Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA.
Nat Rev Nephrol. 2024 Aug;20(8):530-540. doi: 10.1038/s41581-024-00838-w. Epub 2024 Apr 24.
Hypertension is a leading risk factor for morbidity and mortality worldwide. Despite current anti-hypertensive therapies, most individuals with hypertension fail to achieve adequate blood pressure control. Moreover, even with adequate control, a residual risk of cardiovascular events and associated organ damage remains. These findings suggest that current treatment modalities are not addressing a key element of the underlying pathology. Emerging evidence implicates immune cells as key mediators in the development and progression of hypertension. In this Review, we discuss our current understanding of the diverse roles of innate and adaptive immune cells in hypertension, highlighting key findings from human and rodent studies. We explore mechanisms by which these immune cells promote hypertensive pathophysiology, shedding light on their multifaceted involvement. In addition, we highlight advances in our understanding of autoimmunity, HIV and immune checkpoints that provide valuable insight into mechanisms of chronic and dysregulated inflammation in hypertension.
高血压是全球发病率和死亡率的主要危险因素。尽管有目前的抗高血压治疗方法，但大多数高血压患者仍无法达到足够的血压控制。此外，即使血压得到充分控制，心血管事件和相关器官损害的残余风险仍然存在。这些发现表明，目前的治疗方法并没有解决潜在病理的一个关键因素。新出现的证据表明，免疫细胞是高血压发生和发展的关键介质。在这篇综述中，我们讨论了我们目前对先天和适应性免疫细胞在高血压中的多种作用的理解，重点介绍了来自人类和啮齿动物研究的关键发现。我们探讨了这些免疫细胞促进高血压病理生理学的机制，阐明了它们多方面的参与。此外，我们还强调了我们对自身免疫、HIV 和免疫检查点的理解的进展，这些进展为高血压中慢性和失调炎症的机制提供了有价值的见解。
