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Innate immunity and clinical hypertension

Journal of Human Hypertension volume 36, pages 503–509 (2022)Cite this article

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Abstract

Emerging evidence has supported a role of inflammation and immunity in the genesis of hypertension. In humans and experimental models of hypertension, cells of the innate and adaptive immune system enter target tissues, including vessels and the kidney, and release powerful mediators including cytokines, matrix metalloproteinases and reactive oxygen species that cause tissue damage, fibrosis and dysfunction. These events augment the blood pressure elevations in hypertension and promote end-organ damage. Factors that activate immune cells include sympathetic outflow, increased sodium within microenvironments where these cells reside, and signals received from the vasculature. In particular, the activated endothelium releases reactive oxygen species and interleukin (IL)-6 which in turn stimulate transformation of monocytes to become antigen presenting cells and produce cytokines like IL-1β and IL-23, which further affect T cell function to produce IL-17A. Genetic deletion or neutralization of these cytokines ameliorates hypertension and end-organ damage. In this review, we will consider in depth features of the hypertensive milieu that lead to these events and consider new treatment approaches to limit the untoward effects of inflammation in hypertension.

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Fig. 1: The effect of hypertensive endothelial stretch on monocyte activation.
Fig. 2: The effect of high salt microenvironments on monocyte and dendritic cell activation.
Fig. 3: Potential anti-inflammatory therapies for clinical hypertension.

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Authors and Affiliations

  1. Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA

    Justin P. Van Beusecum & David G. Harrison

  2. Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA

    Justin P. Van Beusecum

  3. Divsion of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Justin P. Van Beusecum

  4. Department of Internal Medicine, Faculty of Medical Sciences, Cardiovascular Pharmacology Laboratory, University of Campinas, Campinas, Brazil

    Hietor Moreno

  5. Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA

    David G. Harrison

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JVB, HM and DGH composed and edited this review.

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Correspondence to David G. Harrison.

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Van Beusecum, J.P., Moreno, H. & Harrison, D.G. Innate immunity and clinical hypertension. J Hum Hypertens 36, 503–509 (2022). https://doi.org/10.1038/s41371-021-00627-z

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