The immunological basis of hypertension

B Rodríguez-Iturbe, H Pons, Y Quiroz… - American journal of …, 2014 - academic.oup.com
American journal of hypertension, 2014academic.oup.com
A large number of investigations have demonstrated the participation of the immune system
in the pathogenesis of hypertension. Studies focusing on macrophages and Toll-like
receptors have documented involvement of the innate immunity. The requirements of
antigen presentation and co-stimulation, the critical importance of T cell–driven
inflammation, and the demonstration, in specific conditions, of agonistic antibodies directed
to angiotensin II type 1 receptors and adrenergic receptors support the role of acquired …
A large number of investigations have demonstrated the participation of the immune system in the pathogenesis of hypertension. Studies focusing on macrophages and Toll-like receptors have documented involvement of the innate immunity. The requirements of antigen presentation and co-stimulation, the critical importance of T cell–driven inflammation, and the demonstration, in specific conditions, of agonistic antibodies directed to angiotensin II type 1 receptors and adrenergic receptors support the role of acquired immunity. Experimental findings support the concept that the balance between T cell–induced inflammation and T cell suppressor responses is critical for the regulation of blood pressure levels. Expression of neoantigens in response to inflammation, as well as surfacing of intracellular immunogenic proteins, such as heat shock proteins, could be responsible for autoimmune reactivity in the kidney, arteries, and central nervous system. Persisting, low-grade inflammation in these target organs may lead to impaired pressure natriuresis, an increase in sympathetic activity, and vascular endothelial dysfunction that may be the cause of chronic elevation of blood pressure in essential hypertension.
Oxford University Press