban Saudi Arabia.
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Affiliation(s)
- Muazzam M Sheriff
- Microbiology and Immunology, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Hanin H Abusabah
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Heba B Sindi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | | | | | - Bayan F Alshalawi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Nooraa Y Aljaoser
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Lama K Alghamdi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Razan M Badri
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Safaa D Alotaibi
- Clinical Dietitian Resident, King Fahad General Hospital, Jeddah, SAU
| | | | - Nawaf M Aljadani
- Pediatric Service Resident, King Abdullah Medical Complex, Jeddah, SAU
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8
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Graudal N, Hubeck-Graudal T, Jurgens G. A low dietary sodium dose is associated with a more pronounced aldosterone response in normotensive than in hypertensive individuals. Sci Rep 2023; 13:19027. [PMID: 37923769 PMCID: PMC10624927 DOI: 10.1038/s41598-023-46285-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
In this comprehensive meta-regression analysis encompassing 79 randomized controlled trials, we observed that in populations assigned to a high sodium intake level exceeding 94 mmol, there was no discernible link between plasma aldosterone levels and sodium intake. However, among populations with normal blood pressure subjected to a lower sodium intake, falling below 111 mmol (N = 1544), the association between sodium intake and plasma aldosterone levels manifested as a decrease of 192 pg/ml per 100 mmol of sodium (95% CI - 303 to - 81). In hypertensive populations (N = 1145), this association was less pronounced, with a reduction of 46 pg/ml per 100 mmol sodium, (95% CI - 112 to 20). Furthermore, in normotensive populations the plasma aldosterone increase associated with a decrease in sodium intake was 70 pg/ml per 100 mmol sodium (95% CI 27 to 113). In hypertensive populations, the observed increase was more modest, at 30 pg/ml per 100 mmol sodium, (95% CI 6.8 to 54). A limitation of this study lies in the absence of individual participant data. Our analysis included adjustments for potential effect-modifiers, encompassing bias estimation, which did not substantially alter these associations. One perspective of the present results may be to prompt a reconsideration of current sodium reduction recommendations.
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Affiliation(s)
- Niels Graudal
- Center for Rheumatology and Spine Diseases, The Lupus and Vasculitis Clinic 4242, Copenhagen University Hospital Rigshospitalet, Juliane Maries Vej 10, Copenhagen, Denmark.
| | - Thorbjørn Hubeck-Graudal
- Department of Nuclear Medicine, Zealand University Hospital, Næstved, Ringstedgade 61, 4700, Næstved, Denmark
| | - Gesche Jurgens
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Sygehusvej 10, 4000, Roskilde, Denmark
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Kayode OT, Bello JA, Oguntola JA, Kayode AAA, Olukoya DK. The interplay between monosodium glutamate (MSG) consumption and metabolic disorders. Heliyon 2023; 9:e19675. [PMID: 37809920 PMCID: PMC10558944 DOI: 10.1016/j.heliyon.2023.e19675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023] Open
Abstract
Monosodium glutamate (MSG) is one of the most popular food additives in the world and is often ingested with commercially processed foods. It can be described as a sodium salt of glutamic acid with the IUPAC name - Sodium 2-aminopentanedioate and is ionized by water to produce free sodium ions and glutamic acid. MSG use has significantly increased over the past 30 years, its global demand stands huge at over three million metric tons which is worth over $4.5 billion. Asia was responsible for more than three quarter of world MSG consumption with the country China also leading in global consumption as well as production and export to other countries. Prior to year 2020, global demand for MSG increased by almost four percent each year with the highest significant increase in demand for MSG predicted to rise in Thailand, Indonesia, Vietnam and China, followed by Brazil and Nigeria. However, several researches featured in this review has identified MSG consumption as a major contributor to the development and progression of some metabolic disorders such as obesity, which is a risk factor for other metabolic syndromes like hypertension, diabetes mellitus and cancer initiation. The mechanism by which MSG induce obesity involves induction of hypothalamic lesion, hyperlipidemia, oxidative stress, leptin resistance and increased expression of peroxisome proliferator-activated receptors (PPARs) Gamma and Alpha. Similarly for induction of diabetes mellitus, MSG consumption resulted in decreased pancreatic beta cell mass, increased oxidative stress and metabolic rates, reduced glucose and insulin transport to adipose tissue and skeletal muscles, insulin insensitivity, reduced insulin receptors and induced severe hyperinsulinemia. Dietary salt, an active component of MSG is also found to be a major risk factor for high blood pressure (which may lead to hypertension). MSG is used to enhance the taste of tobacco, causing smokers to consume the product in excess and thereby increasing the risk of cancer development. Depending on the amount consumed, MSG has both positive and negative effects. Despite the controversy surrounding MSG's safety and its probable contribution to risk of development and progression of metabolic disorders, its global consumption is still very high. Therefore, this article will sensitize the public on the need for cautious use of MSG in foods and also aid regulatory agencies to further review the daily MSG consumption limit based on metabolic toxicities observed at the varied dosages reported in this review.
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Affiliation(s)
- Omowumi T Kayode
- Department of Biochemistry, College of Basic and Applied Sciences, Mountain Top University, Prayer City, Nigeria
| | - Jemilat A Bello
- Department of Biochemistry, College of Basic and Applied Sciences, Mountain Top University, Prayer City, Nigeria
- Department of Pharmacology, Therapeutics and Toxicology, College of Medicine, Lagos State University, Lagos, Nigeria
| | - Jamiu A Oguntola
- Department of Biochemistry, College of Basic and Applied Sciences, Mountain Top University, Prayer City, Nigeria
- Department of Anatomy, College of Medicine, Lagos State University, Lagos, Nigeria
| | - Abolanle A A Kayode
- Department of Biochemistry, School of Basic Medical Sciences, Babcock University, Ilishan-Remo, Nigeria
| | - Daniel K Olukoya
- Department of Biological Sciences, College of Basic and Applied Sciences, Mountain Top University, Prayer City, Nigeria
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10
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Tampe D, Baier E, Hakroush S, Tampe B. Serum sodium levels associate with recovery of kidney function in immune checkpoint inhibitor nephrotoxicity. Front Med (Lausanne) 2023; 10:1020691. [PMID: 37547603 PMCID: PMC10399621 DOI: 10.3389/fmed.2023.1020691] [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: 08/16/2022] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Background Immune checkpoint inhibitors (ICIs) are novel drugs targeting programmed cell death protein 1-ligand 1 (PD-L1) or its receptor (PD-1). Enhancing the immune system has also been associated with a wide range of immune-related adverse events (irAE). Among them, acute interstitial nephritis (AIN) is a rare but deleterious irAE in the kidney. However, determinants of recovery and long-term kidney function after ICI withdrawal and steroid therapy thereafter remain elusive. Therefore, we here aimed to identify parameters associated with recovery of kidney function in this previous established cohort of AIN in the context of ICI therapy. Methods We here monitored kidney function over a mean follow-up time of 812 days in comparison with clinical, histopathological and laboratory parameters associated with recovery of kidney function after AIN related to ICI nephrotoxicity. Results Abundance of intrarenal PD-L1/PD-1 did not correlate with recovery of kidney function. Furthermore, cumulative steroid dose that was initiated for treatment of AIN related to ICI nephrotoxicity was also not associated with improvement of kidney function. Finally, chronic lesions in the kidney including glomerular sclerosis and interstitial fibrosis/tubular atrophy (IF/TA) did not correlate with eGFR change during the follow-up time. However, we here identified that lower levels of serum sodium at time of kidney biopsy were the strongest independent predictor of renal recovery in ICI-related nephrotoxicity. Conclusion Because low serum sodium levels associated with better improvement of kidney function, these observations might contribute to novel approaches to enhance recovery after AIN related to ICI nephrotoxicity.
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Affiliation(s)
- Désirée Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Eva Baier
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Samy Hakroush
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
- SYNLAB Pathology Hannover, SYNLAB Holding Germany, Augsburg, Germany
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
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11
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Yuan Y, Jin A, Neal B, Feng X, Qiao Q, Wang H, Zhang R, Li J, Duan P, Cao L, Zhang H, Hu S, Li H, Gao P, Xie G, Yuan J, Cheng L, Wang S, Zhang H, Niu W, Fang H, Zhao M, Gao R, Chen J, Elliott P, Labarthe D, Wu Y. Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial. Nat Med 2023; 29:973-981. [PMID: 37055566 DOI: 10.1038/s41591-023-02286-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 03/02/2023] [Indexed: 04/15/2023]
Abstract
There is a paucity of high-quality evidence on the effectiveness and safety of salt reduction strategies, particularly for older people, who have the most to benefit but are at higher risk of adverse effects. Here, we conducted a clinical trial in which 48 residential elderly care facilities in China (1,612 participants including 1,230 men and 382 women, 55 years or older) were cluster-randomized using a 2 × 2 factorial design to provision of salt substitute (62.5% NaCl and 25% KCl) versus usual salt and to a progressively restricted versus usual supply of salt or salt substitute for 2 years. Salt substitute compared with usual salt lowered systolic blood pressure (-7.1 mmHg, 95% confidence interval (CI) -10.5 to -3.8), meeting the primary outcome of the trial, whereas restricted supply compared with usual supply of salt or salt substitute had no effect on systolic blood pressure. Salt substitute also lowered diastolic blood pressure (-1.9 mmHg, 95% CI -3.6 to -0.2) and resulted in fewer cardiovascular events (hazard ratio (HR) 0.60, 95% CI 0.38-0.96), but had no effect on total mortality (HR 0.84, 95% CI 0.63-1.13). From a safety standpoint, salt substitute increased mean serum potassium and led to more frequent biochemical hyperkalemia, but was not associated with adverse clinical outcomes. In contrast, salt restriction had no effect on any study outcome. The results of this trial indicate that use of salt substitute, but not efforts to restrict salt supply, may achieve blood pressure lowering and deliver health benefits to residents of elderly care facilities in China. Clinicaltrials.gov registration: NCT03290716.
