title: Role of the vascular wall in sodium homeostasis and salt sensitivity.
abstract: Excessive sodium intake is associated with both hypertension and an increased risk of cardiovascular events, presumably because of an increase in extracellular volume. The extent to which sodium intake affects extracellular volume and BP varies considerably among individuals, discriminating subjects who are salt-sensitive from those who are salt-resistant. Recent experiments have shown that, other than regulation by the kidney, sodium homeostasis is also regulated by negatively charged glycosaminoglycans in the skin interstitium, where sodium is bound to glycosaminoglycans without commensurate effects on extracellular volume. The endothelial surface layer is a dynamic layer on the luminal side of the endothelium that is in continuous exchange with flowing blood. Because negatively charged glycosaminoglycans are abundantly present in this layer, it may act as an intravascular buffer compartment that allows sodium to be transiently stored. This review focuses on the putative role of the endothelial surface layer as a contributor to salt sensitivity, the consequences of a perturbed endothelial surface layer on sodium homeostasis, and the endothelial surface layer as a possible target for the treatment of hypertension and an expanded extracellular volume.
authors.affiliation: Department of Internal Medicine, Divisions of Nephrology, and.
authors.forename: Rik H G
authors.initials: RH
authors.lastname: Olde Engberink
authors.affiliation: Department of Internal Medicine, Divisions of Nephrology, and.
authors.forename: Nienke M G
authors.initials: NM
authors.lastname: Rorije
authors.affiliation: Department of Internal Medicine, Divisions of Nephrology, and.
authors.forename: Jaap J
authors.initials: JJ
authors.lastname: Homan van der Heide
authors.affiliation: Department of Internal Medicine, Vascular Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
authors.forename: Bert-Jan H
authors.initials: BJ
authors.lastname: van den Born
authors.affiliation: Department of Internal Medicine, Divisions of Nephrology, and l.vogt@amc.uva.nl.
authors.forename: Liffert
authors.initials: L
authors.lastname: Vogt
mesh_terms: D000818:Animals; D004730:Endothelium, Vascular / Q000378:metabolism*; D006801:Humans; D012964:Sodium / Q000378:metabolism*; D014882:Water-Electrolyte Balance
chemical_list: D012964:Sodium
keywords: BP; EnNaC; cardiovascular; endothelial cells; salt sensitivity; sodium