1
|
Guzik TJ, Nosalski R, Maffia P, Drummond GR. Immune and inflammatory mechanisms in hypertension. Nat Rev Cardiol 2024; 21:396-416. [PMID: 38172242 DOI: 10.1038/s41569-023-00964-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
Hypertension is a global health problem, with >1.3 billion individuals with high blood pressure worldwide. In this Review, we present an inflammatory paradigm for hypertension, emphasizing the crucial roles of immune cells, cytokines and chemokines in disease initiation and progression. T cells, monocytes, macrophages, dendritic cells, B cells and natural killer cells are all implicated in hypertension. Neoantigens, the NLRP3 inflammasome and increased sympathetic outflow, as well as cytokines (including IL-6, IL-7, IL-15, IL-18 and IL-21) and a high-salt environment, can contribute to immune activation in hypertension. The activated immune cells migrate to target organs such as arteries (especially the perivascular fat and adventitia), kidneys, the heart and the brain, where they release effector cytokines that elevate blood pressure and cause vascular remodelling, renal damage, cardiac hypertrophy, cognitive impairment and dementia. IL-17 secreted by CD4+ T helper 17 cells and γδ T cells, and interferon-γ and tumour necrosis factor secreted by immunosenescent CD8+ T cells, exert crucial effector roles in hypertension, whereas IL-10 and regulatory T cells are protective. Effector mediators impair nitric oxide bioavailability, leading to endothelial dysfunction and increased vascular contractility. Inflammatory effector mediators also alter renal sodium and water balance and promote renal fibrosis. These mechanisms link hypertension with obesity, autoimmunity, periodontitis and COVID-19. A comprehensive understanding of the immune and inflammatory mechanisms of hypertension is crucial for safely and effectively translating the findings to clinical practice.
Collapse
Affiliation(s)
- Tomasz J Guzik
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK.
- Department of Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University, Collegium Medicum, Kraków, Poland.
- Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Glasgow, UK.
| | - Ryszard Nosalski
- Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK
| | - Pasquale Maffia
- Africa-Europe Cluster of Research Excellence (CoRE) in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance ARUA & The Guild, Glasgow, UK
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Grant R Drummond
- Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, Melbourne, Victoria, Australia
- Centre for Cardiovascular Biology and Disease Research, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Caiazzo E, Sharma M, Rezig AOM, Morsy MI, Czesnikiewicz-Guzik M, Ialenti A, Sulicka-Grodzicka J, Pellicori P, Crouch SH, Schutte AE, Bruzzese D, Maffia P, Guzik TJ. Circulating cytokines and risk of developing hypertension: A systematic review and meta-analysis. Pharmacol Res 2024; 200:107050. [PMID: 38159784 DOI: 10.1016/j.phrs.2023.107050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Immune responses play a significant role in hypertension, though the importance of key inflammatory mediators remains to be defined. We used a systematic literature review and meta-analysis to study the associations between key cytokines and incident hypertension. METHODS We performed a systematic search of Pubmed/Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), for peer-reviewed studies published up to August 2022. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg and/or the use of antihypertensive medications. Random effects meta-analyses were used to calculate pooled hazard ratios (HRs)/risk ratios (RRs) and 95% confidence intervals by cytokine levels (highest vs. lowest quartile). RESULTS Only IL-6 and IL-1β levels have evidence allowing for quantitative evaluation concerning the onset of hypertension. Six studies (10406 participants, 2932 incident cases) examined the association of IL-6 with incident hypertension. The highest versus lowest quartile of circulating IL-6 was associated with a significant HR/RR of hypertension (1.61, 95% CI: 1.00 to 2.60; I2 =87%). After adjusting for potential confounders, including body mass index (BMI), HR/RR was no longer significant (HR/RR: 1.24; 95% CI, 0.96 to 1.61; I2 = 56%). About IL-1β, neither the crude (HR/RR: 1.03; 95% CI, 0.60 to 1.76; n = 2) nor multivariate analysis (HR/RR: 0.97, 95% CI, 0.60 to 1.56; n = 2) suggested a significant association with the risk of developing hypertension. CONCLUSIONS A limited number of studies suggest that higher IL-6, but not IL-1β, might be associated with the development of hypertension.
Collapse
Affiliation(s)
- Elisabetta Caiazzo
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Malvika Sharma
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Asma O M Rezig
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Moustafa I Morsy
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Marta Czesnikiewicz-Guzik
- School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Periodontology, Prophylaxis and Oral Medicine, Jagiellonian University, Krakow, Poland
| | - Armando Ialenti
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Joanna Sulicka-Grodzicka
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Rheumatology and Immunology, Jagiellonian University Medical College, Kracow, Poland
| | - Pierpaolo Pellicori
- School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Simone H Crouch
- SA MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa; The George Institute for Global Health, Sydney, Australia; School of Population Health, University of New South Wales, Sydney, Australia
| | - Dario Bruzzese
- Department of Public Health, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pasquale Maffia
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy; Africa-Europe Cluster of Research Excellence in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance (ARUA) & The Guild of European Research-intensive Universities, South Africa.
| | - Tomasz J Guzik
- Africa-Europe Cluster of Research Excellence in Non-Communicable Diseases & Multimorbidity, African Research Universities Alliance (ARUA) & The Guild of European Research-intensive Universities, South Africa; Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK; Department of Internal and Agricultural Medicine and Omicron Medical Genomics Laboratory, Jagiellonian University Medical College, Krakow, Poland.
| |
Collapse
|
3
|
Nemtsova V, Vischer AS, Burkard T. Hypertensive Heart Disease: A Narrative Review Series-Part 3: Vasculature, Biomarkers and the Matrix of Hypertensive Heart Disease. J Clin Med 2024; 13:505. [PMID: 38256639 PMCID: PMC10816030 DOI: 10.3390/jcm13020505] [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: 11/08/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Over the last few decades, research efforts have resulted in major advances in our understanding of the pathophysiology of hypertensive heart disease (HHD). This is the third part of a three-part review series. Here, we focus on the influence of high blood pressure on the micro- and macroalterations that occur in the vasculature in HHD. We also provide an overview of circulating cardiac biomarkers that may prove useful for a better understanding of the pathophysiology, development and progression of HHD, and may play a unique role in the diagnostic and prognostic evaluation of patients with HHD, taking into account their properties showing as abnormal long before the onset of the disease. In the conclusion, we propose an updated definition of HHD and a matrix for clinical classification, which we suspect will be useful in practice, allowing an individual approach to HHD patients.
Collapse
Affiliation(s)
- Valeriya Nemtsova
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Internal Diseases and Family Medicine Department, Educational and Scientific Medical Institute of National Technical University «Kharkiv Polytechnic Institute», 61000 Kharkiv, Ukraine
| | - Annina S. Vischer
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (V.N.); (A.S.V.)
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
- Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland
| |
Collapse
|
4
|
Kringeland E, Gerdts E, Ulvik A, Tell GS, Igland J, Haugsgjerd TR, Ueland PM, Midtbø H. Inflammation, sex, blood pressure changes and hypertension in midlife: the Hordaland Health Study. J Hum Hypertens 2023; 37:718-725. [PMID: 36400946 PMCID: PMC10403349 DOI: 10.1038/s41371-022-00772-z] [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: 04/28/2022] [Revised: 10/09/2022] [Accepted: 10/28/2022] [Indexed: 11/19/2022]
Abstract
Our aim was to test sex-specific associations of circulating markers of inflammation with blood pressure (BP) and incident hypertension in midlife. Participants in the Hordaland Health study (n = 3280, 56% women, mean age 48 years) were examined at baseline and followed for 6 years. Circulating levels of inflammatory markers including high-sensitive C-reactive protein (hs-CRP), neopterin, and pyridoxic acid ratio (PAr) index were measured at follow-up. The associations with systolic/diastolic BP and incident hypertension were tested in sex-specific linear- or logistic-regression analyses adjusted for body mass index, serum triglycerides, creatinine, physical activity, smoking and diabetes. At follow-up, women had lower mean BP than men (124/72 vs. 130/78 mmHg, p < 0.001). Higher hs-CRP was significantly associated with greater systolic and diastolic BP (standardized β = 0.07 and β = 0.09, both p < 0.01) in women, but not in men. Higher neopterin was associated with higher diastolic BP in women and higher PAr index was associated with higher diastolic BP in women and higher systolic and diastolic BP in men (all p < 0.01). Compared to hs-CRP < 1 mg/l, higher levels of hs-CRP 1-<3 mg/l and hs-CRP ≥ 3 mg/l were associated with new-onset hypertension only in women (odds ratio (OR) 1.74, 95% CI 1.20-2.53 and OR 1.87, 95% CI 1.20-2.90). Sex-interactions were found for hs-CRP and neopterin in models on incident hypertension and diastolic BP, respectively (both p < 0.05). Higher levels of circulating markers of inflammation were associated with higher BP and incident hypertension in a sex-specific manner. Our results suggest a sex-specific interaction between cardiovascular inflammation and BP in midlife.
