Nowotny Hanna F, Zheng Tingting, Seiter Thomas Marchant, Ju Jing, Schneider Holger, Kroiss Matthias, Sarkis Anna-Lina, Sturm Lisa, Britz Vera, Lechner Andreas, Potzel Anne L, Kunz Sonja, Bidlingmaier Martin, Neuhaus Klaus, Gottschlich Adrian, Kobold Sebastian, Reisch Nicole, Schirmer Melanie, Reincke Martin, Adolf Christian
Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Chair of Translational Microbiome Data Integration, Technical University of Munich, Freising, Germany.
Front Immunol. 2024 Dec 19;15:1428054. doi: 10.3389/fimmu.2024.1428054. eCollection 2024.
High dietary sodium intake is a major cardiovascular risk factor and adversely affects blood pressure control. Patients with primary aldosteronism (PA) are at increased cardiovascular risk, even after medical treatment, and high dietary sodium intake is common in these patients. Here, we analyze the impact of a moderate dietary sodium restriction on microbiome composition and immunophenotype in patients with PA.
Prospective two-stage clinical trial including two subgroups: 15 treatment-naive PA patients compared to matched normotensive controls; and 31 PA patients on mineralocorticoid receptor antagonist treatment before and three months after sodium restriction. Patients underwent blood pressure measurements, laboratory tests, analysis of peripheral blood mononuclear cells via flow cytometry and microbiome analysis.
We observed a higher percentage of Tregs in treatment-naive PA patients (p = 0.0303), while the abundance of was higher in PA patients compared to normotensive controls (p = 0.00027) and the abundance of species however was higher in the subgroup of normotensive controls (p = 0.0290). Sodium restriction was accompanied by a decrease in pro-inflammatory Tc17 cells in male patients (p = 0.0081, females p = 0.3274). abundance was higher in female patients (0.01230, p = 0.0016) and decreased upon sodium restriction (0.002309, p = 0.0068).
Dietary sodium restriction in patients with PA modulates the peripheral immune cell composition toward a less inflammatory phenotype. This suggests a potential mechanism by which sodium reduction modulates immune cell composition, leading to blood pressure reduction and positively impacting cardiovascular risk.
高钠饮食摄入是主要的心血管危险因素，对血压控制产生不利影响。原发性醛固酮增多症（PA）患者即使在接受药物治疗后心血管风险仍会增加，且这些患者中高钠饮食摄入很常见。在此，我们分析适度限制饮食中钠对PA患者微生物组组成和免疫表型的影响。
前瞻性两阶段临床试验，包括两个亚组：15例未经治疗的PA患者与匹配的血压正常对照；以及31例接受盐皮质激素受体拮抗剂治疗的PA患者，在限钠前和限钠三个月后进行观察。患者接受血压测量、实验室检查、通过流式细胞术分析外周血单个核细胞以及微生物组分析。
我们观察到未经治疗的PA患者中调节性T细胞（Tregs）百分比更高（p = 0.0303），而与血压正常对照相比，PA患者中 的丰度更高（p = 0.00027），然而在血压正常对照亚组中 物种的丰度更高（p = 0.0290）。限钠伴随着男性患者促炎性辅助性T细胞17（Tc17）细胞减少（p = 0.0081，女性p = 0.3274）。 在女性患者中的丰度更高（0.01230，p = 0.0016），限钠后降低（0.002309，p = 0.0068）。
PA患者限制饮食中钠可使外周免疫细胞组成向炎症性较低的表型转变。这提示了一种潜在机制，即减少钠摄入可调节免疫细胞组成，从而降低血压并对心血管风险产生积极影响。
