Development Of Salt-sensitive Hypertension Research Articles

High salt intake and HIV infection on endothelial glycocalyx shedding in salt-sensitive hypertension.

The endothelial glycocalyx is closely associated with various physiological and pathophysiological events. Significant modification of the endothelial glycocalyx is an early process in the pathogenesis of cardiovascular disease. High dietary salt and HIV infection damages the endothelial glycocalyx causing endothelial dysfunction and increasing the risk for salt-sensitive hypertension and cardiovascular disease. The two factors, HIV infection and dietary salt are critical independent predictors of hypertension and cardiovascular disease and often synergize to exacerbate and accelerate disease pathogenesis. Salt-sensitive hypertension is more common among people living with HIV and is associated with risk for cardiovascular disease, stroke, heart attack and even death. However, the underlying mechanisms linking endothelial glycocalyx damage to dietary salt and HIV infection are lacking. Yet, both HIV infection/treatment and dietary salt are closely linked to endothelial glycocalyx damage and development of salt-sensitive hypertension. Moreover, the majority of individuals globally, consume more salt than is recommended and the burden of HIV especially in sub-Sahara Africa is disproportionately high. In this review, we have discussed the missing link between high salt and endothelial glycocalyx shedding in the pathogenesis of salt-sensitive hypertension. We have further elaborated the role played by HIV infection and treatment in modifying endothelial glycocalyx integrity to contribute to the development of hypertension and cardiovascular disease.

Global Deletion of DPP4 Prevents the Development of Salt-sensitive Hypertension in Obese Mice via Regulation of Sodium and Water Excretion

Salt-sensitivity of hypertension (HTN) occurs in up to 50% of hypertensive patients and is more common in the older population, Blacks and the obesity/diabetes/hypertension subsets. The renin-angiotensin aldosterone system (RAAS), in particular Angiotensin II (Ang II) and aldosterone known to regulate the Na+/H+ exchanger isoform 3 (NHE3) and ENaC respectively, is thought to be activated in the obesity/diabetes/hypertension subsets and thereby plays an important role in salt-sensitive HTN. RAAS blockade is an acceptable treatment for salt-sensitive HTN along with the use of diuretics. However, not every patient can tolerate RAAS blockade. Recently, dipeptidyl peptidase 4 (DPP4) has been shown to bind to NHE3, colocalizes to the microvillar fractions with active NHE3 and DPP4 inhibition reduces sodium uptake into proximal tubule cells and isolated rat proximal tubules. In addition, DPP4 may act on more distal transporters. Furthermore, data from our lab has revealed that DPP4 knockout (DPP4KO) mice have a lower sodium balance both under conditions of high salt (1.23%) and low salt (0.02%) ingestion suggesting that DPP4 regulates sodium transport and/or balance under physiological conditions. However, whether DPP4 has any effects on salt-sensitive HTN and the underlying mechanisms remain unknown. Therefore, we hypothesized that the absence of DPP4 could mitigate the development of salt-sensitive HTN in an obesity model, by improving the natriuretic and diuretic response mediated by NHE3 and/or distal mechanisms. To this end, 6-8wk old DPP4KO and C57Bl/6 littermate wild-type (WT) mice were fed a control (CD) or Western diet (WD, high in refined fats and sugars) to induce obesity. Circulating (175%) and kidney (125%) DPP4 activity were both elevated in the obese WT mice compared to the CD-fed WT mice (100%) and DPP4KO mice had minimal DPP4 activity as expected. The lack of DPP4 prevented the increase in systolic blood pressure (~15 mmHg) in the obese animals, and the absence of the development of cardiac hypertrophy in this group corroborated the pressure effect. The development of salt-sensitive HTN in the obese WT mice was associated with a lower natriuretic and diuretic response assessed by the salt overload experiment, suggesting higher tubular reabsorption of sodium and water by the nephrons. In turn, the lack of DPP4 prevented the lowering of natriuretic and diuretic response in obese mice, indicating that the beneficial effect of the absence of DPP4 on the development of salt-sensitive HTN is closely related to effects on renal tubule transport. Importantly, a high salt diet increased sodium balance and blood pressure in the obese WT mice and DPP4 deletion mitigated this increase. Furthermore, on low salt diet, the absence of DPP4 led to “salt wasting” in the obese mice similar to the CD-fed mice. Surprisingly, gene and protein expression measurements showed involvement of distal tubule sodium transporters and aquaporins and not NHE3. In contrast, assessment of the DPP4 interactome in obese mice showed binding to Myosin 6 and APN, which may regulate proximal tubule transporters and hypertension. Transdermal measurements showed no changes in the glomerular filtration rate. In conclusion, deletion of DPP4 protects against the development of salt-sensitive hypertension in obese mice by improving the natriuretic and diuretic response likely via regulation of sodium and water transporters. FAPESP, Brazil NIH K08DK115886, USA. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Deletion of ADAM17 on microglia attenuates salt-sensitive hypertension

