Division of Nephrology and Hypertension, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Hypertension. 2013 Sep;62(3):585-91. doi: 10.1161/HYPERTENSIONAHA.113.01621. Epub 2013 Jun 24.
Morbidity and mortality attributable to hypertension are higher in black essential hypertensive (EH) compared with white EH patients, possibly related to differential effects on vascular injury and repair. Although circulating endothelial progenitor cells (EPCs) preserve endothelial integrity, inflammatory endothelial cells (IECs) detach from sites of injury and represent markers of vascular damage. We hypothesized that blood levels of IECs and inflammatory markers would be higher in black EH compared with white EH patients. Inferior vena cava and renal vein levels of CD34+/KDR+ (EPC) and VAP-1+ (IEC) cells were measured by fluorescence-activated cell sorting in white EH and black EH patients under fixed sodium intake and blockade of the renin-angiotensin system, and compared with systemic levels in normotensive control subjects (n=19 each). Renal vein and inferior vena cava levels of inflammatory cytokines and EPC homing factors were measured by Luminex. Blood pressure, serum creatinine, lipids, and antihypertensive medications did not differ between white and black EH patients, and EPC levels were decreased in both. Circulating IEC levels were elevated in black EH patients, and inversely correlated with EPC levels (R(2)=0.58; P=0.0001). Systemic levels of inflammatory cytokines and EPC homing factors were higher in black EH compared with white EH patients, and correlated directly with IECs. Renal vein inflammatory cytokines, EPCs, and IECs did not differ from their circulating levels. Most IECs expressed endothelial markers, fewer expressed progenitor cell markers, but none showed lymphocyte or phagocytic cell markers. Thus, increased release of cytokines and IECs in black EH patients may impair EPC reparative capacity and aggravate vascular damage, and accelerate hypertension-related complications.
黑种人原发性高血压（EH）患者的发病率和死亡率高于白种人原发性高血压患者，这可能与血管损伤和修复的差异效应有关。虽然循环内皮祖细胞（EPC）可维持内皮完整性，但炎性内皮细胞（IEC）会从损伤部位脱落，是血管损伤的标志物。我们假设黑种人 EH 患者血液中 IEC 和炎性标志物的水平高于白种人 EH 患者。在固定钠摄入量和阻断肾素-血管紧张素系统的情况下，通过荧光激活细胞分选法测量了白种人 EH 和黑种人 EH 患者下腔静脉和肾静脉中 CD34+/KDR+（EPC）和 VAP-1+（IEC）细胞的水平，并与血压正常的对照组（n=19）的系统水平进行了比较。通过 Luminex 法测量了肾静脉和下腔静脉中炎性细胞因子和 EPC 归巢因子的水平。白种人和黑种人 EH 患者的血压、血清肌酐、血脂和抗高血压药物没有差异，且两者的 EPC 水平均降低。黑种人 EH 患者的循环 IEC 水平升高，且与 EPC 水平呈负相关（R²=0.58；P=0.0001）。与白种人 EH 患者相比，黑种人 EH 患者的系统性炎性细胞因子和 EPC 归巢因子水平较高，且与 IEC 呈直接相关。肾静脉中的炎性细胞因子、EPC 和 IEC 与其循环水平无差异。大多数 IEC 表达内皮标志物，较少表达祖细胞标志物，但没有一个标志物显示淋巴细胞或吞噬细胞标志物。因此，黑种人 EH 患者中细胞因子和 IEC 的过度释放可能会损害 EPC 的修复能力，加重血管损伤，并加速与高血压相关的并发症。
