title: The immunological basis of hypertension.
abstract: A large number of investigations have demonstrated the participation of the immune system in the pathogenesis of hypertension. Studies focusing on macrophages and Toll-like receptors have documented involvement of the innate immunity. The requirements of antigen presentation and co-stimulation, the critical importance of T cell-driven inflammation, and the demonstration, in specific conditions, of agonistic antibodies directed to angiotensin II type 1 receptors and adrenergic receptors support the role of acquired immunity. Experimental findings support the concept that the balance between T cell-induced inflammation and T cell suppressor responses is critical for the regulation of blood pressure levels. Expression of neoantigens in response to inflammation, as well as surfacing of intracellular immunogenic proteins, such as heat shock proteins, could be responsible for autoimmune reactivity in the kidney, arteries, and central nervous system. Persisting, low-grade inflammation in these target organs may lead to impaired pressure natriuresis, an increase in sympathetic activity, and vascular endothelial dysfunction that may be the cause of chronic elevation of blood pressure in essential hypertension.
authors.affiliation: Hospital Universitario y Universidad del Zulia, Maracaibo, Venezuela; Instituto Venezolano de Investigaciones Científicas-Zulia, Maracaibo, Venezuela; brodrigueziturbe@gmail.com.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rodríguez-Iturbe
authors.affiliation: Hospital Universitario y Universidad del Zulia, Maracaibo, Venezuela;
authors.forename: Héctor
authors.initials: H
authors.lastname: Pons
authors.affiliation: Instituto Venezolano de Investigaciones Científicas-Zulia, Maracaibo, Venezuela;
authors.forename: Yasmir
authors.initials: Y
authors.lastname: Quiroz
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado, Denver, Colorado.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D001323:Autoantibodies / Q000276:immunology / Q000378:metabolism; D001324:Autoantigens / Q000276:immunology / Q000378:metabolism; D001794:Blood Pressure; D006801:Humans; D006973:Hypertension / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D007113:Immunity, Innate; D007249:Inflammation / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D018836:Inflammation Mediators / Q000276:immunology / Q000378:metabolism; D015398:Signal Transduction
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D018836:Inflammation Mediators
keywords: autoimmunity; blood pressure; hypertension; immunity; lymphocytes; macrophages.