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Immune system deregulation in hypertensive patients chronically RAS suppressed developing albuminuria
Marta Martin-Lorenzo1, Laura Gonzalez-Calero1, Paula J Martinez1
1Departament of Immunology, IIS-Fundacion JimenezDiaz, REDinREN, Madrid, Spain.
Scientific Reports
|August 23, 2017
Summary
Hypertension patients on renin-angiotensin system suppression still develop albuminuria. This study identified urinary proteins linked to albuminuria, revealing immune system alterations and potential therapeutic targets for cardiovascular and renal protection.
Area of Science:
- Nephrology
- Cardiology
- Proteomics
Background:
- Albuminuria in hypertensive patients signals increased cardiovascular risk and kidney damage.
- Renin-angiotensin system (RAS) suppression controls blood pressure but doesn't prevent albuminuria.
Purpose of the Study:
- Identify urinary protein biomarkers associated with albuminuria development in hypertensive patients under RAS suppression.
- Explore the link between immune responses and albuminuria in this patient population.
Main Methods:
- Collected urine from 100 hypertensive patients categorized by albuminuria status (persistent normoalbuminuria, de novo, maintained albuminuria).
- Utilized quantitative proteomics (isobaric labeling) in a discovery cohort and targeted mass spectrometry in an independent validation cohort.
- Identified 2416 proteins and 1223 functional categories.
Main Results:
- Significantly altered immune responses, including immune cell adhesion and phagocytosis, were observed in patients with albuminuria.
- Urinary levels of complement system C3 increased, while Annexin A1, CD44, S100A8, and S100A9 proteins decreased in patients with albuminuria.
- Established links between immune system modulation and albuminuria development in controlled hypertension.
Conclusions:
- Urinary proteomic analysis reveals key immune system alterations in hypertensive patients developing albuminuria despite RAS suppression.
- Identified specific proteins (C3, Annexin A1, CD44, S100A8, S100A9) as potential biomarkers for albuminuria.
- These findings suggest novel therapeutic targets for preventing renal damage and cardiovascular events in hypertensive individuals.
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