Salt, Hypertension, and Immunity

Annu Rev Physiol. 2018 Feb 10:80:283-307. doi: 10.1146/annurev-physiol-021317-121134. Epub 2017 Nov 16.

Abstract

The link between inappropriate salt retention in the kidney and hypertension is well recognized. However, growing evidence suggests that the immune system can play surprising roles in sodium homeostasis, such that the study of inflammatory cells and their secreted effectors has provided important insights into salt sensitivity. As part of the innate immune system, myeloid cells have diverse roles in blood pressure regulation, ranging from prohypertensive actions in the kidney, vasculature, and brain, to effects in the skin that attenuate blood pressure elevation. In parallel, T lymphocyte subsets, as key constituents of the adaptive immune compartment, have variable effects on renal sodium handling and the hypertensive response, accruing from the functions of the cytokines that they produce. Conversely, salt can directly modulate the phenotypes of myeloid and T cells, illustrating bidirectional regulatory mechanisms through which sodium and the immune system coordinately impact blood pressure. This review details the complex interplay between myeloid cells, T cells, and salt in the pathogenesis of essential hypertension.

Keywords: T cells; cytokines; dendritic cells; macrophage; monocyte; sodium.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adaptive Immunity / physiology*
  • Animals
  • Blood Pressure / physiology*
  • Cytokines / metabolism
  • Humans
  • Hypertension / immunology
  • Hypertension / metabolism
  • Hypertension / physiopathology*
  • Kidney / immunology
  • Kidney / metabolism
  • Kidney / physiopathology*
  • Monocytes / immunology*
  • Monocytes / metabolism
  • Sodium Chloride / metabolism*
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / metabolism

Substances

  • Cytokines
  • Sodium Chloride