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Affiliation(s)
- Yifang Yuan
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | - Aoming Jin
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, UK
| | | | - Qianku Qiao
- Yangcheng Ophthalmic Hospital, Shanxi, China
| | - Hongxia Wang
- Department of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Inner Mongolia, China
| | - Ruijuan Zhang
- Department of Public Health, Xi'an Jiaotong University, Shaanxi, China
| | - Jiayu Li
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | | | - La'e Cao
- Yangcheng Ophthalmic Hospital, Shanxi, China
| | - Hui Zhang
- Department of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Inner Mongolia, China
| | - Senke Hu
- Department of Public Health, Xi'an Jiaotong University, Shaanxi, China
| | - Huijuan Li
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | - Pei Gao
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Gaoqiang Xie
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China
| | | | - Lili Cheng
- Yangcheng Ophthalmic Hospital, Shanxi, China
| | - Sujuan Wang
- Department of Nutrition and Food Safety, Hohhot Center for Disease Control and Prevention, Inner Mongolia, China
| | - Haijun Zhang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Wenyi Niu
- Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing, China
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Minghui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Peking Union Medical College, Beijing, China
| | - Junshi Chen
- China National Food Safety Risk Assessment Center, Beijing, China
| | - Paul Elliott
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- UK Dementia Research Institute at Imperial College London, London, UK
- British Heart Foundation Centre for Research Excellence, Imperial College London, London, UK
| | - Darwin Labarthe
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yangfeng Wu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China.
- Peking University Clinical Research Center, Peking University First Hospital, Beijing, China.
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12
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Stocker SD. Altered Neuronal Discharge in the Organum Vasculosum of the Lamina Terminalis Contributes to Dahl Salt-Sensitive Hypertension. Hypertension 2023; 80:872-881. [PMID: 36752103 PMCID: PMC10023399 DOI: 10.1161/hypertensionaha.122.20798] [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] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Salt-sensitive hypertension in humans and experimental models is associated with higher plasma and cerebrospinal fluid sodium chloride (NaCl) concentrations. Changes in extracellular NaCl concentrations are sensed by specialized neurons in the organum vasculosum of the lamina terminalis (OVLT). Stimulation of OVLT neurons increases sympathetic nerve activity (SNA) and arterial blood pressure (ABP), whereas chronic activation produces hypertension. Therefore, the present study tested whether OVLT neuronal activity was elevated and contributed to SNA and ABP in salt-sensitive hypertension. METHODS Male Dahl salt-sensitive (Dahl S) and Dahl salt-resistant (Dahl R) rats were fed 0.1% or 4.0% NaCl diets for 3 to 4 weeks and used for single-unit recordings of OVLT neurons or simultaneous recording of multiple sympathetic nerves during pharmacological inhibition of the OVLT. RESULTS Plasma and cerebrospinal fluid Na+ and Cl- concentrations were higher in Dahl S rats fed 4% versus 0.1% or Dahl R rats fed either diet. In vivo single-unit recordings revealed a significantly higher discharge of NaCl-responsive OVLT neurons in Dahl S rats fed 4% versus 0.1% or Dahl R rats. Interestingly, intracarotid infusion of hypertonic NaCl evoked greater increases in OVLT neuronal discharge of Dahl S versus Dahl R rats regardless of NaCl diet. The activity of non-NaCl-responsive OVLT neurons was not different across strain or diets. Finally, inhibition of OVLT neurons by local injection of the gamma-aminobutyric acid agonist muscimol produced a greater decrease in renal SNA, splanchnic SNA, and ABP of Dahl S rats fed 4% versus 0.1% or Dahl R rats. CONCLUSIONS A high salt diet activates NaCl-responsive OVLT neurons to increase SNA and ABP in salt-sensitive hypertension.
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Affiliation(s)
- Sean D Stocker
- Department of Neurobiology, University of Pittsburgh School of Medicine, PA
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13
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Ioannidou S, Kazeli K, Ventouris H, Amanatidou D, Gkinoudis A, Lymperaki E. Correlation of Vitamin 25(OH)D, Liver Enzymes, Potassium, and Oxidative Stress Markers with Lipid Profile and Atheromatic Index: A Pilot Study. J Xenobiot 2023; 13:193-204. [PMID: 37092503 PMCID: PMC10123670 DOI: 10.3390/jox13020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 04/05/2023] Open
Abstract
According to recent literature, there is a limited amount of data about the correlation of vitamin 25(OH)D, potassium (K), oxidative stress parameters, and other biomarkers with dyslipidemia, which is an established risk factor for cardiovascular diseases (CVDs). This study aims to investigate the correlation of lipid profile and atheromatic index TC/HDL with several biomarkers and oxidative stress parameters. A total of 102 volunteers, 67 with atheromatic index TC/HDL > 3.5 (Group A) and 35 with TC/HDL < 3.5 (Group B), aged from 26 to 78 years, participated in this study. Serum levels of triglycerides (TG), total cholesterol (TC), low- and high-density lipoproteins (LDL and HDL), vitamin 25(OH)D [25(OH)D], potassium (K), sodium (Na), lactose dehydrogenase (LDH), liver enzymes including serum glutamic oxaloacetic and glutamic pyruvic transaminases (SGOT and SGPT), gamma-glutamyl transferase (γ-GT), and alkaline phosphatase (ALP) were analyzed using standard photometric methods. Oxidative stress parameters such as reactive oxygen species (ROS) were detected with fluorometric methods, whereas total oxidative (TOS) and antioxidative status (TAS) were measured with spectrophotometric methods. According to the results, negative correlations of HDL (r = −0.593) and 25(OH)D (r = −0.340) and K (r = −0.220) were found, and positive expected correlations of LDL (r = 0.731), TC (r = 0.663), and TG (r = 0.584) with atheromatic index in the total studied sample were found. In conclusion, patients with a dyslipidemic profile should frequently check not only their lipid profile but also other biomarkers such as 25(OH)D, potassium, and oxidative stress markers to predict dyslipidemia and avoid subsequent disorders.
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Affiliation(s)
- Stavroula Ioannidou
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Konstantina Kazeli
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Department of Condensed Matter and Materials Physics, School of Physics, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Hristos Ventouris
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Dionysia Amanatidou
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Argyrios Gkinoudis
- School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Evgenia Lymperaki
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
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14
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Martin K, Toussaint ND, Tan SJ, Hewitson TD. Skin regulation of salt and blood pressure and potential clinical implications. Hypertens Res 2023; 46:408-416. [PMID: 36434290 DOI: 10.1038/s41440-022-01096-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/12/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022]
Abstract
Sodium chloride, as salt, gives rise to hypertension. Nevertheless, individual susceptibility to the ramifications of sodium chloride is heterogeneous. The conventional nephron-centric regulation of sodium with neurohormonal inputs and responses is now expanded to include an intricate extrarenal pathway including the endothelium, skin, lymphatics, and immune cells. An overabundance of sodium is buffered and regulated by the skin interstitium. Excess sodium passes through (and damages) the vascular endothelium and can be dynamically stored in the skin, modulated by skin immune cells and lymphatics. This excess interstitially stored sodium is implicated in hypertension, cardiovascular dysfunction, metabolic disruption, and inflammatory dysregulation. This extrarenal pathway of regulating sodium represents a novel target for better blood pressure management, rebalancing disturbed inflammation, and hence addressing cardiovascular and metabolic disease.
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Affiliation(s)
- Kylie Martin
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia. .,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.
| | - Nigel D Toussaint
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Sven-Jean Tan
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Timothy D Hewitson
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
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15
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Kang EJ, Prager O, Lublinsky S, Oliveira-Ferreira AI, Reiffurth C, Major S, Müller DN, Friedman A, Dreier JP. Stroke-prone salt-sensitive spontaneously hypertensive rats show higher susceptibility to spreading depolarization (SD) and altered hemodynamic responses to SD. J Cereb Blood Flow Metab 2023; 43:210-230. [PMID: 36329390 PMCID: PMC9903222 DOI: 10.1177/0271678x221135085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Spreading depolarization (SD) occurs in a plethora of clinical conditions including migraine aura, delayed ischemia after subarachnoid hemorrhage and malignant hemispheric stroke. It describes waves of near-breakdown of ion homeostasis, particularly Na+ homeostasis in brain gray matter. SD induces tone alterations in resistance vessels, causing either hyperperfusion in healthy tissue; or hypoperfusion (inverse hemodynamic response = spreading ischemia) in tissue at risk. Observations from mice with genetic dysfunction of the ATP1A2-encoded α2-isoform of Na+/K+-ATPase (α2NaKA) suggest a mechanistic link between (1) SD, (2) vascular dysfunction, and (3) salt-sensitive hypertension via α2NaKA. Thus, α2NaKA-dysfunctional mice are more susceptible to SD and show a shift toward more inverse hemodynamic responses. α2NaKA-dysfunctional patients suffer from familial hemiplegic migraine type 2, a Mendelian model disease of SD. α2NaKA-dysfunctional mice are also a genetic model of salt-sensitive hypertension. To determine whether SD thresholds and hemodynamic responses are also altered in other genetic models of salt-sensitive hypertension, we examined these variables in stroke-prone spontaneously hypertensive rats (SHRsp). Compared with Wistar Kyoto control rats, we found in SHRsp that electrical SD threshold was significantly reduced, propagation speed was increased, and inverse hemodynamic responses were prolonged. These results may have relevance to both migraine with aura and stroke.