Previous work from our group identified ADAM17-mediated shedding as a major mechanism responsible for ACE2 shedding, thus impairing ACE2 compensatory activity and contributing to the development of salt sensitive hypertension. While microglia have been shown to contribute to salt sensitive hypertension, the mechanisms responsible are unknown. Accordingly, we hypothesize that ADAM17 promotes microglia priming, sympatho-excitation and neuro-inflammation in salt sensitive hypertension, and thus targeting ADAM17 or its maturation, via iRhom2, provides a multi-pronged strategy to normalize BP. Here, we aimed to evaluate whether deletion of ADAM17 on microglia attenuates hypertension. Uninephrectomized male and female mice (14–16-week-old, n=10/group) with selective deletion of ADAM17 in microglia (Cx3CR1-ADAM17tom) or with global deletion of iRhom2 (iRhom2-KO) and littermate controls (Cx3CR1-Cretom) mice were used to monitor blood pressure (BP telemetry, DSI) at baseline and following the initiation of salt sensitive hypertension (DOCA 1mg/g body weight sc + 1% saline po for 3 weeks). Following the establishment of hypertension (7 days post DOCA implantation) mice were injected with tamoxifen (200 nl ICV) and monitored for 2 more weeks. At the end of the treatment, mice were euthanized, and their brains were collected. Baseline mean arterial pressure (MAP) was not different in Cx3CR1-ADAM17tom, iRhom2-KO compared to controls (102±1, 106±1 and 104±1 mmHg, respectively). Surprisingly, all mice developed hypertension following DOCA implantation, including iRhom2 KO (Cx3CR1-ADAM17tom: 131±1, iRhom2 KO: 131±1, control: 126±1 mmHg, respectively. p<0.05). Interestingly, following tamoxifen injection Cx3CR1-ADAM17tom mice showed a blunted hypertension compared to the control group (MAP: 122±0.2 vs. 146±0.5 mmHg, one way ANOVA, p<0.05) suggesting that ADAM17 in microglia contributes to salt sensitive hypertension. In vitro, human microglia cells (iCell microglia — hIPSC) were shown to express lower ACE2 protein (0.03 ± 0.1 vs. 1.18 ± 0.3, Student’s t test, p<0.05) when exposed to Ang-II (100 ng) with a trend for ADAM17 upregulation (1.5 ± 0.3 vs. 1.1 ± 0.1, p<0.05). Together, our data suggest that overactivity of the renin-angiotensin system is associated with overexpression of ADAM17 in microglia and a simultaneous downregulation of ACE2. In addition, knockdown of ADAM17 specifically on microglia blunted the development of hypertension. We conclude that ADAM17 expression in microglia plays a pivotal role in salt sensitive hypertension. This work was supported in part by a research grant from the National Institutes of Health (HL163588). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex Dependent Exacerbation of Salt Sensitive Hypertension and Cardiac Dysfunction Is Associated With Upregulation of miRNA Targeting ADAM17 and ACE2 in the Brain

