Genetic aspects of ion transport systems in hypertension

Environmental factors, genetic polymorphism and differences in experimental design have been the main impediments to evaluating the evidence for a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. The present paper reviews the results obtained in the Milan hypertensive rat (MHS) and in its corresponding normotensive strain (MNS) in order to illustrate our approach to defining the role of cation transport abnormality in a particular type of genetic hypertension. Kidney cross-transplantation between the strains showed that hypertension is transplanted along with the kidney. Proximal tubular cell volume and sodium content were lower in MHS rats while sodium transport across the brush border membrane vesicles of MHS rats was faster. Erythrocytes of MHS rats have a smaller volume, faster Na,K cotransport and a lower Km for internal sodium compared with MNS rats. The faster cotransport is also present in renal cells of the ascending limb and in vascular muscle cells. Moreover, these erythrocyte abnormalities are genetically associated in F2 hybrids and are primarily determined in the stem cells. These differences in ion transport between MHS and MNS rats are not present when studied in erythrocyte inside-out vesicles, which are deprived of membrane skeletal proteins, suggesting that a molecular abnormality underlies the functional one. We have identified a point mutation of one of these cytoskeletal membrane protein adducin genes in MHS rats. At present we are evaluating the possibility that mutation of the adducin gene in MHS rats might account for the differences in ion transport and, therefore, in blood pressure between the two strains.