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Affiliation(s)
- Eun-Jeung Kang
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ofer Prager
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Svetlana Lublinsky
- Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ana I Oliveira-Ferreira
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Clemens Reiffurth
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sebastian Major
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dominik N Müller
- Experimental and Clinical Research Center (ECRC), a Joint Cooperation between the Charité - Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Alon Friedman
- Department of Physiology & Cell Biology, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Cognitive & Brain Sciences, The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jens P Dreier
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany.,Einstein Center for Neurosciences Berlin, Berlin, Germany
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16
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Al-Hajj S, Lemoine R, Chadet S, Goumard A, Legay L, Roxburgh E, Heraud A, Deluce N, Lamendour L, Burlaud-Gaillard J, Gatault P, Büchler M, Roger S, Halimi JM, Baron C. High extracellular sodium chloride concentrations induce resistance to LPS signal in human dendritic cells. Cell Immunol 2023; 384:104658. [PMID: 36566700 DOI: 10.1016/j.cellimm.2022.104658] [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: 06/22/2022] [Revised: 11/24/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Recent evidence showed that in response to elevated sodium dietary intakes, many body tissues retain Na+ ions for long periods of time and can reach concentrations up to 200 mM. This could modulate the immune system and be responsible for several diseases. However, studies brought contrasted results and the effects of external sodium on human dendritic cell (DC) responses to danger signals remain largely unknown. Considering their central role in triggering T cell response, we tested how NaCl-enriched medium influences human DCs properties. We found that DCs submitted to high extracellular Na+ concentrations up to 200 mM remain viable and maintain the expression of specific DC markers, however, their maturation, chemotaxis toward CCL19, production of pro-inflammatory cytokines and ROS in response to LPS were also partially inhibited. In line with these results, the T-cell allostimulatory capacity of DCs was also inhibited. Finally, our data indicate that high NaCl concentrations triggered the phosphorylation of SGK1 and ERK1/2 kinases. These results raised the possibility that the previously reported pro-inflammatory effects of high NaCl concentrations on T cells might be counterbalanced by a downregulation of DC activation.
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Affiliation(s)
- Sally Al-Hajj
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Roxane Lemoine
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Stéphanie Chadet
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Annabelle Goumard
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France; Nephrology, Clinical Immunology Department, University Hospital of Tours, Tours, France
| | - Laura Legay
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Ellena Roxburgh
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Audrey Heraud
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Nora Deluce
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Lucille Lamendour
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France
| | - Julien Burlaud-Gaillard
- U1259 Morphogenesis and Antigenicity of HIV and Hepatitis virus (MAVIVH), University of Tours, Tours, France; IBISA Facility of Electronic Microscopy, University Hospital of Tours, Tours, France
| | - Philippe Gatault
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France; Nephrology, Clinical Immunology Department, University Hospital of Tours, Tours, France
| | - Mathias Büchler
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France; Nephrology, Clinical Immunology Department, University Hospital of Tours, Tours, France
| | - Sébastien Roger
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France.
| | - Jean-Michel Halimi
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France; Nephrology, Clinical Immunology Department, University Hospital of Tours, Tours, France
| | - Christophe Baron
- EA4245 Transplantation, Immunology & Inflammation (T2I), University of Tours, Tours, France; Nephrology, Clinical Immunology Department, University Hospital of Tours, Tours, France
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17
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The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers. Biomedicines 2022; 10:biomedicines10112804. [PMID: 36359324 PMCID: PMC9687451 DOI: 10.3390/biomedicines10112804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers.
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18
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Dmitrieva NI, Liu D, Wu CO, Boehm M. Middle age serum sodium levels in the upper part of normal range and risk of heart failure. Eur Heart J 2022; 43:3335-3348. [PMID: 35348651 PMCID: PMC10263272 DOI: 10.1093/eurheartj/ehac138] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/01/2022] [Accepted: 03/03/2022] [Indexed: 07/29/2023] Open
Abstract
AIMS With increasing prevalence of heart failure (HF) owing to the ageing population, identification of modifiable risk factors is important. In a mouse model, chronic hypohydration induced by lifelong water restriction promotes cardiac fibrosis. Hypohydration elevates serum sodium. Here, we evaluate the association of serum sodium at middle age as a measure of hydration habits with risk to develop HF. METHODS AND RESULTS We analysed data from Atherosclerosis Risk in Communities study with middle age enrolment (45-66 years) and 25 years of follow-up. Participants without water balance dysregulation were selected: serum sodium within normal range (135-146 mmol/L), not diabetic, not obese and free of HF at baseline (N = 11 814). In time-to-event analysis, HF risk was increased by 39% if middle age serum sodium exceeded 143 mmol/L corresponding to 1% body weight water deficit [hazard ratio 1.39, 95% confidence interval (CI) 1.14-1.70]. In a retrospective case-control analysis performed on 70- to 90-year-old attendees of Visit 5 (N = 4961), serum sodium of 142.5-143 mmol/L was associated with 62% increase in odds of left ventricular hypertrophy (LVH) diagnosis [odds ratio (OR) 1.62, 95% CI 1.03-2.55]. Serum sodium above 143 mmol/L was associated with 107% increase in odds of LVH (OR 2.07, 95% CI 1.30-3.28) and 54% increase in odds of HF (OR 1.54, 95% CI 1.06-2.23). As a result, prevalence of HF and LVH was increased among 70- to 90-year-old participants with higher middle age serum sodium. CONCLUSION Middle age serum sodium above 142 mmol is a risk factor for LVH and HF. Maintaining good hydration throughout life may slow down decline in cardiac function and decrease prevalence of HF.
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Affiliation(s)
- Natalia I Dmitrieva
- The Laboratory of Cardiovascular Regenerative Medicine, National Heart Lung and Blood Institute, Bethesda, MD 20892, USA
| | - Delong Liu
- The Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, Bethesda, MD 20892, USA
| | - Colin O Wu
- Office of Biostatistics Research, National Heart Lung and Blood Institute, Bethesda, MD 20892, USA
| | - Manfred Boehm
- The Laboratory of Cardiovascular Regenerative Medicine, National Heart Lung and Blood Institute, Bethesda, MD 20892, USA
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19
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Beer MC, Kuhrt H, Kohen L, Wiedemann P, Bringmann A, Hollborn M. Kir4.2 Potassium Channels in Retinal Pigment Epithelial Cells In Vitro: Contribution to Cell Viability and Proliferation, and Down-Regulation by Vascular Endothelial Growth Factor. Biomolecules 2022; 12:biom12060848. [PMID: 35740973 PMCID: PMC9220994 DOI: 10.3390/biom12060848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 01/27/2023] Open
Abstract
Dedifferentiation and proliferation of retinal pigment epithelial (RPE) cells are characteristics of retinal diseases. Dedifferentiation is likely associated with changes of inwardly rectifying potassium (Kir) channels. The roles of Kir4.2 channels in viability, and proliferation of cultured RPE cells were investigated. Gene expression levels were determined using qRT-PCR. RPE cells expressed Kir2.1, 2.2, 2.4, 3.2, 4.1, 4.2, 6.1, and 7.1 mRNA. Kir4.2 protein was verified by immunocytochemistry and Western blotting. Kir4.2 mRNA in cultured cells was upregulated by hypoxia (hypoxia mimetic CoCl2 or 0.2% O2) and extracellular hyperosmolarity (addition of high NaCl or sucrose). Kir4.2 mRNA was suppressed by vascular endothelial growth factor (VEGF), blood serum, and thrombin whereas platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), and transforming growth factor-β1 (TGF-β1) increased it. Hyperosmotic Kir4.2 gene expression was mediated by TGF-β1 receptor signaling while hypoxic gene transcription was dependent on PDGF receptor signaling. VEGF receptor-2 blockade increased Kir4.2 mRNA level under control, hyperosmotic, and hypoxic conditions. SiRNA-mediated knockdown of Kir4.2 decreased the cell viability and proliferation under control and hyperosmotic conditions. Kir4.2 channels play functional roles in maintaining the viability and proliferation of RPE cells. Downregulation of Kir4.2 by VEGF, via activation of VEGF receptor-2 and induction of blood-retinal barrier breakdown, may contribute to decreased viability of RPE cells under pathological conditions.
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Affiliation(s)
- Marie-Christin Beer
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103 Leipzig, Germany; (M.-C.B.); (L.K.); (P.W.); (A.B.)
| | - Heidrun Kuhrt
- Institute of Anatomy, University of Leipzig, 04103 Leipzig, Germany;
| | - Leon Kohen
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103 Leipzig, Germany; (M.-C.B.); (L.K.); (P.W.); (A.B.)
- Department of Ophthalmology, Helios Klinikum Aue, 08280 Aue, Germany
| | - Peter Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103 Leipzig, Germany; (M.-C.B.); (L.K.); (P.W.); (A.B.)
| | - Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103 Leipzig, Germany; (M.-C.B.); (L.K.); (P.W.); (A.B.)
| | - Margrit Hollborn
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103 Leipzig, Germany; (M.-C.B.); (L.K.); (P.W.); (A.B.)
- Correspondence:
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20
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Affiliation(s)
- Friedrich C Luft
- Experimental and Clinical Research Center and Charité Medical Faculty, Lindenbergerweg 80, D-13125, Berlin, Germany
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21
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Hu H, Eguchi M, Miki T, Kochi T, Kabe I, Nanri A, Macgregor GA, Mizoue T, He FJ. Serum sodium and risk of hypertension: a cohort study. Hypertens Res 2021; 45:354-359. [PMID: 34759331 DOI: 10.1038/s41440-021-00797-w] [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: 05/31/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 11/09/2022]
Abstract
This study aimed to investigate the cross-sectional association between serum sodium and blood pressure at baseline and, more importantly, investigate the prospective association between serum sodium and the risk of incident hypertension. We used data from 1 638 workers aged 18 to 71 years who participated in 2015-2016 survey of the Furukawa Nutrition and Health Study. During a maximum follow-up of 3 years, 229 participants developed hypertension. Multivariable linear regression models were used to evaluate the cross-sectional association. The Cox proportional hazards model was used to calculate the hazard ratio and 95% confidence interval of incident hypertension across quartiles of serum sodium (137-140, 141-142, 143, and 144-147 mmol/L). In the cross-sectional analysis, we did not observe a significant association between serum sodium and blood pressure at baseline. In the prospective analysis, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident hypertension were 1.03 (0.71-1.51), 1.35 (0.87-2.08), and 1.46 (0.97-2.20) for the upper three quartiles of the serum sodium levels compared with the lowest quartile (P for trend=0.02). When serum sodium was treated as a continuous variable, the multivariable-adjusted hazard ratio for hypertension was 1.10 (1.03-1.18). The association was slightly attenuated after additionally adjusting for baseline blood pressure, with a hazard ratio of 1.08 (1.00-1.16) for a 1 mmol/L increase in serum sodium. In conclusion, an elevated serum sodium level was associated with an increased risk of developing hypertension, suggesting that serum sodium could be a potential risk factor for hypertension.
