Abstract
Small resistance arteries undergo either inward eutrophic or hypertrophic remodeling, which contributes to raise blood pressure and impairs tissue perfusion. Vasoconstriction, growth, oxidative stress, and inflammation are mechanisms in the vascular wall that participate in vascular remodeling. Inflammatory and immune cells infiltrating the adventitia and perivascular fat produce cytokines that contribute to vascular injury. Molecular studies may identify diagnostic and therapeutic targets in the future that will improve our ability to prevent and treat vascular injury associated with hypertension and cardiovascular disease.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Schiffrin EL. The vascular phenotypes in hypertension: relation to the natural history of hypertension. J Am Soc Hypertens. 2007;1:56–67.
Mitchell GF, Lacourcière Y, Ouellet JP, et al. Determinants of elevated pulse pressure in middle-aged and older subjects with uncomplicated systolic hypertension—the role of proximal aortic diameter and the aortic pressure-flow relationship. Circulation. 2003;108:1592–8.
Schiffrin EL. Vascular stiffening and arterial compliance—implications for systolic blood pressure. Am J Hypertens. 2004;17:39S–48S.
Heagerty AM, Aalkjaer C, Bund SJ, Korsgaard N, Mulvany MJ. Small artery structure in hypertension: dual processes of remodeling and growth. Hypertension. 1993;21:391–7.
Schiffrin EL, Deng LY, Larochelle P. Morphology of resistance arteries and comparison of effects of vasoconstrictors in mild essential hypertensive patients. Clin Invest Med. 1993;16:177–86.
Mulvany MJ, Baumbach GL, Aalkjaer C, et al. Vascular remodeling. Hypertension. 1996;28:505–6.
Schiffrin EL. Remodeling of resistance arteries in essential hypertension and effects of antihypertensive treatment. Am J Hypertens. 2004;17:1192–200.
Rizzoni D, Porteri E, Castellano M, et al. Vascular hypertrophy and remodeling in secondary hypertension. Hypertension. 1996;28:785–90.
Rizzoni D, Porteri E, Guelfi D, et al. Structural alterations in subcutaneous small arteries of normotensive and hypertensive patients with non-insulin-dependent diabetes mellitus. Circulation. 2001;103:1238–44.
Endemann D, Pu Q, De Ciuceis C, et al. Persistent remodeling of resistance arteries in type 2 diabetic patients on antihypertensive treatment. Hypertension. 2004;43:399–404.
Rizzoni D, Porteri E, Giustina A, et al. Acromegalic patients show the presence of hypertrophic remodeling of subcutaneous small resistance arteries. Hypertension. 2004;43:561–5.
Li JS, Larivière R, Schiffrin EL. Effect of a nonselective endothelin antagonist on vascular remodeling in deoxycorticosterone acetate-salt hypertensive rats: evidence for a role of endothelin in vascular hypertrophy. Hypertension. 1994;24:183–8.
Schiffrin EL, Larivière R, Li JS, Sventek P. Enhanced expression of the endothelin-1 gene in blood vessels of DOCA-salt hypertensive rats: correlation with vascular structure. J Vasc Res. 1996;33:235–48.
D'Uscio LV, Barton M, Shaw S, Moreau P, Lüscher TF. Structure and function of small arteries in salt-induced hypertension—effects of chronic endothelin-subtype-A-receptor blockade. Hypertension. 1997;30:905–11.
Schiffrin EL, Touyz RM. From bedside to bench to bedside: role of renin-angiotensin-aldosterone system in remodeling of resistance arteries in hypertension. Am J Physiol Heart Circ Physiol. 2004;287:H435–46.
Schiffrin EL, Larivière R, Li JS, Sventek P, Touyz RM. Deoxycorticosterone acetate plus salt induces overexpression of vascular endothelin-1 and severe vascular hypertrophy in spontaneously hypertensive rats. Hypertension. 1995;25(Part 2):769–73.
Schiffrin EL, Deng LY, Sventek P, Day R. Enhanced expression of endothelin-1 gene in resistance arteries in severe human essential hypertension. J Hypertens. 1997;15:57–63.
Amiri F, Virdis A, Neves MF, et al. Endothelium-restricted overexpression of human endothelin-1 causes vascular remodeling and endothelial dysfunction. Circulation. 2004;110:2233–40.
Coelho SC, Berillo O, Ouerd S, et al. Three-month endothelial human endothelin-1 overexpression causes blood pressure elevation and vascular and kidney injury. Hypertension. 2018;71:208–16.
Lee RMKW, Garfield RE, Forrest JB, Daniel EE. Morphometric study of structural changes in the mesenteric blood vessels of spontaneously hypertensive rats. Blood Vessels. 1983;20:57–71.
Mulvany MJ, Baandrup U, Gundersen HJ. Evidence for hyperplasia in mesenteric resistance vessels of spontaneously hypertensive rats using a three-dimensional disector. Circ Res. 1985;57:794–800.
Intengan HD, Deng LY, Li JS, Schiffrin EL. Mechanics and composition of human subcutaneous resistance arteries in essential hypertension. Hypertension. 1999;33:569–74.
