title: Inflammation, immunity, and hypertensive end-organ damage.
abstract: For >50 years, it has been recognized that immunity contributes to hypertension. Recent data have defined an important role of T cells and various T cell-derived cytokines in several models of experimental hypertension. These studies have shown that stimuli like angiotensin II, deoxycorticosterone acetate-salt, and excessive catecholamines lead to formation of effector like T cells that infiltrate the kidney and perivascular regions of both large arteries and arterioles. There is also accumulation of monocyte/macrophages in these regions. Cytokines released from these cells, including interleukin-17, interferon-γ, tumor necrosis factorα, and interleukin-6 promote both renal and vascular dysfunction and damage, leading to enhanced sodium retention and increased systemic vascular resistance. The renal effects of these cytokines remain to be fully defined, but include enhanced formation of angiotensinogen, increased sodium reabsorption, and increased renal fibrosis. Recent experiments have defined a link between oxidative stress and immune activation in hypertension. These have shown that hypertension is associated with formation of reactive oxygen species in dendritic cells that lead to formation of gamma ketoaldehydes, or isoketals. These rapidly adduct to protein lysines and are presented by dendritic cells as neoantigens that activate T cells and promote hypertension. Thus, cells of both the innate and adaptive immune system contribute to end-organ damage and dysfunction in hypertension. Therapeutic interventions to reduce activation of these cells may prove beneficial in reducing end-organ damage and preventing consequences of hypertension, including myocardial infarction, heart failure, renal failure, and stroke.
authors.affiliation: From the Department of Surgery, Division of Clinical Pharmacology (W.G.M.) and the Department of Medicine (W.G.M., A.K., M.S.M., D.G.H.), Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: William G
authors.initials: WG
authors.lastname: McMaster
authors.affiliation: From the Department of Surgery, Division of Clinical Pharmacology (W.G.M.) and the Department of Medicine (W.G.M., A.K., M.S.M., D.G.H.), Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Annet
authors.initials: A
authors.lastname: Kirabo
authors.affiliation: From the Department of Surgery, Division of Clinical Pharmacology (W.G.M.) and the Department of Medicine (W.G.M., A.K., M.S.M., D.G.H.), Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Meena S
authors.initials: MS
authors.lastname: Madhur
authors.affiliation: From the Department of Surgery, Division of Clinical Pharmacology (W.G.M.) and the Department of Medicine (W.G.M., A.K., M.S.M., D.G.H.), Vanderbilt University School of Medicine, Nashville, TN. david.g.harrison@vanderbilt.edu.
authors.forename: David G
authors.initials: DG
authors.lastname: Harrison
mesh_terms: D056704:Adaptive Immunity / Q000502:physiology; D000818:Animals; D001596:Benzylamines / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016207:Cytokines / Q000172:deficiency / Q000502:physiology; D004353:Drug Evaluation, Preclinical; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D007113:Immunity, Innate / Q000502:physiology; D007249:Inflammation / Q000276:immunology* / Q000503:physiopathology; D007668:Kidney / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D008213:Lymphocyte Activation; D051379:Mice; D018345:Mice, Knockout; D023421:Models, Animal; D008955:Models, Cardiovascular; D018448:Models, Immunological; D018384:Oxidative Stress / Q000502:physiology; D017382:Reactive Oxygen Species / Q000378:metabolism; D015398:Signal Transduction; D016176:T-Lymphocyte Subsets / Q000502:physiology; D066253:Vascular Remodeling; D059289:Vascular Stiffness
chemical_list: D001596:Benzylamines; D016207:Cytokines; D017382:Reactive Oxygen Species; C032416:2-(aminomethyl)phenol
keywords: angiotensin II; antigen presenting cell; cytokines; effector T cell; nitric oxide synthase; sodium