The Contribution Of The Immune System Essay

The Contribution Of The Immune System Essay

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The contribution of the immune system to the pathogenesis of hypertension has been implicated by studies focusing on T lymphocytes and their cytokines. It has been demonstrated that mice lacking adaptive immunity, specifically recombinase-activating gene deficient and mice with severe combined immunodeficiency, have diminished hypertension to stimuli such as angiotensin II, high salt and noradrenaline and adoptive transfer of T cells restores this BP response to the stimuli (Guzik et al., 2007). Evidence also indicates that the production of cytokines, including tumour necrosis factor-α, interleukin-17 and interleukin-6 play a role in hypertension, which promote sodium and water retention in the kidneys (Schiffrin, 2013). It has been suggested that antigen-specific T cell responses drive hypertension, as co-stimulatory signalling is required to induce an elevation in BP (Vinh et al., 2010). A recent hypothesis describes the activity of immune cells in hypertension; hypertensive stimuli lead to an initial rise in BP, resulting in oxidative modifications to proteins which serve as ‘neoantigens’, causing T cell activation. Activated T cells produce cytokines that exert their effects on the vasculature and kidneys, resulting in hypertension (Trott & Harrison, 2014). This proposal requires further refinement and precise mechanisms are yet to be established.

The prevalence of essential hypertension has made it one of the most important public health issues in developed countries. Lifestyle modifications are promoted such as a reduction in dietary sodium, weight loss, increase in physical activity to reduce BP. Results from the PREMIER trial, show this can lower BP and reduce cardiovascular disease risk in prehypertensive patients and ...

... middle of paper ... for the future progress of therapeutic strategies to treat hypertension.

A complex combination of regulatory mechanisms determines normal control of BP, across multiple physiological systems (Figure 3.). Dysfunction in one or more of these controls causes a sustained increase in arterial pressure. Hypertension, which is defined as a persistent elevation in BP, is therefore the result of many potential causative mechanisms. Common pathways that are involved with increase in BP, have been targeted and these therapeutics are now well established in the treatment of essential hypertension. Refining clinical phenotypes, investigating genetic mechanisms and considering alternative pathways will provide further insights into this complex heterogeneous disorder and potentially develop more personalised and effective approaches for clinical management of hypertension.

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