Background: The DOCA-salt model has been widely used to study salt-sensitive hypertension and we previously reported that it is associated with ADAM17-mediated ACE2 shedding in the central nervous system. However, previously reported data are mainly from male mice, and it is unclear whether female mice exhibit the same phenotypes. Objective: We aimed to compare sex specific development of salt sensitive hypertension and cardiac dysfunction and investigate miRNA regulation associated with these changes. Methods: C57 mice (male and females, n = 8 -15) underwent uninephrectomy and telemetry implantation (DSI Inc.) for blood pressure (BP) conscious recording. After baseline recording, a DOCA pellet (50 mg, 21 days, Innovative Research of America) was implanted subcutaneously and drinking water was replaced by 1% NaCl solution to induce salt sensitive hypertension. Cerebral Spinal fluid (CSF) was collected at baseline and after 3 weeks of DOCA-salt treatment for exosome miRNA sequencing (Creative Biolab). In another set of mice, cardiac function was assessed by echocardiography (Visualsonics Vevo F2) and invasive left ventricular hemodynamics (Transonic). Mortality from each group was analyzed as well. Results: Baseline BP was not different between male and female mice. Following DOCA-salt treatment for 3 weeks, BP was increased in both sexes, with higher systolic BP observed in males compared to females (active phase: 173.0 ± 19.6 vs. 154.2 ± 19.1 mmHg, p<0.05). Although ejection fraction was not changed in either male or female mice, mitral peak early diastolic filling velocity and tissue doppler showed that E/E’ was increased in both sexes compared to baselines (Male: 33.4 ± 4 vs. 26.6 ± 1.9; Female: 30.3 ± 5.0 vs. 26.4 ± 4), with a greater increase in males (25.3% vs. 14.4%). In addition, hemodynamics revealed increased left ventricular end-diastolic pressure (11.1 ± 1.9 vs. 4.5 ± 0.5 mmHg, p<0.01) and relaxation time constant Tau (6.7 ± 1.0 vs. 4.9 ± 0.5 msec, p<0.01) in DOCA-salt treated males compared to non-treated controls, with no changes shown in female mice. These data suggest worsened cardiac diastolic function in males compared to females following DOCA-salt treatment. Moreover, a 20% mortality was observed in males while no death occured in females, confirming a more severe phenotype in males. Furthermore, miRNAseq analysis of CSF exosomes showed several upregulated miRNA in males but not in females following DOCA-salt treatment. Notably, miR206 associated with increased ADAM17 activity was increased by 8-fold in males but only 3-fold n females. Conclusion: DOCA-salt treatment promotes exacerbated hypertension, impaired cardiac function and mortality in a sex dependent manner, associated with upregulation of key miRNA targeting the brain renin-angiotensin system. The changes of ADAM17 and ACE2 targeted exosome miRNAs in the central nervous system might contribute to the sex difference in the cardiovascular dysfunction phenotypes in this model. This work was supported in part by a research grant from the National Institutes of Health (HL163588). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Pathophysiology of Carnitine Palmitoyltransferase 2 (CPT2) Deficiency in the Dahl Salt-sensitive R at

Carnitine palmitoyltransferase 2 (CPT2) is an essential enzyme of the carnitine shuttle, which facilitates fatty acid -oxidation in mitochondria. This study aims to characterize the various effects of CPT2 deficiency on the Dahl salt-sensitive (SS) rat metabolome and its concomitant influence on renal homeostasis. CRISPR/Cas9 was used to insert a single base pair into the SS Cpt2 gene, causing a frameshift mutation found to be lethal in homozygotes (SSCpt2−/−). Western blotting and qPCR analysis of renal cortex tissue confirmed a reduced expression of CPT2 in heterozygous (SSCpt2+/-) rats compared to wild-type (WT) littermates; therefore, male and female heterozygotes were used for all experiments. Lipid metabolomics of renal cortex samples collected from SSCpt2+/- animals at 8 weeks old on a baseline 0.4% NaCl diet revealed a significant upregulation in inflammatory lipids such as 11-HETE (p<0.01) and 12-HHT (p<0.05) when compared to WT littermates. Urine analysis from the SSCpt2+/- group demonstrated a severe reduction in acetoacetic acid production (p<0.001), indicating ketogenesis is likely impacted by the loss of CPT2 in -oxidation. Additionally, TCA cycle metabolites fumaric acid (p<0.05) and oxaloacetic acid (p<0.01) are significantly downregulated in urine from SSCpt2+/- animals. Radio telemeters were implanted into the rats at 8 weeks of age to continuously record mean arterial pressure (MAP) and monitor the development of SS hypertension over the course of several dietary treatment protocols. Three weeks of either a 4% NaCl high-salt (HS) diet or a HS + ketogenic (HSK) diet with equivalent caloric content (4:1 caloric ratio, fat: carbohydrate) were administered to the animals. No difference in MAP elevation occurred between groups after the HS challenge alone, but SSCpt2+/- animals on the HSK diet had a significantly attenuated development of hypertension (p=0.03). Further metabolic analysis after the HSK diet illustrated that both groups had similar increases in long-chain fatty acids, liver enzymes, and cholesterol levels with a decrease in short-chain fatty acids. These experiments show that the partial loss of CPT2 in the Dahl SS rat leads to dysregulation across multiple metabolic pathways. Moreover, a ketogenic diet appears to protect heterozygous animals from the development of salt-sensitive hypertension. Funding: NIH R35 HL135749 and VA I01 BX004024. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Abstract P3027: Potasium Adaptation Down-regulates PSGL-1 And I-CAM-1 Gene Expressions In Salt -Induced Hypertensive Sprague Dawley Rats

