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Fibulin 2 Deficiency Drives Epigenetic Hypertension. 纤维蛋白2缺乏驱动表观遗传性高血压。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-29 DOI: 10.1161/hypertensionaha.125.25803
Xiaobin Han,Zhongjie Sun
BACKGROUNDAlthough epigenetic modification of histone in embryonic development is well documented, its mechanistic role in the pathogenesis of hypertension is poorly understood. The purpose of this study is to investigate how histone 3 modification (H3K27me3 [trimethylation of histone 3 lysine 27]) in renal tubule cells regulates sodium excretion and blood pressure.METHODSA mouse model of inducible renal tubule cell-specific deletion of KDM6A cKO (histone 3 lysine 27 demethylase 6A gene) was generated.RESULTSHere, we uncovered the potential role of FBLN2 (fibulin 2) in the pathogenesis of epigenetic hypertension due to KDM6A cKO. KDM6A is a specific demethylase for H3K27me3. ChIP-seq analysis revealed that the H3K27me3 mark was increased in the promoter region of the FBLN2 gene, resulting in downregulation of FBLN2 protein expression in the kidney of KDM6A cKO mice. Treatment with rFBLN2 (recombinant FBLN2) largely attenuated blood pressure elevation, rescued impairment in sodium excretion, and prevented high salt-induced salt-sensitive hypertension in KDM6A cKO mice. Mechanistically, treatment with rFBLN2 rescued upregulation of NCC (Na-Cl cotransporter) and AQP2 (aquaporin 2) expression and decreased NKCC2 expression in renal tubular cells in the KDM6A cKO hypertensive mice. Intriguingly, FBLN2 may regulate NCC trafficking via forming an FBLN2/NCC complex, which decreases the cell membrane abundance of NCC by translocating NCC to the total membrane in distal convoluted tubule cells.CONCLUSIONSThese findings highlight a critical role of FBLN2 in the regulation of renal sodium excretion and blood pressure and suggest that FBLN2 deficiency may drive KDM6A deficiency-induced epigenetic hypertension. FBLN2 treatment may provide a new preventive and therapeutic strategy for salt-sensitive hypertension.
虽然胚胎发育过程中组蛋白的表观遗传修饰已被证实,但其在高血压发病机制中的作用尚不清楚。本研究旨在探讨肾小管细胞组蛋白3修饰(H3K27me3[组蛋白3赖氨酸27的三甲基化])如何调节钠排泄和血压。方法建立诱导肾小管细胞特异性缺失KDM6A cKO(组蛋白3赖氨酸27去甲基化酶6A基因)小鼠模型。结果本研究揭示了FBLN2(纤连蛋白2)在KDM6A cKO所致的表观遗传性高血压发病机制中的潜在作用。KDM6A是H3K27me3的特异性去甲基化酶。ChIP-seq分析显示,FBLN2基因启动子区域H3K27me3标记增加,导致KDM6A cKO小鼠肾脏中FBLN2蛋白表达下调。在KDM6A cKO小鼠中,用rFBLN2(重组FBLN2)治疗可显著降低血压升高,恢复钠排泄障碍,并预防高盐诱导的盐敏感性高血压。在机制上,rFBLN2治疗可挽救KDM6A cKO高血压小鼠肾小管细胞中NCC (Na-Cl共转运蛋白)和AQP2(水通道蛋白2)表达上调,并降低NKCC2表达。有趣的是,FBLN2可能通过形成FBLN2/NCC复合物来调节NCC的转运,FBLN2/NCC复合物通过将NCC转运到远曲小管细胞的总膜中来降低NCC的细胞膜丰度。结论FBLN2在调节肾钠排泄和血压中的重要作用,提示FBLN2缺乏可能驱动KDM6A缺乏诱导的表观遗传性高血压。FBLN2治疗可能为盐敏感性高血压提供新的预防和治疗策略。
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引用次数: 0
Genetic Dissection of Plasma Proteins and Blood Pressure in Small Vessel Disease. 小血管疾病血浆蛋白与血压的遗传解剖。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-29 DOI: 10.1161/hypertensionaha.125.25608
Yaoyao Yu,Tianyi Xia,Yinlu Wang,Keli Qin,Lingling Gao,Ben Zhao,Junhao Zha,Jiaying Zhou,Ying Cui,Chunqiang Lu,Tianyu Tang,Zebin Xiao,Shenghong Ju
BACKGROUNDWhite matter hyperintensities (WMH), a hallmark imaging feature of small vessel disease, are strongly associated with neurodegenerative and cardiovascular conditions.METHODSWe performed bidirectional and mediation Mendelian randomization analyses using summary statistics from GWAS (genome-wide association studies) of 9 large cohorts of plasma proteins (n=997-35 559), blood pressure (n=1 028 980), and WMH (n=21 381). The inverse-variance-weighted method or Wald ratio was applied as the primary Mendelian randomization approach, with false discovery rate correction and independent replication. We further integrated Mendelian randomization with PheWAS (phenome-wide association studies) to prioritize WMH risk factors and assess mediation via systolic blood pressure and diastolic blood pressure.RESULTSEighteen plasma proteins were genetically associated with WMH, 13 of which were replicated. Thirteen antihypertensive target genes were also linked to WMH burden, including ADRB3, AOC1 (amine oxidase copper containing 1), SHBG (sex hormone binding blobulin), and KCNH2 (potassium voltage-gated channel subfamily H member 2), which influenced both systolic blood pressure and diastolic blood pressure. Mendelian randomization-PheWAS highlighted systolic blood pressure and diastolic blood pressure as the top-ranked WMH risk factors among 21 976 traits. Antihypertensive drug targets, including angiotensin II receptor blockers, β-blockers, calcium channel blockers, and diuretics, were significantly associated with WMH burden. Mediation analysis showed that systolic blood pressure partially mediated TFPI's effect (3.04%), and diastolic blood pressure mediated the effects of ACP1 (acid phosphatase 1) (2.74%) and LAMC1 (laminin subunit gamma 1; 4.94%).CONCLUSIONSThe findings outline protein- and blood pressure-centered mechanisms in small vessel disease, highlighting proteins and antihypertensive targets as biomarkers and therapeutic entry points for precision intervention.