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Affiliation(s)
- Huan Hu
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. .,Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan. .,Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health, Kanagawa, Japan.
| | | | - Takako Miki
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Isamu Kabe
- KUBOTA Corporation Co., Ltd., Ibaraki, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Graham A Macgregor
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Feng J He
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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22
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Na + i/K + i imbalance contributes to gene expression in endothelial cells exposed to elevated NaCl. Heliyon 2021; 7:e08088. [PMID: 34632152 PMCID: PMC8488490 DOI: 10.1016/j.heliyon.2021.e08088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/27/2021] [Accepted: 09/26/2021] [Indexed: 12/16/2022] Open
Abstract
High-salt consumption contributes to the development of hypertension and is considered an independent risk factor for vascular remodelling, cardiac hypertrophy and stroke incidence. Alterations in NO production, inflammation and endothelial cell stiffening are considered now as plausible mediators of cardiovascular dysfunction. We studied early responses of endothelial cells (HUVEC) caused by a moderate increase in extracellular sodium concentration. Exposure of HUVEC to elevated sodium within the physiological range up to 24 h is accompanied by changes in monovalent cations fluxes and Na,K-ATPase activation, and, in turn, results in a significant decrease in the content of PTGS2, IL6 and IL1LR1 mRNAs. The expression of NOS3 and FOS genes, as well as the abundance of cytosolic and nuclear NFAT5 protein, remained unchanged. We assessed the mechanical properties of endothelial cells by estimating Young's modulus and equivalent elastic constant using atomic force and interference microscopy, respectively. These parameters were unaffected by elevated-salt exposure for 24 h. The data obtained suggest that even small and short-term elevations of extracellular sodium concentration affect the expression of genes involved in the control of endothelial function through the Na+i/K+i-dependent mechanism(s).
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23
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Sodium Intake as a Cardiovascular Risk Factor: A Narrative Review. Nutrients 2021; 13:nu13093177. [PMID: 34579054 PMCID: PMC8470268 DOI: 10.3390/nu13093177] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/05/2021] [Accepted: 09/10/2021] [Indexed: 01/11/2023] Open
Abstract
While sodium is essential for human homeostasis, current salt consumption far exceeds physiological needs. Strong evidence suggests a direct causal relationship between sodium intake and blood pressure (BP) and a modest reduction in salt consumption is associated with a meaningful reduction in BP in hypertensive as well as normotensive individuals. Moreover, while long-term randomized controlled trials are still lacking, it is reasonable to assume a direct relationship between sodium intake and cardiovascular outcomes. However, a consensus has yet to be reached on the effectiveness, safety and feasibility of sodium intake reduction on an individual level. Beyond indirect BP-mediated effects, detrimental consequences of high sodium intake are manifold and pathways involving vascular damage, oxidative stress, hormonal alterations, the immune system and the gut microbiome have been described. Globally, while individual response to salt intake is variable, sodium should be perceived as a cardiovascular risk factor when consumed in excess. Reduction of sodium intake on a population level thus presents a potential strategy to reduce the burden of cardiovascular disease worldwide. In this review, we provide an update on the consequences of salt intake on human health, focusing on BP and cardiovascular outcomes as well as underlying pathophysiological hypotheses.
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24
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High Na + Salt Diet and Remodeling of Vascular Smooth Muscle and Endothelial Cells. Biomedicines 2021; 9:biomedicines9080883. [PMID: 34440087 PMCID: PMC8389691 DOI: 10.3390/biomedicines9080883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Our knowledge on essential hypertension is vast, and its treatment is well known. Not all hypertensives are salt-sensitive. The available evidence suggests that even normotensive individuals are at high cardiovascular risk and lower survival rate, as blood pressure eventually rises later in life with a high salt diet. In addition, little is known about high sodium (Na+) salt diet-sensitive hypertension. There is no doubt that direct and indirect Na+ transporters, such as the Na/Ca exchanger and the Na/H exchanger, and the Na/K pump could be implicated in the development of high salt-induced hypertension in humans. These mechanisms could be involved following the destruction of the cell membrane glycocalyx and changes in vascular endothelial and smooth muscle cells membranes’ permeability and osmolarity. Thus, it is vital to determine the membrane and intracellular mechanisms implicated in this type of hypertension and its treatment.
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25
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Chang HW, Frey G, Liu H, Xing C, Steinman L, Boyle WJ, Short JM. Generating tumor-selective conditionally active biologic anti-CTLA4 antibodies via protein-associated chemical switches. Proc Natl Acad Sci U S A 2021; 118:e2020606118. [PMID: 33627407 PMCID: PMC7936328 DOI: 10.1073/pnas.2020606118] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Anticytotoxic T lymphocyte-associated protein 4 (CTLA4) antibodies have shown potent antitumor activity, but systemic immune activation leads to severe immune-related adverse events, limiting clinical usage. We developed novel, conditionally active biologic (CAB) anti-CTLA4 antibodies that are active only in the acidic tumor microenvironment. In healthy tissue, this binding is reversibly inhibited by a novel mechanism using physiological chemicals as protein-associated chemical switches (PaCS). No enzymes or potentially immunogenic covalent modifications to the antibody are required for activation in the tumor. The novel anti-CTLA4 antibodies show similar efficacy in animal models compared to an analog of a marketed anti-CTLA4 biologic, but have markedly reduced toxicity in nonhuman primates (in combination with an anti-PD1 checkpoint inhibitor), indicating a widened therapeutic index (TI). The PaCS encompass mechanisms that are applicable to a wide array of antibody formats (e.g., ADC, bispecifics) and antigens. Examples shown here include antibodies to EpCAM, Her2, Nectin4, CD73, and CD3. Existing antibodies can be engineered readily to be made sensitive to PaCS, and the inhibitory activity can be optimized for each antigen's varying expression level and tissue distribution. PaCS can modulate diverse physiological molecular interactions and are applicable to various pathologic conditions, enabling differential CAB antibody activities in normal versus disease microenvironments.
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MESH Headings
- 5'-Nucleotidase/antagonists & inhibitors
- 5'-Nucleotidase/genetics
- 5'-Nucleotidase/immunology
- Animals
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized/chemistry
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Neoplasm/chemistry
- Antibodies, Neoplasm/pharmacology
- B7-H1 Antigen/antagonists & inhibitors
- B7-H1 Antigen/genetics
- B7-H1 Antigen/immunology
- Bicarbonates/chemistry
- CD3 Complex/antagonists & inhibitors
- CD3 Complex/genetics
- CD3 Complex/immunology
- CTLA-4 Antigen/antagonists & inhibitors
- CTLA-4 Antigen/genetics
- CTLA-4 Antigen/immunology
- Cell Adhesion Molecules/antagonists & inhibitors
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/immunology
- Colonic Neoplasms/genetics
- Colonic Neoplasms/immunology
- Colonic Neoplasms/pathology
- Colonic Neoplasms/therapy
- Epithelial Cell Adhesion Molecule/antagonists & inhibitors
- Epithelial Cell Adhesion Molecule/genetics
- Epithelial Cell Adhesion Molecule/immunology
- GPI-Linked Proteins/antagonists & inhibitors
- GPI-Linked Proteins/genetics
- GPI-Linked Proteins/immunology
- Gene Expression
- Humans
- Hydrogen Sulfide/chemistry
- Hydrogen-Ion Concentration
- Immunotherapy/methods
- Macaca fascicularis
- Mice
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Protein Engineering/methods
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/immunology
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- T-Lymphocytes, Cytotoxic/pathology
- Tumor Burden/drug effects
- Tumor Microenvironment/drug effects
- Xenograft Model Antitumor Assays
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Affiliation(s)
| | | | | | | | - Lawrence Steinman
- Stanford University School of Medicine, Stanford University, Stanford, CA 94305
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26
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Overwyk KJ, Pfeiffer CM, Storandt RJ, Zhao L, Zhang Z, Campbell NRC, Wiltz JL, Merritt RK, Cogswell ME. Serum Sodium and Potassium Distribution and Characteristics in the US Population, National Health and Nutrition Examination Survey 2009-2016. J Appl Lab Med 2021; 6:63-78. [PMID: 33236098 DOI: 10.1093/jalm/jfaa127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/24/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Concern has been expressed by some that sodium reduction could lead to increased prevalence of hyponatremia and hyperkalemia for specific population subgroups. Current concentrations of serum sodium and potassium in the US population can help address this concern. METHODS We used data from the National Health and Nutrition Examination Survey 2009-2016 to examine mean and selected percentiles of serum sodium and potassium by sex and age group among 25 520 US participants aged 12 years or older. Logistic regression models with predicted residuals were used to examine the age-adjusted prevalence of low serum sodium and high serum potassium among adults aged 20 or older by selected sociodemographic characteristics and by health conditions or medication use. RESULTS The distributions of serum sodium and potassium concentrations were within normal reference intervals overall and across Dietary Reference Intake life-stage groups, with a few exceptions. Overall, 2% of US adults had low serum sodium (<135 mmol/L) and 0.6% had high serum potassium (>5 mmol/L). Prevalence of low serum sodium and high serum potassium was higher among adults aged 71 or older (4.7 and 2.0%, respectively) and among adults with chronic kidney disease (3.4 and 1.9%), diabetes (5.0 and 1.1%), or using certain medications (which varied by condition), adjusted for age; whereas, prevalence was <1% among adults without these conditions or medications. CONCLUSIONS Most of the US population has normal serum sodium and potassium concentrations; these data describe population subgroups at higher risk of low serum sodium and high serum potassium and can inform clinical care.