Background: There is an increasing prevalence of hypertension and dietary salt intake has been linked as its risk factor. Although many studies have elucidated this association, the mechanisms by which the increase in salt intake leads to development hypertension have been postulated but yet inconclusive. P - Selectin glycoprotein ligand-1(PSGL-1) and Intercellular adhesion molecule (I-CAM-1) have been implicated in the development of salt sensitive hypertension through vascular inflammation and injury. The role of potassium in blood pressure regulation has been severally reported. Scarce reports of the association of potassium adaptation with high blood pressure development form the basis of this study. We aimed at defining the role of potassium adaptation in the development of salt -induced hypertension in Sprague Dawley rats. Methods: This study was divided into two phases: the induction and confirmation of hypertension and the effect of potassium adaptation. The test group received high salt diet (8% NaCl) for 6 weeks while the control animals were fed with standard rat chow and given water ad libitum. Phase II comprised of pre-treated animals with KCl before induction of hypertension and post induction treatment group with KCl. Blood pressures were monitored as well as blood samples taken for analysis of the gene expressions of I-CAM-1 and PSGL-1 using Standard Laboratory methods Results: We observed a spontaneous significant increases in the blood pressures of the test animals as from the 4 th week compared with the control (P<.05, respectively), the potassium -adapted group and KCl post treated groups exhibited relatively stable blood pressure compared with the control. There were significant increases in the expression of PSGL -1 and I-CAM-1 protein in all the test groups but lower in the potassium adapted and post-treated animal groups when compared with hypertensive group. The potassium adapted group did not develop hypertension throughout the period. Conclusion: Raised arterial blood pressure is inducible by high salt diet. This is associated with an increased expressions of PSGL-1 and ICAM-1. Potassium adaptation inhibited the development of hypertension and down-regulate PSGL-1 expression significantly.

The Interaction of Kidneys and Gut in Development of Salt-Sensitive Hypertension.

The incidence of salt-sensitive hypertension is quite common and varies between 30-60% in hypertensive patients. Regarding the causal role of high salt intake in the development of salt-sensitive hypertension, recent evidence has demonstrated that the gut through its microbiota plays a significant role in its genesis. Besides the gut, the kidneys also play important role in salt-sensitive hypertension and there is clinical and experimental evidence of an interrelationship between the gut and the kidneys in the development of salt-sensitive hypertension through the so-called "gastro-renal axis." The gut besides being an absorptive organ, it is also a hormonal secretory organ involving the secretion of gastrin, dopamine, norepinephrine, angiotensin, and aldosterone which through their action with the kidneys are involved in the development of salt-sensitive hypertension. In addition, the kidneys exert a protective role against the development of hypertension through the secretion of prostaglandins and their vasodilatory action. To assess the current evidence on the role of high salt intake and the interplay of the gut and kidneys in its development, a Medline search of the English literature was contacted between 2012 and 2022, and 46 pertinent papers were selected. These papers together with collateral literature will be discussed in this review.

Effects of varying dietary potassium on the development of salt-sensitive hypertension and expression of basolateral Kir channels

The inverse effects that dietary sodium and potassium have on blood pressure have been known for some time. High sodium consumption is detrimental, while potassium supplementation is known to be beneficial, and the ratio of sodium/potassium consumption is also very important to consider when determining how these electrolytes affect salt-induced hypertension; however, the mechanisms behind the beneficial effects of potassium are still not yet entirely established. Inwardly rectifying potassium (Kir) channels have been shown to play a major role in potassium transport and homeostasis in the kidney and might contribute to these effects. Here we aimed to examine how different variations in the sodium/potassium ratio affect the development of salt-sensitive hypertension and how channels and transporters in the kidney are altered to accommodate these changes. We hypothesize that these diets will affect the development of salt-sensitive hypertension, and that Kir channels will play a major role in the renal adaptations to varying intakes of potassium. At 9 weeks of age, male Dahl SS rats were given a high salt (4% NaCl) diet for 5 weeks either supplemented with high potassium (HK, 1.41% K+), normal potassium (NK, 0.36% K+), or a potassium depleted diet (DK). Telemetry blood pressure recordings revealed that potassium supplementation attenuated the development of salt-sensitive hypertension in rats fed HK diet compared to NK; surprisingly, the DK group did not develop hypertension. Diets had a similar effect on heart rates, we observed the largest heart rate in the NK group, which was reduced with HK, and even further reduced in DK. Comparing terminal body weights, there was no difference between the HK and NK groups, but rats fed DK diet were significantly smaller. The 2 kidney/total body weight ratios were not different in the HK and NK groups, but the potassium deficient rat kidneys were significantly larger, likely due to their smaller body weights. There was no difference in heart/body weight ratios in the HK, NK, or DK groups; however, there is a trend in increased heart weight the lower the dietary potassium. Female animals were also utilized for experiments and followed similar trends as seen in the male rats. Western blot analyses further revealed the expression of Kir channels in Dahl SS rats fed a high salt diet supplemented with varying amounts of potassium. Altogether we provided a comprehensive analysis of various potassium diets on the development of salt-sensitive hypertension and Kir channels. National Institute of Health R35 HL135749 and the Department of Veteran Affairs I01 BX004024 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

