Division of Endocrinology, Diabetes, Hypertension, Brigham and Women's, Harvard Medical School, USA.
Cell and Molecular Biology Laboratory, Department of Cellular Biology & Pharmacology, Faculty of Medicine & Health Sciences, UCSI University, Malaysia.
Am J Hypertens. 2017 Dec 8;31(1):124-131. doi: 10.1093/ajh/hpx146.
Understanding the interactions between genetics, sodium (Na+) intake, and blood pressure (BP) will help overcome the lack of individual specificity in our current treatment of hypertension. This study had 3 goals: expand on the relationship between striatin gene (STRN) status and salt-sensitivity of BP (SSBP); evaluate the status of Na+ and volume regulating systems by striatin risk allele status; evaluate potential SSBP mechanisms.
We assessed the relationship between STRN status in humans (HyperPATH cohort) and SSBP and on volume regulated systems in humans and a striatin knockout mouse (STRN+/-).
The previously identified association between a striatin risk allele and systolic SSBP was demonstrated in a new cohort (P = 0.01). The STRN-SSBP association was significant for the combined cohort (P = 0.003; β = +5.35 mm Hg systolic BP/risk allele) and in the following subgroups: normotensives, hypertensives, men, and older subjects. Additionally, we observed a lower epinephrine level in risk allele carriers (P = 0.014) and decreased adrenal medulla phenylethanolamine N-methyltransferase (PNMT) in STRN+/- mice. No significant associations were observed with other volume regulated systems.
These results support the association between a variant of striatin and SSBP and extend the findings to normotensive individuals and other subsets. In contrast to most salt-sensitive hypertensives, striatin-associated SSBP is associated with normal plasma renin activity and reduced epinephrine levels. These data provide clues to the underlying cause and a potential pathway to achieve, specific, personalized treatment, and prevention.
了解遗传学、钠(Na+)摄入和血压(BP)之间的相互作用将有助于克服我们目前治疗高血压缺乏个体特异性的问题。本研究有 3 个目标:扩展 STRN 基因状态与 BP 盐敏感性(SSBP)之间的关系;评估 STRN 风险等位基因状态下的 Na+和容量调节系统的状态;评估潜在的 SSBP 机制。
我们评估了 STRN 状态在人类(HyperPATH 队列)和人类及 STRN 敲除小鼠(STRN+/-)中的 SSBP 和容量调节系统之间的关系。
在一个新队列中证实了先前发现的 STRN 风险等位基因与收缩期 SSBP 之间的关联(P = 0.01)。STRN-SSBP 关联在联合队列中具有统计学意义(P = 0.003;β=+5.35 毫米汞柱收缩压/风险等位基因),并且在以下亚组中具有统计学意义:血压正常者、高血压患者、男性和老年受试者。此外,我们观察到风险等位基因携带者的肾上腺素水平较低(P = 0.014),STRN+/- 小鼠的肾上腺髓质儿茶酚胺 N-甲基转移酶(PNMT)减少。与其他容量调节系统无显著相关性。
这些结果支持 STRN 变异与 SSBP 之间的关联,并将研究结果扩展到血压正常的个体和其他亚组。与大多数盐敏感型高血压患者不同,与 STRN 相关的 SSBP 与正常血浆肾素活性和降低的肾上腺素水平相关。这些数据为潜在的因果关系提供了线索,并为实现特定的、个性化的治疗和预防提供了潜在途径。