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Primary aldosteronism can alter peripheral levels of transforming growth factor β and tumor necrosis factor α

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Abstract

Primary aldosteronism (PA) is the most common secondary cause of hypertension that has recently been implicated in alterations of the immune system and progression of cardiovascular disease. Objective: To study the cytokines transforming growth factor β1 (TGF-β1), tumor necrosis factor α (TNF-α), and interleukin 10 (IL-10) in patients with PA and essential hypertensives (EH) and evaluate its association with the renin-angiotensin-aldosterone system. Patients and methods: We studied 26 PA and 52 EH patients as controls, adjusted by their blood pressure, body mass index, age, and gender. In both groups, PA and EH, we measured serum aldosterone (SA), plasma renin activity (PRA), and cytokines TGF-β1, TNF-α, and IL-10. In addition, 17 PA patients were treated for 6 months with spironolactone, a mineralocorticoid receptor (MR) antagonist. Results: PA patients had lower levels of TGF-β1 (17.6±4.1 vs 34.5±20.5 pg/ml, p<0.001) and TNF-α (17.0±4.4 vs 35.6±21.7 pg/ml, p<0.001) and similar IL-10 levels (99.7±18.7 vs 89.4±49.5 pg/ml, p: ns), as compared with EH controls. TGF-β1 and TNF-α levels showed a remarkable correlation with SA/PRA ratio in the total group (PA+EH). The treatment of PA patients with spironolactone increased the TGF-β1 levels (18.3±5.9 to 28.4±6.3 pg/ml, p<0.001), while TNF-α, and IL-10 remained unchanged. Conclusion: Our results showed that PA patients have lower TGF-β1 and TNF-α cytokine serum levels than EH. TGF-β1 levels were restored with spironolactone, showing a MR-dependent regulation. In this way, the chronic aldosterone excess modifies the TGF-β1 levels, which could produce an imbalance in the immune system homeostasis that may promote an early proinflammatory cardiovascular phenotype.

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Authors and Affiliations

  1. Millennium Nucleus of Immunology and Immunotherapy, Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 85, piso 5, Santiago

    C. A. Carvajal, C. R. Castillo, C. B. Stehr, L. M. Mosso & C. E. Fardella MD

  2. Millennium Nucleus on Immunology and Immunotherapy, Department of Molecular Genetics and Microbiology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile

    C. A. Carvajal, A. A. Herrada, F. J. Contreras, A. M. Kalergis MD & C. E. Fardella MD

  3. Department of Rheumathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    A. A. Herrada, F. J. Contreras & A. M. Kalergis MD

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  1. C. A. Carvajal
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  2. A. A. Herrada
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  3. C. R. Castillo
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  4. F. J. Contreras
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  7. A. M. Kalergis MD
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  8. C. E. Fardella MD
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Correspondence to A. M. Kalergis MD or C. E. Fardella MD.

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These authors contributed equally to this work.

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Carvajal, C.A., Herrada, A.A., Castillo, C.R. et al. Primary aldosteronism can alter peripheral levels of transforming growth factor β and tumor necrosis factor α. J Endocrinol Invest 32, 759–765 (2009). https://doi.org/10.1007/BF03346533

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