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Current Hypertension Reports

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01-01-2018 | Secondary Hypertension: Nervous System Mechanisms (M Wyss, Section Editor)

The Interactions of the Immune System and the Brain in Hypertension

Authors: Marialuisa Perrotta, Giuseppe Lembo, Daniela Carnevale

Published in: Current Hypertension Reports | Issue 1/2018

Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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.

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36.

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37.

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38.

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39.

• Xiao L, Kirabo A, Wu J, Saleh MA, Zhu L, Wang F, et al. Renal denervation prevents immune cell activation and renal inflammation in angiotensin II-induced hypertension. Circ Res. 2015;117(6):547–57. https://doi.org/10.1161/CIRCRESAHA.115.306010. This work reports important results related to the effect of renal denervation on immune mechanisms in a murine model of AngII-induced hypertension. Renal innervation participates to dendritic cells activation, T-cell infiltration and end-organ damage in the kidneys contributing to the development of hypertension. CrossRefPubMedPubMedCentral

40.

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41.

• Carnevale D, Perrotta M, Pallante F, Fardella V, Iacobucci R, Fardella S, et al. A cholinergic-sympathetic pathway primes immunity in hypertension and mediates brain-to-spleen communication. Nat Commun. 2016;7:13035. https://doi.org/10.1038/ncomms13035. This paper reports evidence of a novel component of the sympathetic outflow in hypertension identified by microneurography of the sympathetic splenic nerve in mice. The sympathetic splenic overdrive is activated in different models of hypertension at early time points after the challenges, thus supporting a mechanistic role in priming of immunity.

42.

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43.

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44.

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Title: The Interactions of the Immune System and the Brain in Hypertension
Authors: Marialuisa Perrotta
Giuseppe Lembo
Daniela Carnevale
Publication date: 01-01-2018
Publisher: Springer US
Published in: Current Hypertension Reports / Issue 1/2018
Print ISSN: 1522-6417
Electronic ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-018-0808-8

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Abstract

Purpose of Review

Recent Findings

Summary

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