Collapse
Affiliation(s)
- Ester Kringeland
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | | | - Helga Midtbø
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
5
|
Ghalandari H, Askarpour M, Setayesh L, Ghaedi E. Effect of plum supplementation on blood pressure, weight indices, and C-reactive protein: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN 2022; 52:285-295. [PMID: 36513468 DOI: 10.1016/j.clnesp.2022.09.010] [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: 05/21/2022] [Revised: 08/13/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Metabolic syndrome and its components are major health concerns around the world. Among various factors, overweight/obesity, its consequent inflammation, and hypertension are of special importance. Plums are anti-oxidant-rich fruits which have long been investigated for their health benefits. In this systematic review and meta-analysis, we investigated the possible impact of plum supplementation on obesity, inflammation, and blood pressure. METHODS All of the major databases (PubMed, Scopus, Cochrane, and Web of Science, Google Scholar and EMBASE) were searched to obtain the articles eligible for the review. Relevant data was extracted for the final analysis. Weighted mean difference (WMD) was obtained using fixed and random effect models. The main outcomes included systolic and diastolic blood pressure, body weight, body mass index (BMI), body fat percentage, waist circumference (WC) and blood C-reactive protein (CRP) levels. The effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). RESULTS Crude search provided 3121 articles, among which 11 were eligible to be included. After crude and subgroup analysis, we were unable to detect any significant impact of plum supplementation on body weight (weight mean difference (WMD) of 0.04 kg; 95% CI: -1.55, 1.63, p = 0.959), BMI (WMD 0.39 kg/m2; 95% CI: -0.11, 0.90, p = 0.125), body fat percentage (WMD = 0.59%; 95% CI: -0.41, 1.59, p = 0.249), waist circumference (WMD = 0.60 cm; 95% CI: -1.83, 3.04, p = 0.627), systolic blood pressure (WMD -1.24 mmHg; 95% CI: -3.08, 0.59, p = 0.185), diastolic blood pressure (WMD -4.32 mmHg (95% CI: -9.29, 0.65, p = 0.089), or inflammation indicated by C-reactive protein (CRP) levels (WMD = 0.23 mg/l; 95% CI: -0.27, 0.73, p = 0.371). CONCLUSION Our results show that plum supplementation has no positive effect on factors of metabolic syndrome. We recommend that further research in the form of clinical trials be conducted to make a clear conclusion as of the effectiveness of plum supplementation on parameters of metabolic syndrome.
Collapse
Affiliation(s)
- Hamid Ghalandari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Setayesh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Ghaedi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
6
|
Katayama PL, Leirão IP, Kanashiro A, Luiz JPM, Cunha FQ, Navegantes LCC, Menani JV, Zoccal DB, Colombari DSA, Colombari E. The carotid body detects circulating tumor necrosis factor-alpha to activate a sympathetic anti-inflammatory reflex. Brain Behav Immun 2022; 102:370-386. [PMID: 35339628 DOI: 10.1016/j.bbi.2022.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 12/28/2022] Open
Abstract
Recent evidence has suggested that the carotid bodies might act as immunological sensors, detecting pro-inflammatory mediators and signalling to the central nervous system, which, in turn, orchestrates autonomic responses. Here, we confirmed that the TNF-α receptor type I is expressed in the carotid bodies of rats. The systemic administration of TNF-α increased carotid body afferent discharge and activated glutamatergic neurons in the nucleus tractus solitarius (NTS) that project to the rostral ventrolateral medulla (RVLM), where many pre-sympathetic neurons reside. The activation of these neurons was accompanied by an increase in splanchnic sympathetic nerve activity. Carotid body ablation blunted the TNF-α-induced activation of RVLM-projecting NTS neurons and the increase in splanchnic sympathetic nerve activity. Finally, plasma and spleen levels of cytokines after TNF-α administration were higher in rats subjected to either carotid body ablation or splanchnic sympathetic denervation. Collectively, our findings indicate that the carotid body detects circulating TNF-α to activate a counteracting sympathetic anti-inflammatory mechanism.
Collapse
Affiliation(s)
- Pedro L Katayama
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.
| | - Isabela P Leirão
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Alexandre Kanashiro
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - João P M Luiz
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Q Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luiz C C Navegantes
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jose V Menani
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Daniel B Zoccal
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Débora S A Colombari
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Eduardo Colombari
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.
| |
Collapse
|
7
|
Cheng M, Xue H, Li X, Yan Q, Zhu D, Wang Y, Shi Y, Fu C. Prevalence of hyperhomocysteinemia (HHcy) and its major determinants among hypertensive patients over 35 years of age. Eur J Clin Nutr 2022; 76:616-623. [PMID: 34462555 DOI: 10.1038/s41430-021-00983-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 06/21/2021] [Accepted: 07/06/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Hyperhomocysteinemia (HHcy) and hypertension are associated with cardiovascular events. However, effects of Hcy-lowing interventions on cardiovascular outcome were conflicting. Serum folate level was proposed to be a possible determinant of efficacy of extra folate supplementation on cardiovascular outcome. The aims of the present study were to describe representative information on the levels of serum homocysteine and folate in hypertensive patients, and to explore the major determinants of HHcy. METHODS 11,007 participants with hypertension were analyzed in this cross-sectional study. Blood pressure and serum levels of biochemical indicators were measured. Multivariate logistic regression model was used to assess the associated factors of HHcy. RESULTS Geometric mean of serum total homocysteine was 14.1 (95% CI: 13.9, 14.4) μmol/L and prevalence of HHcy was 36.1 (95% CI: 34.0, 38.1) % in hypertensive patients. HHcy was strongly associated with factors including male sex, older age, elevated serum creatinine (SCr), lower serum folate and vitamin B12, and uncontrolled blood pressure in hypertensive patients. Elevated SCr attributed to HHcy with the etiologic fraction of 0.29. The change of the odds ratio of HHcy associated with folate was significantly higher in patients with elevated SCr compared with that of patients with normal SCr. CONCLUSION The results suggested the protection of female sex and higher levels of folate and vitamin B12 from HHcy and attribution of older age and elevated SCr to HHcy. Restoring renal function deserved attention for hypertensive patients to benefit from Hcy-lowing measures.
Collapse
Affiliation(s)
- Minna Cheng
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Hong Xue
- Shanghai Key Laboratory of Bioactive Small Molecules and Shanghai Key Laboratory of Clinical Geriatric Medicine, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xinjian Li
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qinghua Yan
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Dingliang Zhu
- Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wang
- Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Shi
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China. .,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
| | - Chen Fu
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| |
Collapse
|
8
|
Zhang Q, Yang J, Yang C, Yang X, Chen Y. Eucommia ulmoides Oliver- Tribulus terrestris L. Drug Pair Regulates Ferroptosis by Mediating the Neurovascular-Related Ligand-Receptor Interaction Pathway- A Potential Drug Pair for Treatment Hypertension and Prevention Ischemic Stroke. Front Neurol 2022; 13:833922. [PMID: 35345408 PMCID: PMC8957098 DOI: 10.3389/fneur.2022.833922] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/08/2022] [Indexed: 01/04/2023] Open
Abstract
Background In this study, we used the network pharmacology approach to explore the potential disease targets of the Eucommia ulmoides Oliver (EUO)-Tribulus terrestris L. (TT) drug pair in the treatment of hypertension-associated neurovascular lesions and IS via the ferroptosis pathway. Methods We used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform to search for the key active compounds and targets of the drug pair. Based on the GeneCards database, the relevant targets for the drug pair were obtained. Then, we performed the molecular docking of the screened core active ingredients and proteins using the DAVID database and the R AutoDock Vina software. Based on the GSE22255 dataset, these screened target proteins were used to build random forest (RF) and support vector machine (SVM) models. Finally, a new IS nomogram prediction model was constructed and evaluated. Results There were 36 active compounds in the EUO-TT drug pair. CHRM1, NR3C1, ADRB2, and OPRD1 proteins of the neuroactive ligand-receptor interaction pathway interacted with the proteins related to the ferroptosis pathway. Molecular docking experiments identified 12 active ingredients of the drug pair that may tightly bind to those target proteins. We constructed a visual IS nomogram prediction model using four genes (CHRM1, NR3C1, ADRB2, and OPRD1). The calibration curve, DCA, and clinical impact curves all indicated that the nomogram model is clinically applicable and diagnostically capable. CHRM1, NR3C1, ADRB2, and OPRD1, the target genes of the four effective components of the EUO-TT drug pair, were considered as risk markers for IS. Conclusions The active ingredients of EUO-TT drug pair may act on proteins associated with the neuroactive ligand-receptor interaction pathway to regulate ferroptosis in vascular neurons cells, ultimately affecting the onset and progression of hypertension.