S-38-1: EPIGENETIC MECHANISM OF SALT-SENSITIVE HYPERTENSION

Nutritional and environmental factors contribute to the development of salt sensitive hypertension. DNA methylation, the most extensively studied epigenetic marker, may have more stable, longer lasting effects than transient changes in gene expression. Protein malnutrition during pregnancy causes prenatal programmed salt sensitive hypertension via aberrant DNA methylation of the angiotensin receptor, which is induced by exposure to excessive glucocorticoid in the fetal hypothalamus. In adults, salt sensitive hypertension induced by obesity is attributable to increased renal activity of Rac1 and mineralocorticoid receptor (MR) pathway, and adverse prenatal exposure induces transgenerational hypertension through activation of Rac1 and MR pathway by an epigenetic regulated mechanism. Finally, DNA methylation of Klotho in aged kidneys leads to a reduction in the circulating levels of soluble Klotho, and in turn, resulting in the activation of noncanonical Wnt5a and RhoA signaling in the vasculature and the development of aging associated salt sensitive hypertension. These findings indicate that epigenetic modulation has an important role in the development of salt sensitive hypertension throughout life.

S-40-5: ROLE OF INTERFERON GAMMA IN T CELL MEDIATED SALT-RETENTION IN THE KIDNEY AND PROGRESSION OF HYPERTENSION

Objective: In accordance with previous studies implicating the immune system in the development of hypertension, we found that CD8+ T cells (CD8Ts) infiltrate the kidneys and stimulate distal convoluted tubular cells (DCTs), to upregulate sodium-chloride co-transporter (NCC) activity, leading to excessive salt retention. However, the precise molecules driving this direct interaction between CD8Ts and DCTs have not yet been identified. Here we hypothesize that gamma interferon (IFNg), released by activated CD8Ts, primes the tubular cell to promote interactions between activated CD8Ts and DCTs during the development of salt-sensitive hypertension. We predict blocking this molecular pathway will reduce CD8T-homing into the kidney, lowering blood pressure. Design & Method: In co-culture of mouse CD8Ts and DCTs, recombinant mIFNg, IFNg-neutralizing antibody, and specific siRNAs against the IFNg-receptor or PDL1 were used to determine the role of IFNg-PDL1 pathway in the CD8T-DCT interaction. To validate these studies, we employed IFNg knockout (KO) mice, mice with systemically blocked PDL1 using anti-PDL1 antibody or with renal tubule-specific knockdown of PDL1 (mediated via nanoparticles) in the DOCA-salt model and the CD8T adoptive transfer hypertension models. Blood pressure was monitored using radio-biotelemetry. Endpoint analysis involved flow cytometry, RT-qPCR, and western blot, and immunohistochemistry. Results: We found that CD8Ts isolated from DOCA-salt treated hypertensive mice produce more IFNg and exhibit augmented ability to interact with DCTs compared to those from sham normotensive mice. IFNg stimulation to mDCTs increased expression of CD8-specific antigen presenting molecule MHC-I and CD8T-co-signaling molecule PDL1, which enhanced the interaction between CD8Ts and DCTs, consequently upregulating NCC expression in DCTs, leading to enhanced salt retention. These effects on MHC-I, PDL1, or NCC expression were abolished by neutralizing IFNg in co-culture of DCTs and activated CD8Ts, and knockdown of PDL1 in DCTs blunted NCC expression and sodium retention. In-vivo results verified the in-vitro studies. We found that in both IFNg-KO mice and WT mice receiving PDL1-antagonizing antibodies, DOCA-salt treatment failed to elevate their blood pressure and reduced T cell infiltration and NCC expression within their kidneys compared to WT mice receiving the same treatment (anti-PDL1 results shown in Figure 1). Similar results were observed in DOCA-salt treated mice with renal tubule-specific knockdown of PDL1. Conclusion: In salt-sensitive hypertension, activated CD8Ts demonstrate enhanced ability to interact with DCTs leading to increased expression of NCC and sodium retention through a IFNg-PDL1 pathway mediated mechanism. Blocking the IFNg-PDL1 pathway prevents CD8T-DCT interaction both in vitro and in vivo, ameliorating hypertension.