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Affiliation(s)
- Katherine J Overwyk
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.,IHRC, Inc., Atlanta, GA
| | - Christine M Pfeiffer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Renee J Storandt
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lixia Zhao
- Division of Health Informatics and Surveillance, Center for Surveillance Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Norm R C Campbell
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L Wiltz
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.,United States Public Health Service, Atlanta, GA
| | - Robert K Merritt
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mary E Cogswell
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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27
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Short-term changes in dietary sodium intake influence sweat sodium concentration and muscle sodium content in healthy individuals. J Hypertens 2020; 38:159-166. [PMID: 31503134 DOI: 10.1097/hjh.0000000000002234] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is increasing evidence that sodium can be stored in the skin and muscles without being osmotically active, yet whether acute changes in dietary sodium intake alter sweat and muscle sodium content has not been investigated previously. METHODS In a cross-over design, we assessed muscle sodium content by Na-MRI in 38 healthy normotensive volunteers (aged 33.5 ± 11.1 years, 76.3% women) after 5 days of high-sodium diet (6 g of salt added to their normal diet) and 5 days of a low-sodium diet. In a subgroup of 18 participants (72.2% women) we conducted quantitative pilocarpine iontophoretic sweat collections and measured the sodium concentration in sweat. Plasma aldosterone and plasma renin activity levels were measured in all participants. RESULTS Under high-sodium diet conditions urinary sodium excretion, muscle sodium content and sweat sodium concentration all increased significantly. Muscle sodium content (rm = 0.47, P = 0.03) and sodium sweat concentration (rm = 0.72, P < 0.001) correlated positively with salt intake as estimated by 24-h urine sodium excretion. Age, sex or the phase of the menstrual cycle did not influence muscle or sweat sodium concentrations or their changes. In contrast, plasma aldosterone levels were negatively associated with both muscle sodium (rs = -0.42, P = 0.0001) and sweat sodium content (rs = -0.52, P = 0.002). Plasma renin activity correlated negatively with sweat sodium (rs = -0.43, P = 0.012) and muscle sodium levels (rs = -0.42, P < 0.001). CONCLUSION Muscle and sweat sodium concentrations are significantly higher on a high-salt intake in healthy male and female individuals, suggesting that muscle and sweat play a role in regulating sodium balance in humans.
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28
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He FJ, Tan M, Ma Y, MacGregor GA. Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:632-647. [PMID: 32057379 DOI: 10.1016/j.jacc.2019.11.055] [Citation(s) in RCA: 274] [Impact Index Per Article: 68.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.
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Affiliation(s)
- Feng J He
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Monique Tan
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Yuan Ma
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Graham A MacGregor
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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29
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DeLalio LJ, Sved AF, Stocker SD. Sympathetic Nervous System Contributions to Hypertension: Updates and Therapeutic Relevance. Can J Cardiol 2020; 36:712-720. [PMID: 32389344 DOI: 10.1016/j.cjca.2020.03.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/15/2022] Open
Abstract
The sympathetic nervous system plays a pivotal role in the long-term regulation of arterial blood pressure through the ability of the central nervous system to integrate neurohumoral signals and differentially regulate sympathetic neural input to specific end organs. Part 1 of this review will discuss neural mechanisms of salt-sensitive hypertension, obesity-induced hypertension, and the ability of prior experiences to sensitize autonomic networks. Part 2 of this review focuses on new therapeutic advances to treat resistant hypertension including renal denervation and carotid baroactivation. Both advances lower arterial blood pressure by reducing sympathetic outflow. We discuss potential mechanisms and areas of future investigation to target the sympathetic nervous system.
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Affiliation(s)
- Leon J DeLalio
- Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alan F Sved
- Department of Neuroscience, University of Pittsburgh, Pennsylvania, USA
| | - Sean D Stocker
- Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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30
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Oppelaar JJ, Vogt L. Body Fluid-Independent Effects of Dietary Salt Consumption in Chronic Kidney Disease. Nutrients 2019; 11:E2779. [PMID: 31731658 PMCID: PMC6893804 DOI: 10.3390/nu11112779] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023] Open
Abstract
The average dietary salt (i.e., sodium chloride) intake in Western society is about 10 g per day. This greatly exceeds the lifestyle recommendations by the WHO to limit dietary salt intake to 5 g. There is robust evidence that excess salt intake is associated with deleterious effects including hypertension, kidney damage and adverse cardiovascular health. In patients with chronic kidney disease, moderate reduction of dietary salt intake has important renoprotective effects and positively influences the efficacy of common pharmacological treatment regimens. During the past several years, it has become clear that besides influencing body fluid volume high salt also induces tissue remodelling and activates immune cell homeostasis. The exact pathophysiological pathway in which these salt-induced fluid-independent effects contribute to CKD is not fully elucidated, nonetheless it is clear that inflammation and the development of fibrosis play a major role in the pathogenic mechanisms of renal diseases. This review focuses on body fluid-independent effects of salt contributing to CKD pathogenesis and cardiovascular health. Additionally, the question whether better understanding of these pathophysiological pathways, related to high salt consumption, might identify new potential treatment options will be discussed.
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Affiliation(s)
| | - Liffert Vogt
- Section of Nephrology, Department of Internal Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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31
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Nowak KL, Chonchol M, Jovanovich A, You Z, Bates J, Foy C, Glasser S, Killeen AA, Kostis J, Rodriguez CJ, Segal M, Simmons DL, Taylor A, Lovato LC, Ambrosius WT, Supiano MA. Serum Sodium and Pulse Pressure in SPRINT. Am J Hypertens 2019; 32:649-656. [PMID: 30977767 DOI: 10.1093/ajh/hpz055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/29/2019] [Accepted: 04/09/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND High dietary sodium intake may induce a small, yet physiologically relevant rise in serum sodium concentration, which associates with increased systolic blood pressure. Cellular data suggest that this association is mediated by increased endothelial cell stiffness. We hypothesized that higher serum sodium levels were associated with greater arterial stiffness in participants in the Systolic Blood Pressure Intervention Trial (SPRINT). METHODS Multivariable linear regression was used to examine the association between baseline serum sodium level and (i) pulse pressure (PP; n = 8,813; a surrogate measure of arterial stiffness) and (ii) carotid-femoral pulse wave velocity (CFPWV; n = 591 in an ancillary study to SPRINT). RESULTS Baseline mean ± SD age was 68 ± 9 years and serum sodium level was 140 ± 2 mmol/L. In the PP analysis, higher serum sodium was associated with increased baseline PP in the fully adjusted model (tertile 3 [≥141 mmol] vs. tertile 2 [139-140 mmol]; β = 0.87, 95% CI = 0.32 to 1.43). Results were similar in those with and without chronic kidney disease. In the ancillary study, higher baseline serum sodium was not associated with increased baseline CFPWV in the fully adjusted model (β = 0.35, 95% CI = -0.14 to 0.84). CONCLUSIONS Among adults at high risk for cardiovascular events but free from diabetes, higher serum sodium was independently associated with baseline arterial stiffness in SPRINT, as measured by PP, but not by CFPWV. These results suggest that high serum sodium may be a marker of risk for increased PP, a surrogate index of arterial stiffness.
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Affiliation(s)
- Kristen L Nowak
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Anna Jovanovich
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Renal Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jeffrey Bates
- Division of General Internal Medicine, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
| | - Capri Foy
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen Glasser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anthony A Killeen
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - John Kostis
- Division of Cardiology, The Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Carlos J Rodriguez
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark Segal
- Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Florida, USA
| | - Debra L Simmons
- Division of Endocrinology, University of Utah and VA Salt Lake City, Salt Lake City, Utah, USA
| | - Addison Taylor
- Division of General Internal Medicine, Houston Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
| | - Laura C Lovato
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Walter T Ambrosius
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Supiano
- Division of Geriatrics, University of Utah, Salt Lake City, Utah, USA
- VA Salt Lake City Health Care System, Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah, USA
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32
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Pääkkö TJW, Perkiömäki JS, Silaste ML, Bloigu R, Huikuri HV, Antero Kesäniemi Y, Ukkola OH. Dietary sodium intake is associated with long-term risk of new-onset atrial fibrillation. Ann Med 2018; 50:694-703. [PMID: 30442022 DOI: 10.1080/07853890.2018.1546054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The association between dietary salt intake and hypertension has been well documented. We evaluated the association between dietary sodium intake and the incidence of new-onset atrial fibrillation (AF) during a mean follow-up of 19 years among 716 subjects from the Oulu Project Elucidating Risk of Atherosclerosis (OPERA) cohort. MATERIAL AND METHODS Dietary sodium intake was evaluated from a seven-day food record. The diagnosis of AF (atrial flutter included) was made if ICD-10 code I48 was listed in the hospital discharge records during follow-up. RESULTS In the Kaplan-Meier curves, when quartiles of sodium consumption were considered, the cumulative proportional probabilities for AF events were higher in the highest (4th) quartile (16.8%) than in the lower quartiles (1st 6.7%, 2nd 7.3% and 3rd 10.6%) (p = .003). In the Cox regression analysis, sodium consumption (g/1000 kcal) as a continuous variable was independently associated with AF events (Hazard Ratio = 2.1 (95% CI, 1.2 to 3.7) p =.015) when age, body mass index, smoking (pack-years), office systolic blood pressure, left atrium diameter, left ventricular mass index and the use of any antihypertensive therapy were added as covariates. CONCLUSIONS These findings indicate that sodium intake is associated with the long-term risk of new-onset AF. Further confirmatory studies are needed. Key messages Sodium consumption correlated positively with CV risk factors: age, smoking, SBP, BMI and LDL-cholesterol. When quartiles of sodium consumption were considered, the AF incidence was higher in the highest quartile compared to lower quartiles. Sodium consumption as a continuous variable was independently associated with AF events when age, BMI, smoking, SBP, LAD, LVMI and the use of any antihypertensive therapy were considered.