Collapse
Affiliation(s)
- Qian Zhang
- Department of Science and Technology Office, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jie Yang
- Department of Cardiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chuanhua Yang
- Department of Cardiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuesong Yang
- Department of Vascular Surgery, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongzhi Chen
- Department of Cardiology, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
9
|
van Apeldoorn JA, van der Linden EL, Bahendeka S, Beune E, Meeks KA, Klipstein-Grobusch K, van den Born BJ, Agyemang C. C-reactive protein and hypertension among Ghanaian migrants and their homeland counterparts: the Research on Obesity and Diabetes among African Migrants study. J Hypertens 2022; 40:283-291. [PMID: 34478414 PMCID: PMC8728758 DOI: 10.1097/hjh.0000000000003006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Hypertension (HTN) is a growing public health problem in sub-Saharan Africa (SSA) and SSA migrants in Europe. Elevated levels of inflammatory marker C-reactive protein (CRP) have been linked to HTN but the relationship of CRP and HTN among SSA populations has not been studied. To address this knowledge gap, we studied the association between CRP and HTN in migrant and nonmigrant SSA populations residing in different settings. METHODS Cross-sectional data from the multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study were analysed including 5683 Ghanaians aged at least 18 years, residing in rural and urban Ghana, and Europe. Multivariate logistic regression analyses were used to assess the association between high levels of CRP (≥3 mg/l) and HTN (SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or use of antihypertensive medication) per geographical site and sex. RESULTS The association between CRP levels and HTN varied by sex and geographical location. In age-adjusted models, there was an association between high CRP levels and HTN in urban-Ghanaian women (odds ratio 1.50, 95% confidence interval 1.10-2.03), and European-Ghanaian men (1.68, 1.16-2.43) and women (1.63, 1.28-2.07). However, these associations were attenuated after adjustment for conventional risk factors, especially BMI. No association was found in rural-Ghanaians or urban-Ghanaian men. CONCLUSION Our findings show an association between CRP and HTN among Ghanaian migrants and urban-Ghanaian women, however, this was largely explained by conventional risk factors. Thus, prevention of conventional risk factors, in particular obesity, may help to reduce the potentially low-grade inflammatory mechanism underlying HTN.
Collapse
Affiliation(s)
- Joshua A.N. van Apeldoorn
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
| | - Eva L. van der Linden
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | | | - Erik Beune
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
| | - Karlijn A.C. Meeks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Bert-Jan van den Born
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute
| |
Collapse
|
10
|
C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey. Int J Hypertens 2021; 2021:3326349. [PMID: 34925916 PMCID: PMC8683184 DOI: 10.1155/2021/3326349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/25/2021] [Indexed: 01/28/2023] Open
Abstract
Objective To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. Methods This study was based on the China Health and Nutrition Survey, a continuing open, large-scale prospective cohort study. Adult participants who were free of hypertension were included at baseline survey in 2009 and were followed up in 2015 (follow-up rate: 77.45%). The hs-CRP was measured using the immunoturbidimetric method and divided into three groups: low-risk group (0 ≤ hs-CRP <1 mg/L), average-risk group (1 ≤ hs-CRP <3 mg/L), and high-risk group (3 ≤ hs-CRP ≤10 mg/L). Definite diagnosis of hypertension in the follow-up survey in 2015 was the endpoint event of this study. The areas under the curve (AUC) of the receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive value of the hs-CRP. Results 3794 participants were finally included as study sample, of whom 912 developed hypertension during a 6-year follow-up period (incidence: 24.1%). The incidences of hypertension in hs-CRP low-risk, average-risk, and high-risk groups were 17.6% (200/1135), 25.9% (521/2015), and 29.7% (191/644), respectively. Spearman's correlation analyses showed that there was significant positive correlation between hs-CRP levels and waist circumference, total triglycerides, total cholesterol, age, body mass index, and homeostasis model assessment of insulin resistance index. Stepwise regression analyses showed that participants in the hs-CRP high-risk group had a 46.2% higher risk of developing hypertension compared with those in the hs-CRP low-risk group (odds ratio: 1.462, 95% confidence interval: 1.018–2.101). Baseline systolic and diastolic blood pressure levels and waist circumference contributed the most to the development of hypertension with R2 of 0.076, 0.052, and 0.039, respectively, while hs-CRP had lower area under the curve (AUC) for hypertension, adding baseline BP and WC to the prediction model increased the AUC to 0.708 (95% CI: 0.681–0.735). Conclusion This study revealed a weak positive association between CRP levels and future incidence of hypertension in the Chinese population. The combination of hs-CRP with baseline BP and waist circumference (WC) had a higher predictive value for hypertension (AUC: 0.708), but the predictive value was still limited.
Collapse
|
11
|
Çekiç D, Emir Arman M, Cihad Genç A, İşsever K, Yıldırım İ, Bilal Genç A, Dheir H, Yaylacı S. Predictive role of FAR ratio in COVID-19 patients. Int J Clin Pract 2021; 75:e14931. [PMID: 34606668 DOI: 10.1111/ijcp.14931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/01/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE No effective treatment has yet been found for SARS-Cov-2, which caused a pandemic outbreak in 2019. It is crucial to detect the progression of COVID-19 in patients as early as possible. Fibrinogen to albumin ratio (FAR) has been used as a new inflammatory marker. We aimed to find out whether the use of the FAR as a predictor of mortality in COVID-19 patients provides clinical benefit. MATERIALS AND METHODS Data from 590 patients with COVID-19 from March 15, 2020 to January 15, 2021 in medicine wards and intensive care units (ICU) were retrospectively analysed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR was investigated between patients in the survivor/non-survivor patients. FINDINGS The mean FAR levels in patients who were non-survivor was 24.44 ± 30.3 (n = 272 and 11.29 ± 6.29 (n = 275) (P = .000) in patients survivor COVID-19 infection. In ROC curve for FAR, the threshold FAR that may pose a risk for mortality was determined as 13.84 ((AUC: 0.808 (0.771-0.844)); 74.9% sensitivity, 74.6% specificity; P = .000)). RESULT As a result of this study, increased FAR were found to be important markers in determining the mortality levels in COVID-19 patients.
Collapse
Affiliation(s)
- Deniz Çekiç
- İnternal Medicine Department, Sakarya University, Sakarya, Turkey
| | | | - Ahmed Cihad Genç
- İnternal Medicine Department, Sakarya University, Sakarya, Turkey
| | - Kubilay İşsever
- İnternal Medicine Department, Sakarya University, Sakarya, Turkey
| | - İlhan Yıldırım
- İnternal Medicine Department, Görele State Hospital, Giresun, Turkey
| | - Ahmed Bilal Genç
- İnternal Medicine Department, Sakarya University, Sakarya, Turkey
| | - Hamad Dheir
- Nephrology Department, Sakarya University, Sakarya, Turkey
| | - Selçuk Yaylacı
- İnternal Medicine Department, Sakarya University, Sakarya, Turkey
| |
Collapse
|
12
|
Natural killer cells, gamma delta T cells and classical monocytes are associated with systolic blood pressure in the multi-ethnic study of atherosclerosis (MESA). BMC Cardiovasc Disord 2021; 21:45. [PMID: 33482725 PMCID: PMC7821496 DOI: 10.1186/s12872-021-01857-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension is a major source of cardiovascular morbidity and mortality. Recent evidence from mouse models, genetic, and cross-sectional human studies suggest increased proportions of selected immune cell subsets may be associated with levels of systolic blood pressure (SBP).
Methods We assayed immune cells from cryopreserved samples collected at the baseline examination (2000–2002) from 1195 participants from the multi-ethnic study of atherosclerosis (MESA). We used linear mixed models, with adjustment for age, sex, race/ethnicity, smoking, exercise, body mass index, education, diabetes, and cytomegalovirus titers, to estimate the associations between 30 immune cell subsets (4 of which were a priori hypotheses) and repeated measures of SBP (baseline and up to four follow-up measures) over 10 years. The analysis provides estimates of the association with blood pressure level. Results The mean age of the MESA participants at baseline was 64 ± 10 years and 53% were male. A one standard deviation (1-SD) increment in the proportion of γδ T cells was associated with 2.40 mmHg [95% confidence interval (CI) 1.34–3.42] higher average systolic blood pressure; and for natural killer cells, a 1-SD increment was associated with 1.88 mmHg (95% CI 0.82–2.94) higher average level of systolic blood pressure. A 1-SD increment in classical monocytes (CD14++CD16−) was associated with 2.01 mmHG (95% CI 0.79–3.24) lower average systolic blood pressure. There were no associations of CD4+ T helper cell subsets with average systolic blood pressure. Conclusion These findings suggest that the innate immune system plays a role in levels of SBP whereas there were no associations with adaptive immune cells.