PS-B08-13: PLASMIN INHIBITION ALLEVIATES HYPERTENSION AND PODOCYTE INJURY IN DAHL SALT-SENSITIVE RATS

Objective: The epithelial sodium channel (ENaC) in the kidney plays pivotal roles in blood pressure regulation, and the γ subunit is activated by extracellular serine proteases. In proteinuric renal diseases, plasmin filtered through injured glomeruli proteolytically activates γENaC. In addition, filtered plasmin directly causes podocyte injury. We previously reported that Dahl salt-sensitive (DS) rats fed a high-salt (HS) diet developed severe hypertension and proteinuria together with γENaC activation, and that a synthetic serine protease inhibitor, camostat mesilate, mitigated these changes. However, the role of plasmin in DS rats remains unclear. In this study, we evaluated the relationship between plasmin and hypertension as well as glomerular injury and the effects of plasmin inhibitors in DS rats. Design and method: Five-week-old male DS rats were divided into normal-salt (NS) diet, HS diet, and HS + plasmin inhibitors [tranexamic acid (TA, 2 mg/mL TA in drinking water) and synthetic plasmin inhibitor YO-2 (4 mg/kg/day, intraperitoneal injection)] groups. After systolic blood pressure measurement and 24-h urine collection over time for 5 weeks, the rats were sacrificed for biochemical examination. Results: The HS group displayed severe hypertension and proteinuria together with activation of plasmin in urine and γENaC in the kidney, which were not attenuated by TA. On the other hand, YO-2 mitigated both hypertension and proteinuria [SBP (mmHg): NS, 130.8 ± 7.5; HS, 209.0 ± 14.2; HS+YO-2, 183.8 ± 8.4; Urinary protein (mg/day): NS, 15.4 ± 3.2; HS 259.0 ± 129.3; HS+YO-2, 94.5 ± 31.5]. YO-2 inhibited the attachment of plasmin(ogen) to podocytes and alleviated podocyte injury by reducing glomerular apoptotic cells. Furthermore, YO-2 suppressed the upregulation of protease-activated receptor-1 and phosphorylated ERK1/2 as well as mRNA expression of inflammatory and pro-fibrotic cytokines in the kidney. Conclusion: These results indicate that plasmin plays important roles in the development of salt-sensitive hypertension and glomerular injuries in a rat model of hypertension, and suggest that plasmin inhibition could be a potential therapeutic strategy against salt-sensitive hypertension.

Fumarate hydratase as a potential target to ameliorate salt sensitive hypertension

Salt sensitive hypertension is a major risk factor for stroke, heart failure, and end-stage renal disease. The development of salt sensitive hypertension is involved in genetic and environmental factors. Excessive dietary salt intake is known as a main risk factor and one of the most important environmental determinants, exacerbates the salt sensitive hypertension by a renal redox metabolism.

Recent Advances in Hypertension: Epigenetic Mechanism Involved in Development of Salt-Sensitive Hypertension.

This review highlights recent insights into the epigenetic mechanism of salt-sensitive hypertension from the fetus to the elderly population, mainly focusing on the DNA methylation and histone modification-mediated regulation of hypertension-associated genes. Maternal malnutrition during pregnancy induces upregulation of AT1a (angiotensin receptor 1a) by aberrant DNA methylation, and increased AT1A activity in the hypothalamus develops prenatally programmed salt-sensitive hypertension through renal sympathetic overactivity. In addition, maternal lipopolysaccharide exposure during pregnancy induces upregulation of the Rac1 gene through histone modification by H3K9me2 across generations, resulting in salt-induced activation of the Rac1-MR (mineralocorticoid receptor) pathway in the kidney and the development of salt-sensitive hypertension in F4 and F5 offspring. In mice, aberrant DNA methylation of the Klotho gene, which regulates aging-associated hypertension, decreases the circulating soluble Klotho levels, leading to activation of the vascular Wnt5a-RhoA pathway and vasoconstriction and development of salt-sensitive hypertension because of decreased renal blood flow. A detailed understanding of the environmentally-induced epigenetic modulations related to salt-induced hypertension could be promising for developing preventive and therapeutic approaches to hypertension.

The serine protease plasmin plays detrimental roles in epithelial sodium channel activation and podocyte injury in Dahl salt-sensitive rats.

