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Cutaneous control of blood pressure
Randall S Johnson1, Jens Titze, Richard Weller
1aDepartment of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK bDivision of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA cInterdisciplinary Center for Clinical Research, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany dUniversity Department of Dermatology, University of Edinburgh, Lauriston Building, Lauriston Place, Edinburgh, UK.
Current Opinion in Nephrology and Hypertension
|December 3, 2015
Summary
The skin regulates blood pressure (BP) through a complex capillary system. Sunlight exposure and skin cell activity, involving nitric oxide and sodium regulation, influence BP, challenging traditional theories.
Area of Science:
- Dermatology
- Cardiovascular Physiology
- Immunology
Background:
- Traditional models identify the brain, blood vessels, and kidneys as primary regulators of blood pressure (BP).
- Emerging research indicates a significant role for the skin in systemic BP control.
Purpose of the Study:
- To explore the skin's role in regulating systemic blood pressure.
- To investigate the mechanisms by which skin influences blood pressure.
Main Methods:
- Review of epidemiological data on sunlight exposure and BP.
- Analysis of the skin's capillary countercurrent system and its role in perfusion and thermoregulation.
- Examination of cellular mechanisms involving keratinocytes, immune cells, nitric oxide, and sodium metabolism.
Main Results:
- The skin possesses a capillary countercurrent system influencing body temperature, skin perfusion, and systemic BP.
- Sunlight exposure, specifically Ultraviolet A radiation, causes vasodilation and lowers BP.
- Keratinocytes and immune cells regulate skin perfusion and BP via nitric oxide production and sodium metabolism, with impaired lymphatic clearance increasing BP.
Conclusions:
- The skin is a significant, previously underappreciated, regulator of systemic blood pressure in humans and animals.
- Mechanisms include nitric oxide-dependent vascular tone control and sodium regulation by skin cells and the lymphatic system.
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