Collapse
|
13
|
Palmu J, Watrous JD, Mercader K, Havulinna AS, Lagerborg KA, Salosensaari A, Inouye M, Larson MG, Rong J, Vasan RS, Lahti L, Andres A, Cheng S, Jousilahti P, Salomaa V, Jain M, Niiranen TJ. Eicosanoid Inflammatory Mediators Are Robustly Associated With Blood Pressure in the General Population. J Am Heart Assoc 2020; 9:e017598. [PMID: 32975162 PMCID: PMC7792391 DOI: 10.1161/jaha.120.017598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Epidemiological and animal studies have associated systemic inflammation with blood pressure (BP). However, the mechanistic factors linking inflammation and BP remain unknown. Fatty acid-derived eicosanoids serve as mediators of inflammation and have been suggested to regulate renal vascular tone, peripheral resistance, renin-angiotensin system, and endothelial function. We hypothesize that specific proinflammatory and anti-inflammatory eicosanoids are linked with BP. Methods and Results We studied a population sample of 8099 FINRISK 2002 participants randomly drawn from the Finnish population register (53% women; mean age, 48±13 years) and, for external validation, a sample of 2859 FHS (Framingham Heart Study) Offspring study participants (55% women; mean age, 66±9 years). Using nontargeted liquid chromatography-mass spectrometry, we profiled 545 distinct high-quality eicosanoids and related oxylipin mediators in plasma. Adjusting for conventional hypertension risk factors, we observed 187 (34%) metabolites that were significantly associated with systolic BP (P<Bonferroni-corrected threshold of 0.05/545). We used forward selection linear regression modeling in FINRISK to define a general formula for individual eicosanoid risk score. Individuals of the top risk score quartile in FINRISK had a 9.0 (95% CI, 8.0-10.1) mm Hg higher systolic BP compared with individuals in the lowest quartile in fully adjusted models. Observed metabolite associations were consistent across FINRISK and FHS. Conclusions Plasma eicosanoids demonstrate strong associations with BP in the general population. As eicosanoid compounds affect numerous physiological processes that are central to BP regulation, they may offer new insights about the pathogenesis of hypertension, as well as serve as potential targets for therapeutic intervention.
Collapse
Affiliation(s)
- Joonatan Palmu
- Department of Internal Medicine University of Turku Finland.,Department of Public Health Solutions Finnish Institute for Health and Welfare Turku and Helsinki Finland
| | - Jeramie D Watrous
- Departments of Medicine and Pharmacology University of California, San Diego CA
| | - Kysha Mercader
- Departments of Medicine and Pharmacology University of California, San Diego CA
| | - Aki S Havulinna
- Department of Public Health Solutions Finnish Institute for Health and Welfare Turku and Helsinki Finland.,Institute for Molecular Medicine Finland and Helsinki Institute of Life Science Helsinki Finland
| | - Kim A Lagerborg
- Departments of Medicine and Pharmacology University of California, San Diego CA
| | - Aaro Salosensaari
- Department of Internal Medicine University of Turku Finland.,Department of Future Technologies University of Turku Finland
| | - Mike Inouye
- Department of Public Health and Primary Care University of Cambridge United Kingdom.,National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study Framingham MA
| | - Martin G Larson
- National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,Department of Biostatistics Boston University School of Public Health Boston MA
| | - Jian Rong
- National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study Framingham MA
| | - Ramachandran S Vasan
- National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,Sections of Preventive Medicine and Epidemiology, and Cardiovascular Medicine Department of Medicine Department of Epidemiology Boston University Schools of Medicine and Public Health Boston MA
| | - Leo Lahti
- Department of Future Technologies University of Turku Finland
| | - Allen Andres
- Departments of Medicine and Pharmacology University of California, San Diego CA
| | - Susan Cheng
- National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study Framingham MA.,Division of Cardiology Brigham and Women's Hospital Boston MA.,Smidt Heart InstituteCedars-Sinai Medical Center Los Angeles CA
| | - Pekka Jousilahti
- Department of Public Health Solutions Finnish Institute for Health and Welfare Turku and Helsinki Finland
| | - Veikko Salomaa
- Department of Public Health Solutions Finnish Institute for Health and Welfare Turku and Helsinki Finland
| | - Mohit Jain
- Departments of Medicine and Pharmacology University of California, San Diego CA
| | - Teemu J Niiranen
- Department of Internal Medicine University of Turku Finland.,Department of Public Health Solutions Finnish Institute for Health and Welfare Turku and Helsinki Finland.,Division of Medicine Turku University Hospital Turku Finland
| |
Collapse
|
14
|
Gordon JH, LaMonte MJ, Zhao J, Genco RJ, Cimato TR, Hovey KM, Andrews CA, Wactawski-Wende J. The association between serum inflammatory biomarkers and incident hypertension among postmenopausal women in the Buffalo OsteoPerio Study. J Hum Hypertens 2020; 35:791-799. [PMID: 33028995 PMCID: PMC8024412 DOI: 10.1038/s41371-020-00422-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/27/2020] [Accepted: 09/24/2020] [Indexed: 11/30/2022]
Abstract
Several serum inflammatory biomarkers have been associated with blood pressure and hypertension prevalence in cross-sectional studies. Few of these associations have been evaluated prospectively. We examined associations for 10 serum inflammatory biomarkers with incident hypertension among 471 postmenopausal women (mean age = 65) in the Buffalo OsteoPerio Study. Concentrations of C-reactive protein, interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, adiponectin, and leptin were measured using multiplexed sandwich immunoassays on fasting serum samples collected at baseline (1997–2001). Incident hypertension (195 cases) was defined as physician-diagnosed hypertension and treatment with medication identified on annual mailed health surveys during follow-up (mean 10 years). Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between log-transformed biomarkers (per 1-SD) and hypertension. When adjusted for age, leptin was significantly associated with hypertension risk (HR=1.55, 95% CI: 1.04, 2.29), however, the association was attenuated and not significant after adjustment for demographic and lifestyle factors, including BMI. Significant (P<0.10) interactions were observed for smoking (never, ever) with CRP (HR: Never, 1.31; Ever, 0.91; P=0.06) and MCP-1 (HR: Never, 0.59; Ever, 5.11; P=0.004); for BMI (<25, ≥25) with MCP-1(HR: <25, 3.45; ≥25, 0.95; P=0.07); for systolic BP with IL-10 (HR: <120, 0.85; 120–139, 1.11; P=0.07); and for diastolic BP with MCP-1 (HR: <80, 1.29; 80–89, 0.84; P=0.03) and with adiponectin (HR: <80, 0.86; 80–89, 1.50; P=0.03). This study adds needed understanding on prospective associations between several serum inflammatory biomarkers and hypertension risk in older postmenopausal women, among whom hypertension burden is substantial.
Collapse
Affiliation(s)
- Joshua H Gordon
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA.,Medical Scientist Training Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA.