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Affiliation(s)
- Tero Juho Wilhelm Pääkkö
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Juha S Perkiömäki
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Marja-Leena Silaste
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Risto Bloigu
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Heikki V Huikuri
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Y Antero Kesäniemi
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Olavi H Ukkola
- a Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
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Ajayi S, Adebiyi A, Kadiri S. Increased urinary sodium excretion is associated with systolic blood pressure in first degree relatives of hypertensive patients in Ibadan, Southwestern Nigeria. Pan Afr Med J 2018; 31:168. [PMID: 31086621 PMCID: PMC6488237 DOI: 10.11604/pamj.2018.31.168.16611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/24/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Understanding the risk factors of hypertension has led to a better understanding of the pathogenesis, prevention and reduction in morbidity of hypertension. It is well known that offsprings of hypertensive parents have an increased risk of developing hypertension. It is therefore necessary to explore the physiological differences between normotensive patients with and without a positive family history of hypertension with respect to their urinary excretion of sodium. METHODS This study was carried out at the University College Hospital, Ibadan Nigeria, to determine if normotensive patients with a positive family history of hypertension are different with respect to their urinary excretion of electrolytes and blood pressure. It examined the relationship between 24-hour urinary excretion of sodium, chloride and potassium, urea and creatinine and blood pressure in subjects with and without family history of hypertension. It was a case-control study of sixty-two subjects: normotensive patients' first degree relatives of primary hypertensive patients and normotensive patients without positive family history. RESULTS The mean (SD) systolic blood pressures for subjects with and without family history of hypertension were significantly different: 120.0(22.25) and 105.0(17.50) respectively, (p=0.001). The mean arterial blood pressures were significantly different: 86.4(10.2) mmHg and 80.1(8.1) mmHg respectively (p=0.010). The mean (SD) 24-hour urinary excretion of sodium for normotensive patients with and without positive family history of hypertension were 180.5 (45.50) mEq/L, and 156.0(36.25) mEq/L respectively. Systolic blood pressure and 24-hour urinary excretion of sodium was also higher in normotensive subjects with a positive family history of hypertension. CONCLUSION Systolic blood pressure and twenty-four hour urinary excretion of sodium were higher in normotensive subjects with a positive family history of hypertension than in those without a family history of hypertension.
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Affiliation(s)
- Samuel Ajayi
- Nephrology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adewole Adebiyi
- Cardiology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Solomon Kadiri
- Nephrology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
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Cole NI, Suckling RJ, Desilva V, He FJ, MacGregor GA, Swift PA. Serum sodium concentration and the progression of established chronic kidney disease. J Nephrol 2018; 32:259-264. [PMID: 30328093 PMCID: PMC6422977 DOI: 10.1007/s40620-018-0541-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/29/2018] [Indexed: 02/05/2023]
Abstract
Background Higher serum sodium concentration has been reported to be a risk factor for the development of incident chronic kidney disease (CKD), but its relationship with the progression of established CKD has not been investigated. We hypothesised that increased serum sodium concentration is a risk factor for estimated glomerular filtration rate (eGFR) decline in CKD. Methods This was a retrospective cohort study using data collected over a 6-year period, with baseline data obtained during the first 2 years. We included patients known to our renal service who had had a minimum of three blood tests every 2 years and an eGFR of < 60 mL/min/1.73 m2 at baseline. Exclusion criteria were renal replacement therapy, diabetes mellitus, heart failure and decompensated liver disease. A multiple linear regression model investigated the relationship between baseline serum sodium and eGFR decline after adjustment for confounding factors. Results 7418 blood results from 326 patients were included. There was no relationship between serum sodium concentration and estimated glomerular filtration rate at baseline. After multivariable adjustment, a 1 mmol/L increase in baseline serum sodium was associated with a 1.5 mL/min/1.73 m2 decline in eGFR during the study period (95% CI 0.9, 2.0). A reduction in eGFR was not associated with significant changes in serum sodium concentration over 6 years. Conclusion Higher serum sodium concentration is associated with the progression of CKD, independently of other established risk factors. Conversely, significant alterations in serum sodium concentration do not occur with declining kidney function.
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Affiliation(s)
- Nicholas I Cole
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK.
| | - Rebecca J Suckling
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
| | - Vipula Desilva
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
| | - Feng J He
- Wolfson Institute of Preventative Medicine, Queen Mary University of London, London, UK
| | - Graham A MacGregor
- Wolfson Institute of Preventative Medicine, Queen Mary University of London, London, UK
| | - Pauline A Swift
- South West Thames Renal Unit, Epsom and St Helier University Hospitals NHS Trust, Surrey, London, SM5 1AA, UK
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Wenner MM, Paul EP, Robinson AT, Rose WC, Farquhar WB. Acute NaCl Loading Reveals a Higher Blood Pressure for a Given Serum Sodium Level in African American Compared to Caucasian Adults. Front Physiol 2018; 9:1354. [PMID: 30327611 PMCID: PMC6174209 DOI: 10.3389/fphys.2018.01354] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/07/2018] [Indexed: 01/13/2023] Open
Abstract
Purpose: African American individuals are more prone to salt-sensitive hypertension than Caucasian individuals. Small changes in serum sodium (Na+) result in increased blood pressure (BP). However, it remains unclear if there are racial differences in BP responsiveness to increases in serum Na+. Therefore, the purpose of this investigation was to determine if African American adults have altered BP responsiveness to acute changes in serum Na+ compared to Caucasian adults. Methods: We measured beat-by-beat BP, serum Na+, plasma renin activity (PRA), angiotensin II (Ang II), and aldosterone (Aldo) during a 60-min 3% NaCl infusion (hypertonic saline infusion, HSI) in 39 participants (19 African Americans, age: 23 ± 1, 20 Caucasians, age: 25 ± 1). Data reported as African American vs. Caucasian cohort, mean ± SEM. Results: Baseline BP and serum Na+ were similar between groups and increased during HSI in both African American and Caucasian participants (p < 0.01). However, the peak change in serum Na+ was greater in African American participants (Δ5.8 ± 0.34 vs. Δ4.85 ± 0.38 mmol/L, p = 0.03). There was a significant group effect (p = 0.02) and an interaction between race and serum Na+ on systolic BP (p = 0.02). Larger categorical changes in serum Na+ corresponded to changes in systolic BP (p < 0.01) and African American participants demonstrated greater systolic BP responses for a given categorical serum Na+ increase (p < 0.01). Baseline Aldo was lower in African American adults (7.2 ± 0.6 vs. 12.0 ± 1.9 ng/dL, p = 0.03), there was a trend for lower baseline PRA (0.59 ± 0.9 vs. 1.28 ± 0.34 ng/mL/h, p = 0.07), and baseline Ang II was not different (14.2 ± 1.8 vs. 18.5 ± 1.4 pg/mL, p = 0.17). PRA and Aldo decreased during the HSI (p ≤ 0.01), with a greater decline in PRA (Δ–0.31 ± 0.07 vs. Δ–0.85 ± 0.25 ng/mL/h, p < 0.01) and Aldo (Δ–2.5 ± 0.5 vs. Δ–5.0 ± 1.1 ng/dL, p < 0.01) in Caucasian participants. However, the racial difference in PRA (p = 0.57) and Aldo (p = 0.59) reduction were no longer significant following baseline covariate analysis. Conclusion: African American individuals demonstrate augmented serum Na+ to an acute hypertonic saline load and greater systolic BP responsiveness to a given serum Na+. The altered BP response may be attributable to lower basal PRA and Aldo and a subsequently blunted RAAS response during the HSI.
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Affiliation(s)
- Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Erin P Paul
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Austin T Robinson
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - William C Rose
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
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The association between serum sodium concentration, hypertension and primary cardiovascular events: a retrospective cohort study. J Hum Hypertens 2018; 33:69-77. [DOI: 10.1038/s41371-018-0115-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/07/2018] [Accepted: 08/24/2018] [Indexed: 12/31/2022]
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He X, Liu C, Chen Y, He J, Dong Y. Risk of Cardiovascular Mortality Associated With Serum Sodium and Chloride in the General Population. Can J Cardiol 2018; 34:999-1003. [PMID: 29935992 DOI: 10.1016/j.cjca.2018.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The prognostic value of serum chloride among patients with heart failure was demonstrated by previous studies. However, the association of serum chloride and risk of cardiovascular mortality among the general population remains unclear. METHODS We included 16,483 participants in National Health and Nutrition Examination Survey III. Cox proportional hazards models were used to assess the association of serum sodium and chloride and cardiovascular mortality. Potential confounders were included in the models. Levels of serum sodium and chloride were also modeled with restrictive cubic splines for potential nonlinear associations. Subgroup analyses were based on baseline diseases and use of diuretics. RESULTS The mean age was 43.5 years, and 47.8% of the participants were men. During 277,059 person-years of follow-up, there were 1714 cardiovascular deaths. In the multivariate model, low-level serum sodium was associated with an increased risk of cardiovascular mortality (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.02-1.18 per standard deviation [SD]; P = 0.009), whereas a lower level of serum chloride was not (HR, 1.04; 95% CI, 0.97-1.12 per standard deviation; P = 0.278). Analyses with restrictive cubic splines yielded similar results. CONCLUSIONS Low serum sodium, rather than chloride, was independently associated with an increased risk of cardiovascular mortality.
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Affiliation(s)
- Xin He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Chen Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yili Chen
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Jiangui He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
| | - Yugang Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China.
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The American Heart Association Scientific Statement on salt sensitivity of blood pressure: Prompting consideration of alternative conceptual frameworks for the pathogenesis of salt sensitivity? J Hypertens 2018. [PMID: 28650918 DOI: 10.1097/hjh.0000000000001458] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
: Recently, the American Heart Association (AHA) published a scientific statement on salt sensitivity of blood pressure which emphasized a decades old conceptual framework for the pathogenesis of this common disorder. Here we examine the extent to which the conceptual framework for salt sensitivity emphasized in the AHA Statement accommodates contemporary findings and views of the broader scientific community on the pathogenesis of salt sensitivity. In addition, we highlight alternative conceptual frameworks and important contemporary theories of salt sensitivity that are little discussed in the AHA Statement. We suggest that greater consideration of conceptual frameworks and theories for salt sensitivity beyond those emphasized in the AHA Statement may help to advance understanding of the pathogenesis of salt-induced increases in blood pressure and, in consequence, may lead to improved approaches to preventing and treating this common disorder.
