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Immune regulation of systemic hypertension, pulmonary arterial hypertension, and preeclampsia: shared disease mechanisms and translational opportunities
- Source :
- American journal of physiology. Regulatory, integrative and comparative physiology. 313(6)
- Publication Year :
- 2017
-
Abstract
- Systemic hypertension, preeclampsia, and pulmonary arterial hypertension (PAH) are diseases of high blood pressure in the systemic or pulmonary circulation. Beyond the well-defined contribution of more traditional pathophysiological mechanisms, such as changes in the renin–angiotensin–aldosterone system, to the development of these hypertensive disorders, there is substantial clinical evidence supporting an important role for inflammation and immunity in the pathogenesis of each of these three conditions. Over the last decade, work in small animal models, bearing targeted deficiencies in specific cytokines or immune cell subsets, has begun to clarify the immune-mediated mechanisms that drive changes in vascular structure and tone in hypertensive disease. By summarizing the clinical and experimental evidence supporting a contribution of the immune system to systemic hypertension, preeclampsia, and PAH, the current review highlights the cellular and molecular pathways that are common to all three hypertensive disorders. These mechanisms are centered on an imbalance in CD4+ helper T cell populations, defined by excessive Th17 responses and impaired Treg activity, as well as the excessive activation or impairment of additional immune cell types, including macrophages, dendritic cells, CD8+ T cells, B cells, and natural killer cells. The identification of common immune mechanisms in systemic hypertension, preeclampsia, and PAH raises the possibility of new therapeutic strategies that target the immune component of hypertension across multiple disorders.
- Subjects :
- 0301 basic medicine
Adult
Physiology
Hypertension, Pulmonary
Inflammation
030204 cardiovascular system & hematology
Preeclampsia
Translational Research, Biomedical
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Immunity
Pregnancy
Physiology (medical)
medicine
Humans
business.industry
Disease mechanisms
Immune regulation
medicine.disease
Pulmonary hypertension
3. Good health
030104 developmental biology
Blood pressure
Pathophysiology of hypertension
Immunology
Hypertension
Female
Immunotherapy
medicine.symptom
business
Subjects
Details
- ISSN :
- 15221490
- Volume :
- 313
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- American journal of physiology. Regulatory, integrative and comparative physiology
- Accession number :
- edsair.doi.dedup.....ec0f580769c67c25a47c5610a32f1a64