| | - Jiwei Zhao
- Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert J Genco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA.,Department of Microbiology and Immunology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Thomas R Cimato
- Department of Medicine, Division of Cardiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Christopher A Andrews
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| |
Collapse
|
15
|
Amorim MR, Moreira DA, Santos BM, Ferrari GD, Nogueira JE, de Deus JL, Alberici LC, Branco LGS. Increased lipopolysaccharide-induced hypothermia in neurogenic hypertension is caused by reduced hypothalamic PGE 2 production and increased heat loss. J Physiol 2020; 598:4663-4680. [PMID: 32749717 DOI: 10.1113/jp280321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/31/2020] [Indexed: 12/30/2022] Open
Abstract
KEY POINTS The mechanisms involved in hypothermia and fever during systemic inflammation (SI) remain largely unknown. Our data support the contention that brain-mediated mechanisms are different in hypertension during SI. Considering that, clinically, it is not easy to assess all mechanisms involved in cardiovascular and thermoregulatory control during SI, the present study sheds light on these integrated mechanisms that may be triggered simultaneously in septic hypertensive patients. The result obtained demonstrate that, in lipopolysaccharide-induced SI, an increased hypothermia is observed in neurogenic hypertension, which is caused by reduced hypothalamic prostaglandin E2 production and increased heat loss in conscious rats. Therefore, the results of the present study provide useful insight for clinical trials evaluating the thermoregulatory outcomes of septic patients with hypertension. ABSTRACT Hypertension is a prevalent disease characterized by autonomic-induced elevated and sustained blood pressure levels and abnormal body core temperature (Tb) regulation. The present study aimed to determine the brain-mediated mechanisms involved in the thermoregulatory changes observed during lipopolysaccharide (LPS)-induced systemic inflammation (SI; at a septic-like model) in spontaneously hypertensive rats (SHR). We combined Tb and skin temperature (Tsk) analysis, assessment of prostaglandin (PG) E2 levels (the proximal mediator of fever) in the anteroventral region of the hypothalamus (AVPO; an important site for Tb control), oxygen consumption analysis, cardiovascular recordings, assays of inflammatory markers, and evaluation of oxidative stress in the plasma and brain of male Wistar rats and SHR that had received LPS (1.5 mg kg-1 ) or saline. LPS induced hypothermia followed by fever in Wistar rats, whereas, in SHR, a maintained hypothermia without fever were observed. These thermoregulatory responses were associated with an increased heat loss in SHR compared to Wistar rats. We measured LPS-induced increased PGE2 levels in the AVPO in Wistar rats, but not in SHR. The LPS-induced drop in blood pressure was higher in SHR than in Wistar rats. Furthermore, LPS-induced plasma and brain [regions involved in autonomic control: nucleus tractus solitarius (NTS) and rostral ventrolateral medulla (RVLM)] cytokine surges were blunted, whereas oxidative stress was higher in SHR. LPS-induced SI leads to blunted cytokine surges both systemically (plasma) and centrally (NTS and RVLM) and reduced hypothalamic PGE2 production, which are all associated with increased hypothermia mediated by increased heat loss, but not by heat production, in SHR.
Collapse
Affiliation(s)
- Mateus R Amorim
- Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Diego A Moreira
- Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Bruna M Santos
- Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Gustavo D Ferrari
- Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Biomolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jonatas E Nogueira
- School of Physical Education and Sports of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Júnia L de Deus
- Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,The Solomon H. Snyder. Department of Neuroscience, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Luciane C Alberici
- Department of Biomolecular Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luiz G S Branco
- Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
16
|
Elevated Lipoprotein-Associated Phospholipase A 2 Independently Affects Age-Related Increases in Systolic Blood Pressure: A Nested Case-Control Study in a Prospective Korean Cohort. Int J Hypertens 2020; 2020:5693271. [PMID: 32292598 PMCID: PMC7150680 DOI: 10.1155/2020/5693271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/18/2020] [Indexed: 11/17/2022] Open
Abstract
Inflammatory markers are susceptible to changes over time. Thus, we observed changes in inflammatory markers correlating with age-related increases in blood pressure (BP) through a prospective study. The aim of this study was to investigate changes in inflammatory markers that correlate with age-related increases in BP. The study included 1,500 nondiabetic and normotensive healthy subjects at baseline. Of these, 121 individuals who developed hypertension (defined as systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) after 2 years formed the hypertension group. For each incident hypertension case, 2 age- and sex-matched control subjects were selected among those who did not develop hypertension (control group, n = 242). After baseline adjustment, the hypertension group exhibited greater increases in body mass index (BMI), systolic and diastolic BP, triglyceride, total cholesterol, glucose, Lp-PLA2 activity, and urinary 8-epi-prostaglandin F2α (8-epi-PGF2α ) levels compared to the control group. In the hypertension group, changes in (Δ) systolic BP correlated positively with Δ Lp-PLA2 activity, which correlated positively with Δ low-density lipoprotein (LDL-) cholesterol and Δ urinary 8-epi-PGF2α levels. Moreover, multiple linear regression revealed baseline systolic BP and Δ Lp-PLA2 activity to be independent predictors of Δ systolic BP in the hypertension group. Our results suggest that age-related increases in systolic BP may correlate strongly with elevated Lp-PLA2 activity and that Lp-PLA2 can be considered a biomarker for systolic BP elevation.
Collapse
|
17
|
Lin YT, Fall T, Hammar U, Gustafsson S, Ingelsson E, Ärnlöv J, Lind L, Engström G, Sundström J. Proteomic Analysis of Longitudinal Changes in Blood Pressure. J Clin Med 2019; 8:jcm8101585. [PMID: 31581667 PMCID: PMC6832911 DOI: 10.3390/jcm8101585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 01/01/2023] Open
Abstract
Hypertension is the leading risk factor for premature death worldwide. The identification of modifiable causes of hypertension remains an imperative task. We aimed to investigate associations between 79 proteins implicated in cardiovascular disease and longitudinal blood pressure (BP) changes in three Swedish prospective cohorts. In a discovery phase, we investigated associations between baseline circulating protein levels assessed with a proximity extension assay and BP stage progression at follow-up 5 years later among persons without BP-lowering drugs at baseline in two independent community-based cohorts from the Prospective Investigation of the Vasculature in Uppsala Seniors study (PIVUS) and the Uppsala Longitudinal Study of Adult Men (ULSAM). We used an independent cohort, the Malmö Diet and Cancer Study (MDC), for replication. The primary outcome of BP stage progression was defined as per the 2017 AHA/ACC (American Heart Association/ American College of Cardiology) Guideline BP categories. We also investigated associations of protein levels with changes in BP on a continuous scale, and meta-analyzed all three cohorts. Levels of renin were associated with BP stage progression with a 5% false discovery rate (FDR) in the ULSAM (n = 238) and PIVUS (n = 566) cohorts, but we could not replicate this association in the MDC cohort (n = 2659). The association in the discovery cohorts was modest, with an odds ratio for BP stage progression over 5 years of 1.33 (95% confidence interval 1.14 to 1.56) per standard deviation of baseline renin. In conclusion, we could not find any novel robust associations with longitudinal BP increase in a proximity extension assay-based proteomics investigation in three cohorts.
Collapse
Affiliation(s)
- Yi-Ting Lin
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807 Kaohsiung City, Taiwan.
| | - Tove Fall
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
| | - Ulf Hammar
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
| | - Stefan Gustafsson
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
| | - Erik Ingelsson
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA 94305, USA.
- Stanford Diabetes Research Center, Stanford University, Stanford, CA 94305, USA.
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, 14152 Huddinge, Sweden.
- School of Health and Social Studies, Dalarna University, 79131 Falun, Sweden.
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
| | - Gunnar Engström
- Department of Clinical Sciences, Cardiovascular Epidemiology, Lund University, 21428 Malmö, Sweden.
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, 75236 Uppsala, Sweden.
- The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia.
| |
Collapse
|
18
|
Vascular smooth muscle cell senescence and age-related diseases: State of the art. Biochim Biophys Acta Mol Basis Dis 2019; 1865:1810-1821. [DOI: 10.1016/j.bbadis.2018.08.015] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/20/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023]
|
19
|
Raikwar N, Braverman C, Snyder PM, Fenton RA, Meyerholz DK, Abboud FM, Harwani SC. Renal denervation and CD161a immune ablation prevent cholinergic hypertension and renal sodium retention. Am J Physiol Heart Circ Physiol 2019; 317:H517-H530. [PMID: 31172810 DOI: 10.1152/ajpheart.00234.2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cholinergic receptor activation leads to premature development of hypertension and infiltration of proinflammatory CD161a+/CD68+ M1 macrophages into the renal medulla. Renal inflammation is implicated in renal sodium retention and the development of hypertension. Renal denervation is known to decrease renal inflammation. The objective of this study was to determine the role of CD161a+/CD68+ macrophages and renal sympathetic nerves in cholinergic-hypertension and renal sodium retention. Bilateral renal nerve denervation (RND) and immune ablation of CD161a+ immune cells were performed in young prehypertensive spontaneously hypertensive rat (SHR) followed by infusion of either saline or nicotine (15 mg·kg-1·day-1) for 2 wk. Immune ablation was conducted by injection of unconjugated azide-free antibody targeting rat CD161a+. Blood pressure was monitored by tail cuff plethysmography. Tissues were harvested at the end of infusion. Nicotine induced premature hypertension, renal expression of the sodium-potassium chloride cotransporter (NKCC2), increases in renal sodium retention, and infiltration of CD161a+/CD68+ macrophages into the renal medulla. All of these effects were abrogated by RND and ablation of CD161a+ immune cells. Cholinergic activation of CD161a+ immune cells with nicotine leads to the premature development of hypertension in SHR. The effects of renal sympathetic nerves on chemotaxis of CD161a+ macrophages to the renal medulla, increased renal expression of NKCC2, and renal sodium retention contribute to cholinergic hypertension. The CD161a+ immune cells are necessary and essential for this prohypertensive nicotine-mediated inflammatory response.NEW & NOTEWORTHY This is the first study that describes a novel integrative physiological interaction between the adrenergic, cholinergic, and renal systems in the development of hypertension, describing data for the role of each in a genetic model of essential hypertension. Noteworthy findings include the prevention of nicotine-mediated hypertension following successful immune ablation of CD161a+ immune cells and the necessary role these cells play in the overexpression of the sodium-potassium-chloride cotransporter (NKCC2) in the renal medulla and renal sodium retention. Renal infiltration of these cells is demonstrated to be dependent on the presence of renal adrenergic innervation. These data offer a fertile ground of therapeutic potential for the treatment of hypertension as well as open the door for further investigation into the mechanism involved in inflammation-mediated renal sodium transporter expression. Taken together, these findings suggest immune therapy, renal denervation, and, possibly, other new molecular targets as having a potential role in the development and maintenance of essential hypertension.
