Immunological Aspects of Hypertension
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REVIEW ARTICLE
Immunological Aspects of Hypertension Daniela Carnevale1,2 • Giuseppe Lembo1,2
Received: 11 February 2016 / Accepted: 1 March 2016 Ó Springer International Publishing Switzerland 2016
Abstract Hypertension is a leading cause of morbidity and mortality worldwide, being the major risk factor for stroke, heart failure and kidney diseases. During past decades, several therapies have been developed to afford an optimal regulation of blood pressure levels. However, the prevalence of uncontrolled hypertension still represents an unsolved problem, with a number of patients resistant as well to all ongoing antihypertensive treatments, raising unsolved mechanistic challenges. In the last years, the most attractive novelty in hypertension research postulated that immune system may have a crucial role in blood pressure elevation, as well as in end-organ damage. Here we briefly review the most important contribution revealing the role of innate and adaptive immune system in hypertension. Moreover, we discuss evidence showing that, in the regulation of body hemodynamics, the immune system and the autonomic nervous systems serve as two major sensory organs whose interaction is crucial for blood pressure increase and target organ damage in hypertension. Keywords Hypertension T cells PlGF Neuroimmune interactions
& Giuseppe Lembo [email protected] 1
Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
2
Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli (IS), Italy
1 Introduction Hypertension is a leading cause of morbidity and mortality worldwide, being the major risk factor for stroke, heart failure and kidney diseases [1, 2]. Although several therapeutic strategies have been developed against the main components involved in blood pressure homeostasis (i.e. vasculature; kidney; autonomic nervous system), the prevalence of uncontrolled hypertension continues to rise [3]. Indeed, there is a number of patients which are resistant to all ongoing antihypertensive treatments, suggesting that there still are unidentified mechanisms, which sustain the increase of blood pressure. In the first half of the past century, the Mosaic Theory of Hypertension was proposed [4], highlighting that many factors, including genetics, environment, neural, mechanical, and hormonal perturbations interplay to raise blood pressure. On this basis, it should be supposed that, as the etiology is multifaceted, the ‘‘solution of the problem’’ could be more complex than expected, and ascribable to more than a simple anatomical organ. Thus, unraveling both the causes of hypertension and novel possibilities of treatment, requires a multidisciplinary approach that, considering the many systems contributing to blood pressure homeostasis, look at them for the crosstalk that regulates their reciprocal interactions. Mounting evidence suggests that components of the innate and adaptive immunity also contribute to the development of the hypertensive disease [5–9]. On this issue,
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