Bakker ENTP, Van der Meulen ET, Van den Berg BM, et al. Inward remodeling follows chronic vasoconstriction in isolated resistance arteries. J Vasc Res. 2002;39:12–20.
Intengan HD, Thibault G, Li JS, Schiffrin EL. Resistance artery mechanics, structure, and extracellular components in spontaneously hypertensive rats—effects of angiotensin receptor antagonism and converting enzyme inhibition. Circulation. 1999;100:2267–75.
Pu Q, Neves MF, Virdis A, Touyz RM, Schiffrin EL. Endothelin antagonism on aldosterone-induced oxidative stress and vascular remodeling. Hypertension. 2003;42:49–55.
Neves MF, Virdis A, Schiffrin EL. Resistance artery mechanics and composition in angiotensin II-infused rats: effects of aldosterone antagonism. J Hypertens. 2003;21:189–98.
Bakker ENTP, Buus CL, Spaan JAE, et al. Small artery remodeling depends on tissue-type transglutaminase. Circ Res. 2005;96:119–26.
Brassard P, Amiri F, Thibault G, Schiffrin EL. Role of angiotensin type-1 and angiotensin type-2 receptors in the expression of vascular integrins in angiotensin II-infused rats. Hypertension. 2006;47:122–7.
Brassard P, Amiri F, Schiffrin EL. Combined angiotensin II type 1 and type 2 receptor blockade on vascular remodeling and matrix metalloproteinases in resistance arteries. Hypertension. 2005;46:598–606.
Barhoumi T, Mian MOR, Fraulob-Aquino JC, et al. Matrix metalloproteinase-2 knockout prevents angiotensin II-induced endothelial dysfunction and vascular remodeling, oxidative stress and inflammation. Cardiovasc Res. 2017;113:1752–62.
Park JB, Schiffrin EL. Small artery remodeling is the most prevalent (earliest?) form of target organ damage in mild essential hypertension. J Hypertens. 2001;19:921–30.
Intengan HD, Schiffrin EL. Vascular remodeling in hypertension—roles of apoptosis, inflammation, and fibrosis. Hypertension. 2001;38:581–7.
Levy B, Schiffrin EL, Mourad JJ, et al. Impaired tissue perfusion: a pathology common to hypertension, obesity and diabetes. Circulation. 2008;118:968–76.
Rizzoni D, Porteri E, Boari GE, et al. Prognostic significance of small-artery structure in hypertension. Circulation. 2003;108:2230–5.
Marchesi C, Ebrahimian T, Angulo O, Paradis P, Schiffrin EL. Endothelial NO synthase uncoupling and perivascular adipose oxidative stress and inflammation contribute to vascular dysfunction in a rodent model of metabolic syndrome. Hypertension. 2009;54:1384–92.
Deng LY, Li JS, Schiffrin EL. Endothelium-dependent relaxation of small arteries from essential hypertensive patients: mechanisms and comparison with normotensive subjects and with responses of vessels from spontaneously hypertensive rats. Clin Sci. 1995;88:611–22.
Endemann DH, Schiffrin EL. Endothelial dysfunction. J Am Soc Nephrol. 2004;15:1983–92.
Mason JC, Libby P. Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions. Eur Heart J. 2015;36:482–9.
Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens. 2013;31:433–43.
Savoia C, Schiffrin EL. Vascular inflammation in hypertension and diabetes: molecular mechanisms and therapeutic interventions. Clin Sci. 2007;112:375–84.
Hoeppli RE, Wu D, Cook L, Levings MG. The environment of regulatory T cell biology: cytokines, metabolites, and the microbiome. Front Immunol. 2015;6:1–14.
Wilck N, Matus MG, Kearney SM, et al. Salt-responsive gut commensal modulates TH17 axis and disease. Nature. 2017;551:585–9.
Kirabo A, Fontana V, de Faria AP, et al. DC isoketal-modified proteins activate T cells and promote hypertension. J Clin Invest. 2014;124:4642–56.
De Ciuceis C, Amiri F, Brassard P, et al. Reduced vascular remodeling, endothelial dysfunction and oxidative stress in resistance arteries of angiotensin II-infused macrophage colony-stimulating factor-deficient mice: evidence for a role in inflammation in angiotensin-induced vascular injury. Arterioscler Thromb Vasc Biol. 2005;25:2106–13.
Ko EA, Amiri F, Pandey NR, Touyz RM, Schiffrin EL. Resistance artery remodeling in deoxycorticosterone acetate-salt hypertension is dependent on vascular inflammation: evidence from m-csf-deficient mice. Am J Physiol Heart Circ Physiol. 2007;292:H1789–95.
Wenzel P, Knorr M, Kossmann S, et al. Lysozyme M–positive monocytes mediate angiotensin II–induced arterial hypertension and vascular dysfunction. Circulation. 2011;124:1370–81.
Guzik TJ, Hoch NE, Brown KA, et al. Role of the T cell in the genesis of angiotensin II induced hypertension and vascular dysfunction. J Exp Med. 2007;204:2449–60.
