Texas Tech University Health Sciences Center, Nephrology, Lubbock, TX 79430, USA.
Expert Opin Biol Ther. 2010 Jul;10(7):1077-87. doi: 10.1517/14712598.2010.487060.
In the USA only 35% of patients with hypertension achieve adequate blood pressure control. Non-compliance is one of the main barriers to treatment. Vaccine against hypertension is an innovative treatment, injected every 4 - 6 months, to combat non-compliance.
Pathogenesis of hypertension and progress towards developing a hypertension vaccine, including the virus-like-particle-based approach, new adjuvant molecules and the potential toxicity of hypertension vaccine.
The pathogenesis of hypertension is multifactorial. The most common cause is disruption of the Renin-angiotensin-aldosterone system (RAAS), and the first vaccine study was carried out against renin. While the vaccine reduced blood pressure in animal models, it also caused autoimmune disease. In the last decade, vaccines against angiotensin I, angiotensin II, and angiotensin II-type 1 receptors have demonstrated acceptable safety profiles in animal and human studies.
Reduction in blood pressure can be achieved by inducing immunity against targets in the RAAS. The target antigen and selection of adjuvant are crucial factors determining effectiveness and safety of the vaccine. CYT006-AngQb (angiotensin II vaccine) reduced blood pressure in humans but the results were not reproducible with more frequent dosing. Vaccines for hypertension are still in the early phase. We hope for an effective vaccine for hypertension in the years to come.
在美国，只有 35%的高血压患者能达到足够的血压控制。不遵医嘱是治疗的主要障碍之一。高血压疫苗是一种创新的治疗方法，每 4-6 个月注射一次，以对抗不遵医嘱。
高血压的发病机制和开发高血压疫苗的进展，包括基于类似病毒颗粒的方法、新佐剂分子以及高血压疫苗的潜在毒性。
高血压的发病机制是多因素的。最常见的原因是肾素-血管紧张素-醛固酮系统（RAAS）的破坏，第一项针对肾素的疫苗研究就是这样进行的。虽然疫苗能降低动物模型的血压，但也会导致自身免疫性疾病。在过去十年中，针对血管紧张素 I、血管紧张素 II 和血管紧张素 II 型 1 受体的疫苗在动物和人体研究中显示出了可接受的安全性。
通过诱导针对 RAAS 中目标的免疫反应，可以降低血压。目标抗原和佐剂的选择是决定疫苗有效性和安全性的关键因素。CYT006-AngQb（血管紧张素 II 疫苗）可降低人类的血压，但更频繁的给药并未产生可重复的结果。高血压疫苗仍处于早期阶段。我们希望在未来几年能有一种有效的高血压疫苗。