Salt-sensitive hypertension is associated with poor clinical outcomes. The epithelial sodium channel (ENaC) in the kidney plays pivotal roles in sodium reabsorption and blood pressure regulation, in which its γ subunit is activated by extracellular serine proteases. In proteinuric nephropathies, plasmin filtered through injured glomeruli reportedly activates γENaC in the distal nephron and causes podocyte injury. We previously reported that Dahl salt-sensitive (DS) rats fed a high-salt (HS) diet developed hypertension and proteinuria along with γENaC activation and that a synthetic serine protease inhibitor, camostat mesilate, mitigated these changes. However, the role of plasmin in DS rats remained unclear. In this study, we evaluated the relationship between plasmin and hypertension as well as podocyte injury and the effects of plasmin inhibitors in DS rats. Five-week-old DS rats were divided into normal-salt diet, HS diet, and HS+plasmin inhibitor (either tranexamic acid [TA] or synthetic plasmin inhibitor YO-2) groups. After blood pressure measurement and 24 h urine collection over 5 weeks, rats were sacrificed for biochemical analyses. The HS group displayed severe hypertension and proteinuria together with activation of plasmin in urine and γENaC in the kidney, which was significantly attenuated by YO-2 but not TA. YO-2 inhibited the attachment of plasmin(ogen) to podocytes and alleviated podocyte injury by inhibiting apoptosis and inflammatory/profibrotic cytokines. YO-2 also suppressed upregulation of protease-activated receptor-1 and phosphorylated ERK1/2. These results indicate an important role of plasmin in the development of salt-sensitive hypertension and related podocyte injury, suggesting plasmin inhibition as a potential therapeutic strategy.

Study of aldosterone and malondialdehyde in obesity related hypertension without A diagnosis of chronic disease

Obese subjects often have hypertension and related cardiovascular and renal diseases. In obese subjects impaired renal-pressure natriuresis causes sodium retention, leading to the development of salt sensitive hypertension. Obesity is due to fluid retention and high fat in cells, so fat cells will active any factors to stimulate the secretion of aldosterone, and there will be salt sensitivity to blood pressure only. But it is not necessarily linked to cardiovascular and renal disease. The oxidative stress which rises with the presence of heart and kidney diseases associated with high blood pressure, so there will be increase in oxidative stress because people do not suffer from chronic diseases and obesity is considered fluid retention and fat accumulation in the body.

Abstract 026: Sex Specific Regulation Of The Sodium-chloride Cotransporter And The Salt Sensitivity Of Blood Pressure In Age-dependent Hypertension

Objectives: Blood pressure (BP) increases with age in a sex-dependent manner and a high salt diet (HSD) raises BP in salt sensitive individuals. The Na + -Cl - cotransporter (NCC) in renal cortex contributes to the fine-tuning of sodium reabsorption and BP regulation. We hypothesized that 1) increased NCC activity and expression contributes to sex- and age-dependent hypertension (HTN), and 2) age impairs HSD evoked suppression of NCC activity and expression with age to drives the development of salt sensitive hypertension (SSH). Methods: Three different age groups (3, 8, 16 month old) of male and female Sprague-Dawley (SD) rats were fed a normal salt diet (NSD; 0.6% NaCl) or HSD (4% NaCl) for 21 days. On day 21, basal MAP and NCC activity (peak natriuresis to IV hydrochlorothiazide (2mg/kg) infusion) were measured in vivo. The expression of NCC, with-no-lysine [K] kinases (WNK) 1, WNK4, STE20/SPS1-related proline-alanine-rich protein kinase (SPAK), oxidative stress responsive kinase 1 (OxSR1), and their phosphorylation status was assessed via immunoblotting (N=6/gp) Results: Male, but not female, rats develop age-dependent HTN with increased NCC activity and increased expression of NCC, WNK1, SPAK and phosphorylated SPAK/OxSR1 with age during NSD. A HSD evokes SSH with age in male, but not female, rats, and HSD evoked suppression of NCC activity and expression, WNK1, SPAK, OxSR1 and their phosphorylation is impaired in aged male rats. Conclusion: These findings suggest that 1) increased NCC activity and expression contributes to age-dependent HTN in male, but not female, SD rats, and 2) HSD evoked suppression of NCC is impaired with age driving SSH in male but not female SD rats.

Association of Genetic Variants of Klotho with BP Responses to Dietary Sodium or Potassium Intervention and Long-Term BP Progression

Objectives: Klotho (KL) plays pivotal roles in the progression of salt-sensitive hypertension. Salt-sensitive hypertension was associated with KL genotypes. We aimed to explore the association of common genetic variants of KL with individual blood pressure (BP) responses to sodium and potassium through a dietary intervention study as well as long-term BP progression. Methods: We conducted family-based dietary interventions among 344 participants from 126 families in rural villages of northern China in 2004. Subjects sequentially underwent a baseline diet, a low-salt diet (51.3 mmol/day Na), a high-salt diet (307.8 mmol/day Na), and a high-salt + potassium supplementation diet (307.8 mmol/day Na + 60 mmol/day K). After dietary intervention, we followed up with these participants in 2009 and 2012. The associations between 6 single-nucleotide polymorphisms (SNPs) of KL and phenotypes were analyzed through a linear mixed-effects model. Results: SNPs rs211247 and rs1207568 were positively correlated with the BP response to high-salt diet in the dominant model after adjusting for confounders (β = 1.670 and 2.163, p = 0.032 and 0.005, respectively). BPs rs526906 and rs525014 were in a haplotype block. Block rs526906-rs525014 was positively correlated with diastolic BP response to potassium and potassium sensitivity in the additive model (β = 0.845, p = 0.032). In addition, regression analysis indicated that rs211247 was associated with long-term systolic BP alterations after 8 years of follow-up in the recessive model (β = 20.47, p = 0.032). Conclusions: Common variants of the KL gene might modify individual BP sensitivity to sodium or potassium and influence the long-term progression of BP, suggesting a potential role in the development of salt-sensitive hypertension. Thus, KL may be a new early intervention target for salt-sensitive hypertension.