Collapse
Affiliation(s)
- Nandita Raikwar
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Cameron Braverman
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Peter M Snyder
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Robert A Fenton
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - David K Meyerholz
- Division of Comparative Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Francois M Abboud
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa.,Departments of Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Sailesh C Harwani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa.,Center for Immunology and Immune Mediated Diseases, University of Iowa Carver College of Medicine, Iowa City, Iowa.,Abboud Cardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
| |
Collapse
|
20
|
Hidru TH, Yang X, Xia Y, Ma L, Li HH. The relationship between Plasma Markers and Essential Hypertension in Middle-aged and Elderly Chinese Population: A Community Based Cross-sectional Study. Sci Rep 2019; 9:6813. [PMID: 31048753 PMCID: PMC6497653 DOI: 10.1038/s41598-019-43278-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 04/16/2019] [Indexed: 12/16/2022] Open
Abstract
Plasma markers have been continuously advocated as pointers to estimate the long-term risk of cardiovascular disease in the general population. We examined the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), high-sensitivity cardiac troponin T (hs-cTnT), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), 25-Hydroxyvitamin D (25OHD), glycosylated hemoglobin A1c (HbA1c), and serum uric acid (SUA) levels and hypertension in middle and old aged population. A total of 2624 Chinese (62.02 ± 5.73 years old) were recruited into a population-based, cross-sectional study. Plasma hs-CRP, Hcy, HbA1c, and SUA levels were significantly higher in the hypertension group compared with control in the entire population and men (P = 0.05 for all). We observed a positive association between the highest quartiles of Hcy, NT-proBNP, HBA1c concentrations, and the prevalence of hypertension, OR (95% CI) = 1.48 (1.16–1.90), 1.62 (1.27–2.07) and 1.94 (1.49–2.52), respectively. The multivariable-adjusted OR of hypertension for the fourth versus the first quartile of homocysteine were 2.00 and 1.39 in men and women, respectively. In conclusion, our study found an independent and robust association between elevated Hcy, NT-ProBNP, and HBA1c levels and prevalence of hypertension in the middle-aged and elderly Chinese population. A follow-up study is necessary to endorse the observed association.
Collapse
Affiliation(s)
| | - Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Li Ma
- School of Public Health, Dalian Medical University, Dalian, 116044, China.
| | - Hui-Hua Li
- School of Public Health, Dalian Medical University, Dalian, 116044, China. .,Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
| |
Collapse
|
21
|
Jayedi A, Rahimi K, Bautista LE, Nazarzadeh M, Zargar MS, Shab-Bidar S. Inflammation markers and risk of developing hypertension: a meta-analysis of cohort studies. Heart 2019; 105:686-692. [PMID: 30700522 DOI: 10.1136/heartjnl-2018-314216] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/14/2018] [Accepted: 12/19/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To systematically assess the association of circulating inflammation markers with the future risk of hypertension. METHODS We did a systematic literature search of PubMed and Scopus, from database inception to July 10, 2018. Prospective and retrospective cohort studies evaluating the association of circulating C reactive protein (CRP), high-sensitive CRP (hs-CRP), interleukin 6 (IL-6) and IL-1β to the risk of developing hypertension in the general population were included. The relative risks (RRs) for the top versus bottom tertiles of circulating biomarkers were calculated using a fixed-effects/random-effects model. A potential non-linear dose-response association was tested. RESULTS Fourteen prospective cohort studies, two retrospective cohort studies and five nested case-control studies involving 142 640 participants and 20 676 cases were identified. The RR for the third versus first tertiles of circulating CRP was 1.23 (95% CI 1.11 to 1.35; I2=59%, n=12). The association remained unchanged after adjustment for body mass index. The RRs for other biomarkers were as follows: hs-CRP (RR 1.20, 95% CI 1.02 to 1.37; I2=74%, n=7), IL-6 (RR 1.51, 95% CI 1.30 to 1.71; I2=0%, n=5), and IL-1β (RR 1.22, 95% CI 0.92 to 1.51; I2=0%, n=3). A non-linear dose-response meta-analysis demonstrated that the risk of hypertension increased linearly with increasing circulating inflammation markers, even within the low-risk and intermediate-risk categories. CONCLUSIONS Higher levels of circulating CRP, hs-CRP and IL-6, but not IL-1β, were associated with the risk of developing hypertension. The association persisted in subgroups of studies defined by major sources of heterogeneity.
Collapse
Affiliation(s)
- Ahmad Jayedi
- Food (salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Kazem Rahimi
- George Institute for Global Health, University of Oxford, Oxford, UK.,Deep Medicine, Oxford Martin School, University of Oxford, Oxford, UK
| | - Leonelo E Bautista
- Department of Population Health, School of Medicine, University of Wisconsin at Madison, Wisconsin, USA
| | - Milad Nazarzadeh
- George Institute for Global Health, University of Oxford, Oxford, UK.,Collaboration Center of Meta-Analysis Research, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mahdieh Sadat Zargar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
22
|
Alp Ç, Dogru MT, Karadeniz M, Sarak T, Demir V, Çelik Y, Kandemir H, Kısa Ü. Serum pentraxin-3 levels and flow-mediated dilation in dipper and non-dipper hypertension. J Clin Lab Anal 2018; 33:e22718. [PMID: 30411809 DOI: 10.1002/jcla.22718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/27/2018] [Accepted: 10/22/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Endothelial dysfunction is one of the main pathological processes of hypertension. The association of serum pentraxin-3 (PTX3) levels and endothelial dysfunction becomes a more interesting scientific research issue due to high potential of PTX3 as a diagnostic and prognostic biomarker. We aimed to investigate the relationship between serum PTX3 levels and flow-mediated dilation results in patients with dipper and non-dipper hypertension. METHODS This study included 90 hypertensive patients were divided into two groups based on 24 hours ambulatory blood pressure monitoring (ABPM): 38 patients with a dipper pattern and 52 patients with non-dipper pattern. Noninvasive evaluation of the endothelial functions was performed using flow-mediated dilation (FMD) method. RESULTS Serum pentraxin-3 levels were higher in patients with non-dipper HT compared to dipper hypertension (P = 0.028). In addition, we found negative correlation between serum PTX3 and FMD basal/FMD hyperemia ratio (r = -0.297, P = 0.05 for FMD basal/FMD hyperemia ratio, respectively). CONCLUSIONS Serum PTX3 levels are closely related with the measures of indirect noninvasive evaluation methods (FMD) in both DH and NDH patients.
Collapse
Affiliation(s)
- Çağlar Alp
- Faculty of Medicine, Department of Cardiology, Kırıkkale University, Kirikkale, Turkey
| | - Mehmet Tolga Dogru
- Faculty of Medicine, Department of Cardiology, Kırıkkale University, Kirikkale, Turkey
| | - Muhammed Karadeniz
- Faculty of Medicine, Department of Cardiology, Kırıkkale University, Kirikkale, Turkey
| | - Taner Sarak
- Faculty of Medicine, Department of Cardiology, Kırıkkale University, Kirikkale, Turkey
| | - Vahit Demir
- Faculty of Medicine, Department of Cardiology, Bozok University, Yozgat, Turkey
| | | | | | - Üçler Kısa
- Department of Biochemistry, Kırıkkale University, Kirikkale, Turkey
| |
Collapse
|
23
|
Yang H, Bai W, Gao L, Jiang J, Tang Y, Niu Y, Lin H, Li L. Mangiferin alleviates hypertension induced by hyperuricemia via increasing nitric oxide releases. J Pharmacol Sci 2018; 137:154-161. [PMID: 29934052 DOI: 10.1016/j.jphs.2018.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/06/2018] [Accepted: 05/22/2018] [Indexed: 12/22/2022] Open
Abstract
Mangiferin, a natural glucosyl xanthone, was confirmed to be an effective uric acid (UA)- lowering agent with dual action of inhibiting production and promoting excretion of UA. In this study, we aimed to evaluate the effect of mangiferin on alleviating hypertension induced by hyperuricemia. Mangiferin (30, 60, 120 mg/kg) was administered intragastrically to hyperuricemic rats induced by gavage with potassium oxonate (750 mg/kg). Systolic blood pressure (SBP), serum levels of UA, nitric oxide (NO), C-reactionprotein (CRP) and ONOO- were measured. The mRNA and protein levels of endothelial nitric oxide synthase (eNOS), intercellular adhesion molecule-1 (ICAM-1), CRP were also analyzed. Human umbilical vein endothelial cells (HUVECs) were used in vitro studies. Administration of mangiferin significantly decreased the serum urate level and SBP at 8 weeks and last to 12 weeks. Further more, mangiferin could increase the release of NO and decrease the level of CRP in blood. In addition, mangiferin reversed the protein expression of eNOS, CRP, ICAM-1 and ONOO- in aortic segments in hyperuricemic rats. The results in vitro were consistent with the observed results in vivo. Taken together, these data suggested that mangiferin has played an important part in alleviating hypertension induced by hyperuricemia via increasing NO secretion and improving endothelial function.
