Abstract
Hypertension affects more than one-third of the adult population of the world. However, the cause of high blood pressure is unknown in the vast majority of patients, classified as patients with essential hypertension. Evidence accumulated over the past decade supports the participation of inflammation in the development of experimental hypertension. Investigations have also demonstrated that immune reactivity to overexpressed heat shock protein 70 (HSP70) is involved in the pathogenesis of salt-induced hypertension. This article reviews, first, the role of T cell-induced inflammation in the arteries, kidney and central nervous system in hypertension and the amelioration of hypertension induced by regulatory T cells. Second, experiments showing that autoimmunity directed to HSP70 in the kidney impairs the pressure natriuresis relationship and has a pivotal role in the pathogenesis of salt sensitive hypertension. Finally, we highlight the clinical evidence that supports the participation of autoimmunity in essential hypertension.
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Acknowledgements
Work in the authors' laboratories is supported by funding from grants from FONACYT, Venezuela (FC-2005000283, to B. Rodríguez-Iturbe) and the National Institutes of Health National Heart Lung and Blood Institute, USA (HL-68607, to R. J. Johnson).
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B. Rodríguez-Iturbe, H. Pons, Y. Quiroz and R. J. Johnson researched data for the article. B. Rodríguez-Iturbe and R. J. Johnson wrote the article and made substantial contribution to discussion of the content. M. A. Lanaspa also made substantial contribution to discussion of the content. All authors reviewed and edited the manuscript before submission.
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Rodríguez-Iturbe, B., Pons, H., Quiroz, Y. et al. Autoimmunity in the pathogenesis of hypertension. Nat Rev Nephrol 10, 56–62 (2014). https://doi.org/10.1038/nrneph.2013.248
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DOI: https://doi.org/10.1038/nrneph.2013.248
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