Tempol Alters Urinary Extracellular Vesicle Lipid Content and Release While Reducing Blood Pressure during the Development of Salt-Sensitive Hypertension.

Salt-sensitive hypertension resulting from an increase in blood pressure after high dietary salt intake is associated with an increase in the production of reactive oxygen species (ROS). ROS are known to increase the activity of the epithelial sodium channel (ENaC), and therefore, they have an indirect effect on sodium retention and increasing blood pressure. Extracellular vesicles (EVs) carry various molecules including proteins, microRNAs, and lipids and play a role in intercellular communication and intracellular signaling in health and disease. We investigated changes in EV lipids, urinary electrolytes, osmolality, blood pressure, and expression of renal ENaC and its adaptor protein, MARCKS/MARCKS Like Protein 1 (MLP1) after administration of the antioxidant Tempol in salt-sensitive hypertensive 129Sv mice. Our results show Tempol infusion reduces systolic blood pressure and protein expression of the alpha subunit of ENaC and MARCKS in the kidney cortex of hypertensive 129Sv mice. Our lipidomic data show an enrichment of diacylglycerols and monoacylglycerols and reduction in ceramides, dihydroceramides, and triacylglycerols in urinary EVs from these mice after Tempol treatment. These data will provide insight into our understanding of mechanisms involving strategies aimed to inhibit ROS to alleviate salt-sensitive hypertension.

The Role of Ketogenic Diet on the Development of Salt-Sensitive Hypertension

The Role of Ketogenic Diet on the Development of Salt-Sensitive Hypertension

Abstract MP35: Pharmacological Inhibition And Knockout Of K ir 7.1 Does Not Affect The Development Of Salt-Sensitive Hypertension In The Dahl SS Rat

Ion channels play a vital role in the kidney’s ability to maintain electrolyte homeostasis, and mutations of certain inwardly rectifying K + channels (K ir ) have been associated with various tubulopathies that can cause salt-wasting and as a consequence, low blood pressure. K ir 7.1 is a member of the K ir family, that helps maintain resting membrane potential; however, its role in the kidney is not well understood. Immunohistochemistry in the kidney confirmed that K ir 7.1 is expressed in both aquaporin 2 and sodium chloride co-transporter positive cells, suggesting it may affect distal tubule K + handling. We hypothesized that K ir 7.1 is involved in renal K + homeostasis and may influence the development of salt-sensitive (SS) hypertension. To examine the role of K ir 7.1 during the development of SS hypertension, we used both a genetic knockout of the gene encoding K ir 7.1, Kcnj13 , on the Dahl SS background and pharmacological inhibition; SS Kcnj13-/- was lethal and we used SS Kcnj13+/- . Mean arterial pressure (MAP) in response to a high salt diet was determined by telemetry or arterial catheter. In the genetic model, there was no difference in MAP development between wild type and SS Kcnj13+/- rats (153±6 vs. 159±7, mmHg; n=11 for each group) after 3 weeks on a 4% NaCl diet. Additionally, there were no differences in K + or Na + urinary excretion in WT vs. SS Kcnj13+/- . For the pharmacological studies, ML418, a novel and highly specific K ir 7.1 inhibitor, was administered daily by i.v. infusion during 2 weeks of 8% NaCl diet. While no significant differences in MAP or K + excretion were observed between vehicle or drug treated rats, administration of ML418 had significantly increased urinary Na + excretion (197±54 vs. 333±21, Na/Cre, vehicle vs. ML418; n≥3 for each group, p=0.02). Moreover, equivalent short circuit current measurements of polarized mCCD cells demonstrated that K ir 7.1 antagonism by ML418 reduced vectoral Na + transport. Overall, these results indicate that K ir 7.1 can impact renal Na + homeostasis, but loss of basolateral K ir 7.1 conductance is insufficient to alter development of hypertension, likely due to compensation by the primary basolateral K ir ’s in the distal nephron such as K ir 4.1 and K ir 5.1.