Elsevier

Pharmacological Research

Volume 120, June 2017, Pages 109-115
Pharmacological Research

Review
Novel adaptive and innate immunity targets in hypertension

https://doi.org/10.1016/j.phrs.2017.03.015Get rights and content

Abstract

Hypertension is a worldwide epidemic and global health concern as it is a major risk factor for the development of cardiovascular diseases. A relationship between the immune system and its contributing role to the pathogenesis of hypertension has been long established, but substantial advancements within the last few years have dissected specific causal molecular mechanisms. This review will briefly examine these recent studies exploring the involvement of either innate or adaptive immunity pathways. Such pathways to be discussed include innate immunity factors such as antigen presenting cells and pattern recognition receptors, adaptive immune elements including T and B lymphocytes, and more specifically, the emerging role of T regulatory cells, as well as the potential of cytokines and chemokines to serve as signaling messengers connecting innate and adaptive immunity. Together, we summarize these studies to provide new perspective for what will hopefully lead to more targeted approaches to manipulate the immune system as hypertensive therapy.

Section snippets

T and B lymphocytes

The hallmark cell types of the adaptive immune system are T and B lymphocytes. T cells are activated after interaction with an antigen presenting cell (APC), then proliferate and differentiate into one of three effector subtypes: cytotoxic, helper, or regulatory T cells. Recent work shows an evolving role of the T cell in the development of HTN and chronic kidney disease. Studies utilizing genetic knockout of the recombination activating gene1 (RAG1) gene, which is essential for T and B cell

Antigen presenting cells

While many studies have documented the contribution of the adaptive immune response in HTN, it is classically understood that activation of innate immunity through APCs is a required and initiating step. This was substantiated by experiments performed by Vinh et al., which demonstrated that T cell activation and the development of DOCA/salt HTN was dependent upon T cell coreceptor CD28 costimulation by APC B7 ligands [44]. Furthermore, depletion of APCs such as macrophages and neutrophils, or

Implications

Recent reports indicate that only 54% of hypertensive patients in 2009–2012 had their hypertension under control [74]. Outside of dietary and lifestyle changes, pharmacological agents, which primarily treat the symptoms rather than the cause of HTN, have been the first line of therapy, but these approaches are not fully effective [74]. This indicates a clear need to identify new and improved treatment strategies; this review, among others, summarizes the role of the immune system and

Funding sources

DK96859, HL116264, 15SFRN2391002, and AHA16POST29900004.

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