title: Interleukin 17A and Toll-like Receptor 4 in Patients with Arterial Hypertension.
abstract: OBJECTIVE
  Immune responses are involved in arterial hypertension. An observational cross-sectional case control study was conducted to estimate the association between Toll-like receptor 4 (TLR4) expression and interleukin (IL)-17A serum levels in patients with controlled and non-controlled hypertension.
  
  
  METHODS
  We have enrolled 105 non-complicated otherwise healthy hypertensive patients: 53 with well-controlled blood pressure and 52 non-controlled. TLR4 peripheral monocytes expression and serum IL-17A levels were determined by flow cytometry and ELISA, respectively.
  
  
  RESULTS
  Non-controlled patients exhibited higher TLR4 expression than well-controlled (25.60 vs. 21.99, P=0.011). TLR4 expression was lower in well-controlled patients who were prescribed beta blockers (18.9 vs. 22.6, P=0.005) and IL-17A concentration was higher in patients using diuretics in either group (1.41 vs. 2.01 pg/ml, P<0.001; well-controlled 1.3 vs. 1.8 pg/ml, P= 0.023; non-controlled 1.6 vs. 2.3 pg/ml, P=0.001). Correlation between IL-17A concentration and hypertension duration was observed in non-controlled patients (Spearman correlation coefficient . ρ=0.566, P<0.001) whereas in well-controlled patients a correlation was found between hypertension duration and TLR4 expression (ρ=0.322, P=0.020).
  
  
  CONCLUSIONS
  Arterial hypertension stimulates the immune response regardless of blood pressure regulation status. Prolonged hypertension influences peripheral monocyte TLR4 expression and IL-17A serum levels. Anti-hypertensive drugs have different immunomodulatory effects: diuretics are associated with higher IL-17A concentration and beta-blockers with lower TLR4 expression.
authors.forename: Tihana
authors.initials: T
authors.lastname: Simundic
authors.forename: Bojan
authors.initials: B
authors.lastname: Jelakovic
authors.forename: Andrea
authors.initials: A
authors.lastname: Dzumhur
authors.forename: Tajana
authors.initials: T
authors.lastname: Turk
authors.forename: Ines
authors.initials: I
authors.lastname: Sahinovic
authors.forename: Blazenka
authors.initials: B
authors.lastname: Dobrosevic
authors.forename: Boris
authors.initials: B
authors.lastname: Takac
authors.forename: Jerko
authors.initials: J
authors.lastname: Barbic
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D001158:Arteries / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000276:immunology; D007109:Immunity; D020381:Interleukin-17 / Q000097:blood*; D009000:Monocytes / Q000737:chemistry; D051197:Toll-Like Receptor 4 / Q000032:analysis*
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D004232:Diuretics; C508717:IL17A protein, human; D020381:Interleukin-17; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4
keywords: Adaptive immunity; Arterial hypertension; Innate immunity; Interleukin 17A; Toll-like receptor 4