Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077, Pozzilli, IS, Italy.
Department of Molecular Medicine, Sapienza University of Rome, 00161, Rome, Italy.
Curr Hypertens Rep. 2018 Feb 24;20(1):7. doi: 10.1007/s11906-018-0808-8.
Hypertension still represents a huge health problem, causing death and disability and rising at epidemic levels worldwide. The availability of a vast array of antihypertensive therapeutic strategies still fails to adequately treat significant fractions of refractory patients. The possible explanation to this disappointing evidence should be ascribed to the fact that myriad of mechanisms contribute to onset and maintenance of hypertension. Although we have been able to develop strategies aimed at counteracting the single mechanisms identified as master regulators of blood pressure, we still lack strategies capable to approach at the complex interactions established among the different pathophysiological mechanisms.
One of the most intriguing pathophysiological interactions in hypertension emerged in the very last years is the one established between the autonomic nervous system and immunity. Here we briefly review the most important contributions revealing neural modulation of immunity in hypertension and how this novel concept is integrated in the already known multitude of regulations exerted by the autonomic nervous system in typical organs involved in blood pressure regulation.
高血压仍然是一个巨大的健康问题,在全球范围内导致死亡和残疾,并呈流行趋势上升。尽管有大量的抗高血压治疗策略,但仍有相当一部分难治性患者得不到充分治疗。这种令人失望的证据的可能解释应该归因于这样一个事实,即无数的机制有助于高血压的发生和维持。尽管我们已经能够制定策略来对抗被确定为血压主要调节因子的单一机制,但我们仍然缺乏能够解决不同病理生理机制之间建立的复杂相互作用的策略。
在高血压中出现的最有趣的病理生理相互作用之一是自主神经系统和免疫系统之间的相互作用。在这里,我们简要回顾了最重要的贡献,揭示了神经在高血压中的免疫调节作用,以及这一新的概念如何整合到自主神经系统在典型的参与血压调节的器官中发挥的已经熟知的多种调节作用中。