Madhur M, Lob HE, McCann LA, et al. Interleukin 17 promotes angiotensin II–induced hypertension and vascular dysfunction. Hypertension. 2010;55:500–5.
Wu J, Thabet SR, Kirabo A, et al. Inflammation and mechanical stretch promote aortic stiffening in hypertension through activation of p38 mitogen-activated protein kinase. Circ Res. 2014;114:616–25.
Norlander AE, Saleh MA, Pandey AK, Itani HA, Wu J, Xiao L, Kang J, Dale BL, Goleva SB, Laroumanie F, Du L, Harrison DG, Madhur MS. A salt-sensing kinase in T lymphocytes, SGK1, drives hypertension and hypertensive end-organ damage. JCI Insight. 2017;2. https://doi.org/10.1172/jci.insight.92801.
Trott DW, Thabet SR, Kirabo A, et al. Oligoclonal CD8+ T cells play a critical role in the development of hypertension. Hypertension. 2014;64:1108–15.
UCSC Human Gene Sorter. http://genome.ucsc.edu/cgi-bin/hgNear. Accessed July 14, 2007.
Viel EC, Lemarié CA, Benkirane K, Paradis P, Schiffrin EL. Immune regulation and vascular inflammation in genetic hypertension. Am J Physiol Heart Circ Physiol. 2010;298:H938–44.
Leibowitz AA, Li MW, Paradis P, Schiffrin EL. Chromosome 2 plays a role in high salt diet-induced hypertension and vascular remodeling in Dahl salt-sensitive rats. Hypertension. 2011;58:e44.
Barhoumi T, Kasal DAB, Li MW, et al. T regulatory lymphocytes prevent angiotensin II-induced hypertension and vascular injury. Hypertension. 2011;57:469–76.
Mian MOR, Barhoumi T, Briet M, Paradis P, Schiffrin EL. Deficiency of T regulatory cells exaggerates angiotensin II-induced microvascular injury by enhancing immune responses. J Hypertens. 2016;34:97–108.
Kasal DA, Barhoumi T, Li MW, et al. Aldosterone-induced hypertension and vascular injury was attenuated by adoptive transfer of T-regulatory lymphocytes. Hypertension. 2012;59:324–30.
Stachon P, Heidenreich A, Merz J, et al. P2X7 deficiency blocks lesional inflammasome activity and ameliorates atherosclerosis in mice. Circulation. 2017;135:2524–33.
Godfrey DI, Uldrich AP, McCluskey J, Rossjohn J, Moody DB. The burgeoning family of unconventional T cells. Nat Immunol. 2015;16:1114–23.
Caillon A, Mian MOR, Fraulob-Aquino JC, et al. Gamma delta T cells mediate angiotensin II-induced hypertension and vascular injury. Circulation. 2017;135:2155–62.
De Ciuceis C, Rossini C, Airo P, et al. Relationship between different subpopulations of circulating CD4+ T-lymphocytes and microvascular structural alterations in humans. Am J Hypertens. 2017;30:51–60.
Chan CT, Sobey CG, Lieu M, et al. Obligatory role for B cells in the development of angiotensin II-dependent hypertension. Hypertension. 2015;66:1023–33.
Markó L, Kvakan H, Park JK, et al. Interferon-γ signaling inhibition ameliorates angiotensin II-induced cardiac damage. Hypertension. 2012;60:1430–6.
Saleh MA, McMaster WG, Wu J, et al. Lymphocyte adaptor protein LNK deficiency exacerbates hypertension and end-organ inflammation. J Clin Invest. 2015;125:1189–202.
Lee DL, Sturgis LC, Labazi H, Osborne JB Jr, Fleming C, Pollock JS, Manhiani M, Imig JD, Brands MW. Angiotensin II hypertension is attenuated in interleukin-6 knockout mice. Am J Physiol Heart Circ Physiol. 2006;290:H935–40.
Ye J, Ji Q, Liu J, et al. Interleukin 22 promotes blood pressure elevation and endothelial dysfunction in angiotensin II–treated mice. J Am Heart Assoc. 2017:e005875. https://doi.org/10.1161/JAHA.117.005875.
Wang L, Zhao XC, Cui W, et al. Genetic and pharmacologic inhibition of the chemokine receptor CXCR2 prevents experimental hypertension and vascular dysfunction. Circulation. 2016;134:1353–68.
Acknowledgments
The work of the author was supported by Canadian Institutes of Health Research (CIHR) grants 37917, 82790, 102606, and 123465 and by the Canada Fund for Innovation and currently by the First Pilot Foundation Grant 143348 from the CIHR and by a Canada Research Chair (CRC) on Hypertension and Vascular Research from the CIHR/Government of Canada CRC Program.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Schiffrin, E.L. (2020). Immune Mechanisms in Vascular Remodeling in Hypertension. In: Agabiti-Rosei, E., Heagerty, A.M., Rizzoni, D. (eds) Microcirculation in Cardiovascular Diseases. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-47801-8_7
Download citation
DOI: https://doi.org/10.1007/978-3-030-47801-8_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-47800-1
Online ISBN: 978-3-030-47801-8
eBook Packages: MedicineMedicine (R0)