背景:白质高信号(WMH)是小血管疾病的标志性影像学特征,与神经退行性疾病和心血管疾病密切相关。方法采用GWAS(全基因组关联研究)的汇总统计数据,对血浆蛋白(n=997-35 559)、血压(n=1 028 980)和WMH (n=21 381)进行双向和中介孟德尔随机化分析。反方差加权法或瓦尔德比被用作主要的孟德尔随机化方法,具有错误发现率校正和独立复制。我们进一步将孟德尔随机化与PheWAS(全现象关联研究)结合起来,确定WMH危险因素的优先级,并通过收缩压和舒张压评估其介导作用。结果18个血浆蛋白与WMH基因相关,其中13个被复制。13个降压靶基因也与WMH负担相关,包括ADRB3、AOC1(胺氧化酶含铜1)、SHBG(性激素结合球蛋白)和KCNH2(钾电压门控通道亚家族H成员2),这些基因影响收缩压和舒张压。孟德尔随机化- phewas强调收缩压和舒张压是21,976个特征中排名最高的WMH危险因素。降压药物靶点,包括血管紧张素II受体阻滞剂、β受体阻滞剂、钙通道阻滞剂和利尿剂,与WMH负担显著相关。中介分析显示,收缩压部分介导TFPI的作用(3.04%),舒张压介导ACP1(酸性磷酸酶1)(2.74%)和LAMC1(层粘连蛋白亚基γ - 1)的作用(4.94%)。结论:研究结果概述了小血管疾病中以蛋白质和血压为中心的机制,强调了蛋白质和降压靶点作为精确干预的生物标志物和治疗切入点。
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引用次数: 0
Degree of Cyclooxygenase-2 Inhibition Modulates Blood Pressure Response. 环氧化酶-2抑制程度调节血压反应。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-29 DOI: 10.1161/hypertensionaha.124.25516
Katherine N Theken,Soumita Ghosh,Carsten Skarke,Susanne Fries,Nicholas F Lahens,Dimitra Sarantopoulou,Gregory R Grant,Garret A FitzGerald,Tilo Grosser
BACKGROUNDLarge clinical trials compared distinct nonsteroidal anti-inflammatory drugs in terms of their risk of adverse cardiovascular events. However, whether pharmacologically equipotent doses were used, that is, whether a similar degree of COX (cyclooxygenase)-2 inhibition was achieved, was not considered. We compared drug target inhibition and blood pressure (BP) response to celecoxib and naproxen.METHODSSixteen healthy participants were treated with celecoxib (200 mg/d), naproxen (500 mg/d), or placebo for 7 days in a double-blind, crossover design. The degree of COX inhibition was assessed ex vivo using established whole blood assays and in vivo by quantifying urinary metabolites of thromboxane A2 (COX-1) and prostacyclin (COX-2). Ambulatory BP was measured throughout the final dosing interval.RESULTSBoth nonsteroidal anti-inflammatory drugs inhibited COX-2 activity relative to placebo, but naproxen inhibited COX-2 activity to a greater degree (62.9±21.7%) than celecoxib (35.7±25.2%; P<0.05). Similarly, naproxen treatment inhibited prostacyclin formation in vivo (48.0±24.9%) to a greater degree than celecoxib (26.7±24.6%; P<0.05). Naproxen significantly increased BP compared with celecoxib (mean arterial pressure, 2.5 [95% CI, 1.5-3.5] mm Hg; systolic BP, 4.0 [95% CI, 2.9-5.1] mm Hg; and diastolic BP, 1.8 [95% CI, 0.8-2.8] mm Hg; P<0.05 for all). The difference in systolic BP relative to placebo was associated with the degree of COX-2 inhibition (P<0.05).CONCLUSIONSFuture studies should consider pharmacokinetic and pharmacodynamic properties, as well as patient-specific factors that may modulate the cardiovascular risk of nonsteroidal anti-inflammatory drug use.