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Elias SO, Sofola OA, Jaja SI. Epithelial sodium channel blockade and new β-ENaC polymorphisms among normotensive and hypertensive adult Nigerians. Clin Exp Hypertens 2018; 41:144-151. [PMID: 29580127 DOI: 10.1080/10641963.2018.1451538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We sought to determine the effect of amiloride on blood pressure (BP) and the presence of polymorphisms of the β-subunit of the epithelial sodium channel (ENaC) among normotensive (NT) and hypertensive (HT) Nigerians. Healthy volunteers-47 NT and 53 age-matched HT were recruited after giving informed consent. Subjects were salt-loaded with 200 mmol of NaCl daily for 5 days. Following a week washout period, salt-loading was repeated in addition to the administration of 5 mg amiloride daily for five days. Blood pressure, plasma and urine electrolytes were measured at baseline, after salt-loading and after salt-loading plus amiloride. PCR amplicons were sequenced for β-ENaC polymorphisms. Salt-loading led to a significant increase (p < 0.05) in SBP among NT and HT and in DBP (p < 0.001) only among HT. Amiloride reduced SBP and DBP to below baseline levels in NT (p < 0.05) and HT (p < 0.001) subjects. Five of the subjects had the β-T594M polymorphism, HT 3/53; NT 2/47 (p = 0.75). Four previously unreported β-ENaC mutations were recorded: E632V and E636V, respectively, among two HT subjects, D638Y in another HT and L628Q in one NT subject. We showed the presence of β-ENaC polymorphisms among our populace and the possible usefulness of amiloride as a single antihypertensive among Nigerians.
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Affiliation(s)
- Simiat O Elias
- Department of Physiology, Lagos State University College of Medicine, Lagos, Nigeria
| | - Olusoga A Sofola
- Department of Physiology, College of Medicine University of Lagos, Lagos, Nigeria
| | - Smith I Jaja
- Department of Physiology, College of Medicine University of Lagos, Lagos, Nigeria
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Sun H, Sun M. Age- and gender-dependent associations of blood pressure and serum sodium and potassium-renal and extrarenal regulations. ACTA ACUST UNITED AC 2018; 12:392-401. [PMID: 29609980 DOI: 10.1016/j.jash.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/02/2018] [Accepted: 03/14/2018] [Indexed: 11/17/2022]
Abstract
Association analyses between blood pressure (BP) and serum sodium and potassium for 14,657 men and 16,977 women between ages 12 and 85 years show that responses of BP to serum sodium and potassium are age and gender dependent. The data were from the National Health and Nutrition Examination Survey between 2003 and 2014. Associations between serum sodium and BP are positive only for advanced age groups and for serum sodium level greater than 139-140 mmol/L in less advanced groups. These positive associations can be explained by traditional renal-centered mechanism. Inverse associations between systolic BP and serum sodium exist when sodium is less than ∼140 mmol/L in less advanced age groups (<60 for men and <70 for women). These inverse associations can partially be explained by the extrarenal regulatory mechanism in which sodium storage in negatively charged glycosaminoglycans in the interstitium may be involved. Associations of high serum potassium and low BP are consistent and exist in most age groups. Effect of potassium on systolic BP and diastolic BP are more prominent in less advanced age groups. Age-dependent associations between sodium and BP support the theory that sodium homeostasis in the body may not be regulated by renal-centered responses alone. There might be regulation of an extrarenal system in which sodium attraction by negatively charged glycosaminoglycans plays a role.
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Affiliation(s)
- Hongbing Sun
- Health Studies Institute, GEMS Department, Rider University, Lawrenceville, NJ.
| | - Michael Sun
- Department of Biology, Johns Hopkins University, Baltimore, MD
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Nowak KL, Yaffe K, Orwoll ES, Ix JH, You Z, Barrett-Connor E, Hoffman AR, Chonchol M. Serum Sodium and Cognition in Older Community-Dwelling Men. Clin J Am Soc Nephrol 2018; 13:366-374. [PMID: 29439092 PMCID: PMC5967671 DOI: 10.2215/cjn.07400717] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/29/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Mild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently unknown. We determined whether lower normal serum sodium is associated with cognitive impairment and risk of cognitive decline in community-dwelling older men. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Five thousand four hundred thirty-five community-dwelling men aged ≥65 years who participated in Osteoporotic Fractures in Men, a cohort study with a median follow-up for cognitive function of 4.6 years, were included in this analysis. Multivariable logistic regression was used to examine the association between baseline fasting serum sodium levels and the odds of prevalent cognitive impairment (cross-sectional analysis; modified Mini-Mental Status [3MS] score <1.5 SD [<84] below or Trail Making Test Part B time >1.5 SD above the mean [>223 seconds]) and cognitive decline (prospective analysis [n=3611]; decrease in follow-up 3MS score or increase in Trails B time >1.5 SD of the mean score/time change [>9 or >67 seconds]). RESULTS Participants were aged 74±6 years with a fasting mean serum sodium level of 141±3 mmol/L. Fifteen percent (n=274), 12% (n=225), and 13% (n=242) had prevalent cognitive impairment in tertiles 1, 2, and 3, respectively. After adjustment, lower serum sodium was associated with prevalent cognitive impairment (tertile 1 [126-140 mmol/L] versus tertile 2 [141-142 mmol/L], odds ratio [OR], 1.30; 95% confidence interval [95% CI], 1.06 to 1.61). Fourteen percent (n=159), 10% (n=125), and 13% (n=159) had cognitive decline in tertiles 1, 2, and 3, respectively. Lower serum sodium was also associated with cognitive decline (tertile 1 versus tertile 2, OR, 1.37; 95% CI, 1.06 to 1.77). Tertile 3 (143-153 mmol/L) was additionally associated with cognitive decline. Results were similar in sensitivity analyses according to clinical cut-offs and by quartiles. CONCLUSIONS In community-dwelling older men, serum sodium between 126-140, and 126-140 or 143-153 mmol/L, are independently associated with prevalent cognitive impairment and cognitive decline, respectively.
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Affiliation(s)
- Kristen L. Nowak
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology, University of California San Francisco, San Francisco, California
| | - Eric S. Orwoll
- Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon
| | - Joachim H. Ix
- Divisions of Nephrology and Preventative Medicine, University of California San Diego, San Diego, California
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California; and
| | - Andrew R. Hoffman
- Division of Endocrinology, Gerontology and Metabolism, Stanford University, Stanford, California
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Jiang E, Chapp AD, Fan Y, Larson RA, Hahka T, Huber MJ, Yan J, Chen QH, Shan Z. Expression of Proinflammatory Cytokines Is Upregulated in the Hypothalamic Paraventricular Nucleus of Dahl Salt-Sensitive Hypertensive Rats. Front Physiol 2018. [PMID: 29520237 PMCID: PMC5826963 DOI: 10.3389/fphys.2018.00104] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Accumulating evidence indicates that inflammation is implicated in hypertension. However, the role of brain proinflammatory cytokines (PICs) in salt sensitive hypertension remains to be determined. Thus, the objective of this study was to test the hypothesis that high salt (HS) diet increases PICs expression in the paraventricular nucleus (PVN) and leads to PVN neuronal activation. Eight-week-old male Dahl salt sensitive (Dahl S) rats, and age and sex matched normal Sprague Dawley (SD) rats were divided into two groups and fed with either a HS (4% NaCl) or normal salt (NS, 0.4% NaCl) diet for 5 consecutive weeks. HS diet induced hypertension and significantly increased cerebrospinal fluid (CSF) sodium concentration ([Na+]) in Dahl S rats, but not in normal SD rats. In addition, HS diet intake triggered increases in mRNA levels and immunoreactivities of PVN PICs including TNF-α, IL-6, and IL-1β, as well as Fra1, a chronic marker of neuronal activation, in Dahl S rats, but not in SD rats. Next, we investigated whether this increase in the expression of PVN PICs and Fra1 was induced by increased CSF [Na+]. Adult male SD rats were intracerebroventricular (ICV) infused with 8 μl of either hypertonic salt (4 μmol NaCl), mannitol (8 μmol, as osmolarity control), or isotonic salt (0.9% NaCl as vehicle control). Three hours following the ICV infusion, rats were euthanized and their PVN PICs expression was measured. The results showed that central administration of hypertonic saline in SD rats significantly increased the expression of PICs including TNF-α, IL-6, and IL-1β, as well as neuronal activation marker Fra1, compared to isotonic NaCl controls and osmolarity controls. Finally, we tested whether the increase in PICs expression occurred in neurons. Incubation of hypothalamic neurons with 10 mM NaCl in a culture medium for 6 h elicited significant increases in TNF-α, IL-6, and Fra1 mRNA levels. These observations, coupled with the important role of PICs in modulating neuronal activity and stimulating vasopressin release, suggest that HS intake induces an inflammatory state in the PVN, which, may in turn, augments sympathetic nerve activity and vasopressin secretion, contributing to the development of salt sensitive hypertension.