Collapse
Affiliation(s)
- Hua Yang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenwei Bai
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lihui Gao
- Biomedical Engineering Research Center, Kunming Medical University, Kunming, China
| | - Jun Jiang
- The Third People's Hospital of Yunnan Province, Kunming, China
| | | | - Yanfen Niu
- Biomedical Engineering Research Center, Kunming Medical University, Kunming, China
| | - Hua Lin
- Biomedical Engineering Research Center, Kunming Medical University, Kunming, China
| | - Ling Li
- Biomedical Engineering Research Center, Kunming Medical University, Kunming, China.
| |
Collapse
|
24
|
Afsar B, Kuwabara M, Ortiz A, Yerlikaya A, Siriopol D, Covic A, Rodriguez-Iturbe B, Johnson RJ, Kanbay M. Salt Intake and Immunity. Hypertension 2018; 72:19-23. [PMID: 29760151 DOI: 10.1161/hypertensionaha.118.11128] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Baris Afsar
- From the Department of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey (B.A.)
| | - Masanari Kuwabara
- Department of Medicine (M. Kuwabara, R.J.J.).,Department of Cardiology, Toranomon Hospital, Tokyo, Japan (M. Kuwabara)
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Spain (A.O.)
| | - Aslihan Yerlikaya
- Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey (A.Y.)
| | - Dimitrie Siriopol
- Department of Nephrology, Dialysis and Renal Transplant Center, "Dr C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania (D.S., A.C.)
| | - Adrian Covic
- Department of Nephrology, Dialysis and Renal Transplant Center, "Dr C.I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania (D.S., A.C.)
| | - Bernardo Rodriguez-Iturbe
- Division of Renal Diseases and Hypertension (B.R.-I.), University of Colorado Anschutz Medical Campus, Aurora, CO.,Renal Service, Hospital Universitario, Universidad del Zulia and Instituto Venezolano de Investigaciones Científicas (IVIC)-Zulia, Maracaibo (B.R.-I.)
| | | | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey (M. Kanbay).
| |
Collapse
|
25
|
Yousefzadeh MJ, Schafer MJ, Noren Hooten N, Atkinson EJ, Evans MK, Baker DJ, Quarles EK, Robbins PD, Ladiges WC, LeBrasseur NK, Niedernhofer LJ. Circulating levels of monocyte chemoattractant protein-1 as a potential measure of biological age in mice and frailty in humans. Aging Cell 2018; 17. [PMID: 29290100 PMCID: PMC5847863 DOI: 10.1111/acel.12706] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 11/29/2022] Open
Abstract
A serum biomarker of biological versus chronological age would have significant impact on clinical care. It could be used to identify individuals at risk of early‐onset frailty or the multimorbidities associated with old age. It may also serve as a surrogate endpoint in clinical trials targeting mechanisms of aging. Here, we identified MCP‐1/CCL2, a chemokine responsible for recruiting monocytes, as a potential biomarker of biological age. Circulating monocyte chemoattractant protein‐1 (MCP‐1) levels increased in an age‐dependent manner in wild‐type (WT) mice. That age‐dependent increase was accelerated in Ercc1−/Δ and Bubr1H/H mouse models of progeria. Genetic and pharmacologic interventions that slow aging of Ercc1−/Δ and WT mice lowered serum MCP‐1 levels significantly. Finally, in elderly humans with aortic stenosis, MCP‐1 levels were significantly higher in frail individuals compared to nonfrail. These data support the conclusion that MCP‐1 can be used as a measure of mammalian biological age that is responsive to interventions that extend healthy aging.
Collapse
Affiliation(s)
- Matthew J. Yousefzadeh
- Department of Molecular Medicine; Center on Aging; The Scripps Research Institute; Jupiter FL USA
| | - Marissa J. Schafer
- Robert and Arlene Kogod Center on Aging; Mayo Clinic College of Medicine; Rochester MN USA
- Department of Physical Medicine and Rehabilitation; Mayo Clinic College of Medicine; Rochester MN USA
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Science; National Institute on Aging; National Institutes of Health; Baltimore MD USA
| | - Elizabeth J. Atkinson
- Division of Biomedical Statistics and Informatics; Department of Health Sciences Research; Mayo Clinic College of Medicine; Rochester MN USA
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Science; National Institute on Aging; National Institutes of Health; Baltimore MD USA
| | - Darren J. Baker
- Department of Pediatric and Adolescent Medicine; Mayo Clinic College of Medicine; Rochester MN USA
| | - Ellen K. Quarles
- Department of Pathology; University of Washington; Seattle WA USA
| | - Paul D. Robbins
- Department of Molecular Medicine; Center on Aging; The Scripps Research Institute; Jupiter FL USA
| | - Warren C. Ladiges
- Department of Comparative Medicine; University of Washington; Seattle WA USA
| | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on Aging; Mayo Clinic College of Medicine; Rochester MN USA
- Department of Physical Medicine and Rehabilitation; Mayo Clinic College of Medicine; Rochester MN USA
| | - Laura J. Niedernhofer
- Department of Molecular Medicine; Center on Aging; The Scripps Research Institute; Jupiter FL USA
| |
Collapse
|
26
|
Harwani SC. Macrophages under pressure: the role of macrophage polarization in hypertension. Transl Res 2018; 191:45-63. [PMID: 29172035 PMCID: PMC5733698 DOI: 10.1016/j.trsl.2017.10.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/05/2017] [Accepted: 10/30/2017] [Indexed: 02/06/2023]
Abstract
Hypertension is a multifactorial disease involving the nervous, renal, and cardiovascular systems. Macrophages are the most abundant and ubiquitous immune cells, placing them in a unique position to serve as key mediators between these components. The polarization of macrophages confers vast phenotypic and functional plasticity, allowing them to act as proinflammatory, homeostatic, and anti-inflammatory agents. Key differences between the M1 and M2 phenotypes, the 2 subsets at the extremes of this polarization spectrum, place macrophages at a juncture to mediate many mechanisms involved in the pathogenesis of hypertension. Neuronal and non-neuronal regulation of the immune system, that is, the "neuroimmuno" axis, plays an integral role in the polarization of macrophages. In hypertension, the neuroimmuno axis results in synchronization of macrophage mobilization from immune cell reservoirs and their chemotaxis, via increased expression of chemoattractants, to end organs critical in the development of hypertension. This complicated system is largely coordinated by the dichotomous actions of the autonomic neuronal and non-neuronal activation of cholinergic, adrenergic, and neurohormonal receptors on macrophages, leading to their ability to "switch" between phenotypes at sites of active inflammation. Data from experimental models and human studies are in concordance with each other and support a central role for macrophage polarization in the pathogenesis of hypertension.
