Tipton Ashlee J, Sullivan Jennifer C
Department of Physiology, Georgia Regents University, Augusta, Georgia.
Department of Physiology, Georgia Regents University, Augusta, Georgia.
Clin Ther. 2014 Dec 1;36(12):1882-1900. doi: 10.1016/j.clinthera.2014.07.011. Epub 2014 Aug 16.
Hypertension is a major risk factor for cardiovascular disease, stroke, and end-organ damage. There is a sex difference in blood pressure (BP) that begins in adolescence and continues into adulthood, in which men have a higher prevalence of hypertension compared with women until the sixth decade of life. Less than 50% of hypertensive adults in the United States manage to control their BP to recommended levels using current therapeutic options, and women are more likely than are men to have uncontrolled high BP. This, is despite the facts that more women compared with men are aware that they have hypertension and that women are more likely to seek treatment for the disease. Novel therapeutic targets need to be identified in both sexes to increase the percentage of hypertensive individuals with controlled BP. The purpose of this article was to review the available literature on the role of T cells in BP control in both sexes, and the potential therapeutic application/implications of targeting immune cells in hypertension.
A search of PubMed was conducted to determine the impact of sex on T cell-mediated control of BP. The search terms included sex, gender, estrogen, testosterone, inflammation, T cells, T regulatory cells, Th17 cells, hypertension, and blood pressure. Additional data were included from our laboratory examinations of cytokine expression in the kidneys of male and female spontaneously hypertensive rats (SHRs) and differential gene expression in both the renal cortex and mesenteric arterial bed of male and female SHRs.
There is a growing scientific literature base regarding the role of T cells in the pathogenesis of hypertension and BP control; however, the majority of these studies have been performed exclusively in males, despite the fact that both men and women develop hypertension. There is increasing evidence that although T cells also mediate BP in females, there are distinct differences in both the T-cell profile and the functional impact of sex differences in T cells on cardiovascular health, although more work is needed to better define the relative impact of different T-cell subtypes on BP in both sexes.
The challenge now is to fully understand the molecular mechanisms by which the immune system regulates BP and how the different components of the immune system interact so that specific mechanisms can be targeted therapeutically without compromising natural immune defenses.
高血压是心血管疾病、中风和终末器官损害的主要危险因素。血压存在性别差异，这种差异始于青春期并持续至成年期，在60岁之前，男性高血压患病率高于女性。在美国，不到50%的高血压成年人通过目前的治疗方法将血压控制在推荐水平，而且女性比男性更易出现血压控制不佳的情况。尽管与男性相比，更多女性知晓自己患有高血压，且更有可能寻求该病的治疗，但仍存在这种情况。需要确定针对男女两性的新治疗靶点，以提高血压得到控制的高血压患者的比例。本文的目的是综述现有文献中关于T细胞在男女两性血压控制中的作用，以及针对高血压中免疫细胞的潜在治疗应用/意义。
在PubMed上进行检索，以确定性别对T细胞介导的血压控制的影响。检索词包括性别、性、雌激素、睾酮、炎症、T细胞、调节性T细胞、辅助性T细胞17、高血压和血压。另外还纳入了我们实验室对雄性和雌性自发性高血压大鼠（SHR）肾脏中细胞因子表达以及雄性和雌性SHR肾皮质和肠系膜动脉床中差异基因表达的检测数据。
关于T细胞在高血压发病机制和血压控制中的作用，科学文献基础日益增多；然而，尽管男性和女性都会患高血压，但这些研究大多仅在男性中进行。越来越多的证据表明，虽然T细胞也介导女性的血压，但T细胞谱以及T细胞性别差异对心血管健康的功能影响存在明显差异，不过还需要更多研究来更好地确定不同T细胞亚型对男女两性血压的相对影响。
现在面临的挑战是充分了解免疫系统调节血压的分子机制，以及免疫系统的不同组成部分如何相互作用，以便在不损害天然免疫防御的情况下针对特定机制进行治疗。