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Affiliation(s)
- Enshe Jiang
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States.,Institute for Nursing and Health Research, Henan University, Kaifeng, China
| | - Andrew D Chapp
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Yuanyuan Fan
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States.,Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Robert A Larson
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Taija Hahka
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Michael J Huber
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Jianqun Yan
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Qing-Hui Chen
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
| | - Zhiying Shan
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, MI, United States
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Hyndman KA, Mironova EV, Giani JF, Dugas C, Collins J, McDonough AA, Stockand JD, Pollock JS. Collecting Duct Nitric Oxide Synthase 1ß Activation Maintains Sodium Homeostasis During High Sodium Intake Through Suppression of Aldosterone and Renal Angiotensin II Pathways. J Am Heart Assoc 2017; 6:e006896. [PMID: 29066445 PMCID: PMC5721879 DOI: 10.1161/jaha.117.006896] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/27/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND During high sodium intake, the renin-angiotensin-aldosterone system is downregulated and nitric oxide signaling is upregulated in order to remain in sodium balance. Recently, we showed that collecting duct nitric oxide synthase 1β is critical for fluid-electrolyte balance and subsequently blood pressure regulation during high sodium feeding. The current study tested the hypothesis that high sodium activation of the collecting duct nitric oxide synthase 1β pathway is critical for maintaining sodium homeostasis and for the downregulation of the renin-angiotensin-aldosterone system-epithelial sodium channel axis. METHODS AND RESULTS Male control and collecting duct nitric oxide synthase 1β knockout (CDNOS1KO) mice were placed on low, normal, and high sodium diets for 1 week. In response to the high sodium diet, plasma sodium was significantly increased in control mice and to a significantly greater level in CDNOS1KO mice. CDNOS1KO mice did not suppress plasma aldosterone in response to the high sodium diet, which may be partially explained by increased adrenal AT1R expression. Plasma renin concentration was appropriately suppressed in both genotypes. Furthermore, CDNOS1KO mice had significantly higher intrarenal angiotensin II with high sodium diet, although intrarenal angiotensinogen levels and angiotensin-converting enzyme activity were similar between knockout mice and controls. In agreement with inappropriate renin-angiotensin-aldosterone system activation in the CDNOS1KO mice on a high sodium diet, epithelial sodium channel activity and sodium transporter abundance were significantly higher compared with controls. CONCLUSIONS These data demonstrate that high sodium activation of collecting duct nitric oxide synthase 1β signaling induces suppression of systemic and intrarenal renin-angiotensin-aldosterone system, thereby modulating epithelial sodium channel and other sodium transporter abundance and activity to maintain sodium homeostasis.
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Affiliation(s)
- Kelly A Hyndman
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL
| | - Elena V Mironova
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, TX
| | - Jorge F Giani
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Courtney Dugas
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL
| | - Jessika Collins
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL
| | - Alicia A McDonough
- Department of Cell and Neurobiology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - James D Stockand
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center at San Antonio, TX
| | - Jennifer S Pollock
- Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL
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Prager-Khoutorsky M, Choe KY, Levi DI, Bourque CW. Role of Vasopressin in Rat Models of Salt-Dependent Hypertension. Curr Hypertens Rep 2017; 19:42. [PMID: 28451854 DOI: 10.1007/s11906-017-0741-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Dietary salt intake increases both plasma sodium and osmolality and therefore increases vasopressin (VP) release from the neurohypophysis. Although this effect could increase blood pressure by inducing fluid reabsorption and vasoconstriction, acute activation of arterial baroreceptors inhibits VP neurons via GABAA receptors to oppose high blood pressure. Here we review recent findings demonstrating that this protective mechanism fails during chronic high salt intake in rats. RECENT FINDINGS Two recent studies showed that chronic high sodium intake causes an increase in intracellular chloride concentration in VP neurons. This effect causes GABAA receptors to become excitatory and leads to the emergence of VP-dependent hypertension. One study showed that the increase in intracellular chloride was provoked by a decrease in the expression of the chloride exporter KCC2 mediated by local secretion of brain-derived neurotrophic factor and activation of TrkB receptors. Prolonged high dietary salt intake can cause pathological plasticity in a central homeostatic circuit that controls VP secretion and thereby contribute to peripheral vasoconstriction and hypertension.
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Affiliation(s)
- Masha Prager-Khoutorsky
- Department of Physiology, McGill University, McIntyre Medical Sciences Bldg., 3655 Promenade Sir-William Osler, Montreal, QC, H3G 1Y6, Canada
| | - Katrina Y Choe
- 2309 Gonda Neuroscience and Genetics Research Center, UCLA Department of Neurology, 695 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - David I Levi
- Centre for Research in Neuroscience, Research Institute of the McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada
| | - Charles W Bourque
- Centre for Research in Neuroscience, Research Institute of the McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue, Montreal, QC, H3G 1A4, Canada.
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Kirabo A. A new paradigm of sodium regulation in inflammation and hypertension. Am J Physiol Regul Integr Comp Physiol 2017; 313:R706-R710. [PMID: 28931546 DOI: 10.1152/ajpregu.00250.2017] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/28/2017] [Accepted: 09/12/2017] [Indexed: 01/13/2023]
Abstract
Dysregulation of sodium (Na+) balance is a major cause of hypertensive cardiovascular disease. The current dogma is that interstitial Na+ readily equilibrates with plasma and that renal excretion and reabsorption is sufficient to regulate extracellular fluid volume and control blood pressure. These ideas have been recently challenged by the discovery that Na+ accumulates in tissues without commensurate volume retention and activates immune cells, leading to hypertension and autoimmune disease. However, objections have been raised to this new paradigm, with some investigators concerned about where and how salt is stored in tissues. Further concerns also include how Na+ is mobilized from tissue stores and how it interacts with various organ systems to cause hypertension and end-organ damage. This review assesses these two paradigms of Na+ regulation in the context of inflammation-mediated hypertension and cardiovascular disease pathogenesis. Also highlighted are future perspectives and important gaps in our understanding of how Na+ is linked to inflammation and hypertension. Understanding mechanisms of salt and body fluid regulation is the sine qua non of research efforts to identify therapeutic targets for hypertension and cardiovascular disease.
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Affiliation(s)
- Annet Kirabo
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and .,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville Tennessee
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Endogenous ouabain and aldosterone are coelevated in the circulation of patients with essential hypertension. J Hypertens 2017; 34:2074-80. [PMID: 27457665 DOI: 10.1097/hjh.0000000000001042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE In the setting of normal sodium (Na) intake, many patients with hypertension have inappropriately elevated plasma aldosterone (Aldo) levels and may be at increased risk for tissue damage. Moreover, other adrenocortical steroids, including endogenous ouabain can stimulate tissue damage. As endogenous ouabain is often elevated in chronically Na-loaded states, is a vasoconstrictor, raises blood pressure (BP), and also promotes tissue fibrosis, we investigated the extent to which plasma Aldo and endogenous ouabain were coelevated among naïve hypertensive patients (NHP). We also investigated the impact of an acute salt load on these steroids, BP, and renal function. METHODS NHP (590) were grouped in tertiles based on their baseline plasma Aldo (mean ± SEM first 7.59 ± 0.18, versus third 24.15 ± 0.31 ng/dl). Baseline plasma renin activity (2.4 ± 0.1 versus 1.2 ± 0.1 ng/ml per h, P < 0.001), endogenous ouabain (268 ± 14.9 pmol/l versus 239.0 ± 13.6 pmol, P < 0.01) and DBP (91.9 ± 0.76 versus 89.6 ± 0.71 mmHg, P = 0.017) were higher in NHP in the third versus the first Aldo tertile, respectively. RESULTS Acute Na loading showed that the BP of the third Aldo tertile NHP was especially salt-sensitive (slope of pressure-natriuresis relationship 0.015 ± 0.002 versus 0.003 ± 0.001 μEq/mmHg per min, P = 0.00024 after adjustment for sex, BMI, and age). Regression analyses showed that plasma Aldo and endogenous ouabain were linearly related (β = 0.181, P = 0.0003). CONCLUSION Among patients with essential hypertension, circulating endogenous ouabain and Aldo are typically coelevated and their BP is salt-sensitive. In conditions where Aldo is inappropriately elevated, both Aldo and endogenous ouabain may contribute to adverse cardiovascular and renal outcomes.
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DiNicolantonio JJ, Mehta V, O'Keefe JH. Is Salt a Culprit or an Innocent Bystander in Hypertension? A Hypothesis Challenging the Ancient Paradigm. Am J Med 2017; 130:893-899. [PMID: 28373112 DOI: 10.1016/j.amjmed.2017.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 12/21/2022]
Abstract
For decades the notion that an excessive consumption of salt (NaCl) leads to hypertension has persisted. However, this idea is based on opinion, not scientific proof. Despite this, every health organization, agency, and clinicians around the world have been advising salt restriction, especially to hypertensive patients. The present review article suggests that the consumption of a high-salt diet is not the cause of hypertension and that there are other factors, such as added sugars, which are causative for inducing hypertension and cardiovascular disease.
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Affiliation(s)
| | - Varshil Mehta
- Mount Sinai Hospital, New York, NY; MGM Medical College, Navi Mumbai, India
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Miskulin DC, Weiner DE. Blood Pressure Management in Hemodialysis Patients: What We Know And What Questions Remain. Semin Dial 2017; 30:203-212. [DOI: 10.1111/sdi.12586] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Dana C. Miskulin
- Department of Medicine; Tufts University School of Medicine; Boston Massachusetts
| | - Daniel E. Weiner
- Department of Medicine; Tufts University School of Medicine; Boston Massachusetts
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50
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Zoccali C, Mallamaci F. Cholesterol: Another Salty Pathway to Cardiovascular Disease? Arterioscler Thromb Vasc Biol 2017; 37:383-384. [PMID: 28228441 DOI: 10.1161/atvbaha.117.308913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Carmine Zoccali
- From the CNR-IFC, Clinical Epidemiology and Pathophysiology of Hypertension and Renal Diseases, Ospedali Riuniti, Reggio Calabria, Italy (C.Z., F.M.); and Nephrology, Hypertension and Renal Transplantation Unit, Ospedali Riuniti Reggio Calabria, Italy (F.M.).
| | - Francesca Mallamaci
- From the CNR-IFC, Clinical Epidemiology and Pathophysiology of Hypertension and Renal Diseases, Ospedali Riuniti, Reggio Calabria, Italy (C.Z., F.M.); and Nephrology, Hypertension and Renal Transplantation Unit, Ospedali Riuniti Reggio Calabria, Italy (F.M.)
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