Collapse
Affiliation(s)
- Sailesh C Harwani
- Department of Internal Medicine, Iowa City, IA; Center for Immunology and Immune Based Diseases, Iowa City, IA; Abboud Cardiovascular Research Center, Iowa City, Io.
| |
Collapse
|
27
|
Nandakumar P, Tin A, Grove ML, Ma J, Boerwinkle E, Coresh J, Chakravarti A. MicroRNAs in the miR-17 and miR-15 families are downregulated in chronic kidney disease with hypertension. PLoS One 2017; 12:e0176734. [PMID: 28771472 PMCID: PMC5542606 DOI: 10.1371/journal.pone.0176734] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/14/2017] [Indexed: 01/11/2023] Open
Abstract
Background In older adults (aged 70–74 years), African-Americans have 4-fold higher risk of developing hypertension-attributed end-stage renal disease (ESRD) than European-Americans. A hypothesized mechanism linking hypertension and progressive chronic kidney disease (CKD) is the innate immune response and inflammation. Persons with CKD are also more susceptible to infection. Gene expression in peripheral blood can provide a view of the innate immune activation profile. We aimed to identify differentially expressed genes, microRNAs, and pathways in peripheral blood between cases with CKD and high blood pressure under hypertension treatment versus controls without CKD and with controlled blood pressure in African Americans. Methods Case and control pairs (N = 15x2) were selected from those without diabetes and were matched for age, sex, body mass index, APOL1 risk allele count, and hypertension medication use. High blood pressure under hypertension treatment was defined as hypertension medication use and systolic blood pressure (SBP) ≥ 145 mmHg. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2. Cases were selected from those with CKD and high blood pressure under hypertension treatment, and controls were selected from those without CKD (eGFR: 75–120 mL/min/1.73m2 and urine albumin-to-creatinine ratio < 30mg/g) and with blood pressure controlled by hypertension medication use (SBP < 135 mmHg and D(diastolic)BP < 90 mm Hg). We perform RNA sequencing of mRNA and microRNA and conducted differential expression and co-expression network analysis. Results Of 347 miRNAs included in the analysis, 14 were significantly associated with case status (Benjamini-Hochberg adjusted p-value [BH p] < 0.05). Of these, ten were downregulated in cases: three of each belong to the miR-17 and miR-15 families. In co-expression network analysis of miRNA, one module, which included 13 of the 14 significant miRNAs, had significant association with case status. Of the 14,488 genes and 41,739 transcripts included in the analysis, none had significant association with case status. Gene co-expression network analyses did not yield any significant associations for mRNA. Conclusion We have identified 14 differentially expressed miRNAs in the peripheral blood of CKD cases with high blood pressure under hypertension treatment as compared to appropriate controls. Most of the significant miRNAs were downregulated and have critical roles in immune cell functions. Future studies are needed to replicate our findings and determine whether the downregulation of these miRNAs in immune cells may influence CKD progression or complications.
Collapse
Affiliation(s)
- Priyanka Nandakumar
- McKusick - Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Predoctoral Training Program in Human Genetics and Molecular Biology, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Adrienne Tin
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, United States of America
| | - Megan L. Grove
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Jianzhong Ma
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, United States of America
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, United States of America
| | - Aravinda Chakravarti
- McKusick - Nathans Institute of Genetic Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
| |
Collapse
|
28
|
Chen YJ, Lin CL, Li CR, Huang SM, Chan JYH, Fang WH, Chen WL. Associations among integrated psychoneuroimmunological factors and metabolic syndrome. Psychoneuroendocrinology 2016; 74:342-349. [PMID: 27728874 DOI: 10.1016/j.psyneuen.2016.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) has been reported to cause considerable psychoneuroimmunology (PNI) disturbances such as, psychological distress, autonomic nervous imbalance, and impaired immune function. Associations among these psychoneuroimmunology (PNI) factors and their integrated effects with MetS and risk components of MetS necessitate further exploration. OBJECTIVE This study investigated associations among psychoneuroimmunological factors, their integrated effects with MetS and risk components of MetS. METHODS This was a cross-sectional study. Participants were recruited from two health management centers at a medical center in Northern Taiwan. Demographics and data on psychological distress (e.g., perceived stress and depression) were collected using self-reported questionnaires. Heart rate variability (HRV) and C-reactive protein values (CRP) were measured to evaluate participants' autonomic nervous function and immune reaction. The risk components of MetS (e.g., elevated blood pressure, impaired fasting glucose, dyslipidemia, and abdominal obesity) were identified according to the Taiwan-specific definition of MetS and were determined based on participants' health examination profiles. RESULTS A total of 345 participants with complete data were included for data analysis. Compared with healthy controls, participants with MetS exhibited higher depression scores (11.2±8.5 vs. 8.7±7.0), higher CRP values (2.1±2.5 vs. 0.7±1.0), and lower HRV (total power: 758.7±774.9 vs. 1064.4±1075.0). However, perceived stress in participants with MetS did not significantly differ from that of their healthy counterparts (p>0.05). Univariate analyses indicated that associations among psychoneuroimmunological factors and MetS risk components were statistically heterogeneous: a) perceived stress and depression were significantly associated only with high blood glucose (p<0.05); b) CRP was significantly associated with all MetS risk components (p<0.05); and c) HRV was significantly associated with high triglycerides and high fasting blood glucose (p<0.05). Multivariate analysis indicated that the integrated effects of depression, CRP, and HRV were significantly associated with MetS (p<0.01) after controlling for age and education level. CONCLUSIONS Higher depression scores, higher CRP values, and lower HRV are independently and additively associated with MetS and risk components of MetS. Accordingly, a multidisciplinary approach to alleviating psychological distress, immune dysfunction, and autonomic nervous imbalance is recommended for promoting well-being in people with subclinical metabolic abnormalities or MetS to minimize downstream health consequences.
Collapse
Affiliation(s)
- Yu-Ju Chen
- School of Nursing, National Defense Medical Center, Taipei, Taiwan.
| | - Chin-Ling Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, Dou_Liou Branch, Tainan, Taiwan
| | - Chi-Rong Li
- Department of Teaching and Research, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Shih-Ming Huang
- Department and Graduate Institute of Biochemistry, National Defense Medical Center, Taipei, Taiwan
| | - James Yi-Hsin Chan
- Department of Microbiology and Immunology, National Defense Medical Center, Taipei 114, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wen-Hui Fang
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan
| | - Wei-Liang Chen
- Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taiwan; Division of Family Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
29
|
Caillon A, Schiffrin EL. Role of Inflammation and Immunity in Hypertension: Recent Epidemiological, Laboratory, and Clinical Evidence. Curr Hypertens Rep 2016; 18:21. [PMID: 26846785 DOI: 10.1007/s11906-016-0628-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Inflammation has been shown to play an important role in the mechanisms involved in the pathogenesis of hypertension. Accordingly, innate and adaptive immune responses participate in blood pressure elevation. Here, we describe recent immunity studies focusing on novel inflammatory mechanisms during the hypertensive process. Different subpopulations of cells involved in innate and adaptive immune responses, such as monocyte/macrophages and dendritic cells on the one hand and B and T lymphocytes on the other hand, play roles leading to vascular injury in hypertension. Innate lymphoid cells, including natural killer cells and γ/δ T cells, have recently been demonstrated to participate in hypertensive mechanisms triggering vascular inflammation. In summary, we discuss the evidence of interaction of these different inflammatory and immune components in both experimental models and in humans during the development of hypertension.
Collapse
Affiliation(s)
- Antoine Caillon
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Rd., Montreal, QC, Canada, H3T 1E2.
| | - Ernesto L Schiffrin
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Côte-Ste-Catherine Rd., Montreal, QC, Canada, H3T 1E2. .,Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, #B-127, 3755 Côte-Ste-Catherine Rd., Montreal, QC, Canada, H3T 1E2.
| |
Collapse
|
30
|
Solak Y, Afsar B, Vaziri ND, Aslan G, Yalcin CE, Covic A, Kanbay M. Hypertension as an autoimmune and inflammatory disease. Hypertens Res 2016; 39:567-73. [PMID: 27053010 DOI: 10.1038/hr.2016.35] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 02/24/2016] [Accepted: 02/29/2016] [Indexed: 12/11/2022]
Abstract
Hypertension that is considered idiopathic is called essential hypertension and accordingly has no clear culprit for its cause. However, basic research and clinical studies in recent years have expanded our understanding of the mechanisms underlying the development of essential hypertension. Of these, increased oxidative stress, both in the kidney and arterial wall, closely coupled with inflammatory infiltration now appear to have a prominent role. Discovery of regulatory and interleukin-17-producing T cells has enabled us to better understand the mechanism by which inflammation and autoimmunity, or autoinflammation, lead to the development of hypertension. Despite achieving considerable progress, the intricate interactions between oxidative stress, the immune system and the development of hypertension remain to be fully elucidated. In this review, we summarize recent developments in the pathophysiology of hypertension with a focus on the oxidant stress-autoimmunity-inflammation interaction.
Collapse
Affiliation(s)
- Yalcin Solak
- Department of Internal Medicine, Division of Nephrology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Baris Afsar
- Department of Medicine, Division of Nephrology, Konya Numune State Hospital, Konya, Turkey
| | - Nosratola D Vaziri
- Department of Medicine, Division of Nephrology and Hypertension, Schools of Medicine and Biological Science, University of California Irvine, California, CA, USA
| | - Gamze Aslan
- Department of Cardiology, Koc University School of Medicine, Istanbul, Turkey
| | - Can Ege Yalcin
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, 'CI PARHON' University Hospital, and 'Grigore T Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| |
Collapse
|