Complementing T Regulatory Cells to Combat Hypertension
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With the recent updates to the definition of hypertension,1 it is expected that over half the adults in the United States will have elevated, stage 1 or stage 2 hypertension and may require blood pressure-lowering medication. Many of the current hypertension medications target the renin–angiotensin system and affect cells within the kidney and vasculature, but basic scientists are discovering new targets for the treatment of hypertension.
Article, see p 970
There is now overwhelming evidence that inflammation and immunity promote the development and maintenance hypertension.2,3 The immune system is divided into 2 branches: the innate, which spontaneously responds to danger signals presented by foreign invaders, and the adaptive, which involves specific cell-mediated responses. It is inevitable that innate and adaptive processes work together to defend the host from pathogens and harm. In this issue of Circulation Research, Chen et al4 explains the intriguing relationship between complement activation (an innate response) and T regulatory (Tregs) cells (an important player in the adaptive response) and their roles in the pathogenesis of hypertension.
The complement system is an intricate mechanism consisting of 3 different pathways (ie, classical, mannan-binding lectin, and alternative pathways) that use >30 blood-bound proteins that are instinctively activated in response to pathogen- or danger-associated molecular patterns.5–7 Within the classical pathway, complement activation products, …