背景:大型临床试验比较了不同的非甾体类抗炎药的不良心血管事件风险。然而,没有考虑是否使用药理学上等效的剂量,即是否达到相似程度的COX(环氧化酶)-2抑制。我们比较了塞来昔布和萘普生的药物靶标抑制和血压(BP)反应。方法采用双盲交叉设计,16名健康受试者接受塞来昔布(200 mg/d)、萘普生(500 mg/d)或安慰剂治疗7天。在体外通过建立全血测定法评估COX抑制程度,在体内通过量化血栓素A2 (COX-1)和前列环素(COX-2)的尿液代谢物来评估COX抑制程度。在最后给药期间测量动态血压。结果两种非甾体类抗炎药均较安慰剂抑制COX-2活性,但萘普生抑制COX-2活性的程度(62.9±21.7%)高于塞来昔布(35.7±25.2%,P<0.05)。同样,萘普生对体内前列环素形成的抑制程度(48.0±24.9%)高于塞来昔布(26.7±24.6%,P<0.05)。与塞来昔布相比,萘普生显著升高血压(平均动脉压,2.5 [95% CI, 1.5-3.5] mm Hg;收缩压,4.0 [95% CI, 2.9-5.1] mm Hg;舒张压,1.8 [95% CI, 0.8-2.8] mm Hg; P<0.05)。收缩压与安慰剂的差异与COX-2抑制程度相关(P<0.05)。结论未来的研究应考虑药代动力学和药效学特性,以及可能调节非甾体抗炎药使用心血管风险的患者特异性因素。
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引用次数: 0
Partially Successful Adrenal Vein Sampling With and Without Cross-Sectional Imaging in Primary Aldosteronism Subtyping. 在原发性醛固酮增多症亚型中,有或没有横断面成像的肾上腺静脉取样部分成功。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-18 DOI: 10.1161/hypertensionaha.125.26149
Peeradon Vibhatavata,Livia M Mermejo,Lili Zhao,James J Shields,Adina F Turcu
BACKGROUNDAdrenal vein (AV) sampling (AVS) is used to guide therapy in primary aldosteronism (PA). When a single AV is successfully cannulated, the relative aldosterone secretion index (RASI), which compares the aldosterone/cortisol ratio in that AV versus the periphery, has been proposed as sufficient for PA subtyping, particularly when <1. Data on RASI reliability have, however, been inconsistent.METHODSThis retrospective cohort study included patients with PA who underwent AVS before and after cosyntropin stimulation at a referral center between January 2015 and December 2024. To simulate partially successful AVS, RASI was calculated from patients with successful bilateral AV cannulation and compared across PA subtypes and postoperative outcomes, with assessment of distributional overlap.RESULTSOf 460 patients (mean age 53±12 years; 58% men), bilateral AVS was successful in 437 patients at baseline and in all patients after cosyntropin stimulation. Without cosyntropin, 98% of dominant AV and 97% of nondominant AV RASI from lateralized PA overlapped with bilateral PA RASI. Similar patterns were observed postcosyntropin. In adrenalectomized patients, RASI did not distinguish between those with and without PA cure. Previously proposed RASI thresholds misclassified up to 74% of lateralized PA and 64% of bilateral PA. When corroborated with cross-sectional imaging, the prediction of correct lateralization improved, particularly when using RASI from cosyntropin-stimulated AVS.CONCLUSIONSConsidering the substantial overlap of RASI across PA subtypes, partially successful AVS has limited utility and is unreliable in guiding adrenalectomy for PA.
肾静脉(AV)取样(AVS)用于指导原发性醛固酮增多症(PA)的治疗。当单个AV成功插管时,相对醛固酮分泌指数(RASI),即比较AV与周围的醛固酮/皮质醇比值,已被认为足以用于PA亚型,特别是当<1时。然而,关于RASI可靠性的数据并不一致。方法本回顾性队列研究纳入2015年1月至2024年12月在转诊中心接受共syntropin刺激前后AVS的PA患者。为了模拟部分成功的AVS,从成功的双侧房室插管患者中计算RASI,并比较不同PA亚型和术后结果,并评估分布重叠。结果460例患者(平均年龄53±12岁,58%为男性)中,437例患者在基线时双侧AVS成功,所有患者在共syntropin刺激后均成功。在不使用共syntropin的情况下,侧侧PA的98%的显性AV和97%的非显性AV RASI与双侧PA RASI重叠。在共syntropin后观察到类似的模式。在肾上腺切除术患者中,RASI不区分PA治愈与否。先前提出的RASI阈值错误分类高达74%的侧侧PA和64%的双侧PA。当与横断成像相证实时,预测正确的侧化得到改善,特别是当使用促心性激素刺激的AVS的RASI时。结论考虑到各种PA亚型之间RASI的大量重叠,部分成功的AVS在指导PA肾上腺切除术方面的作用有限,且不可靠。
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引用次数: 0
GWAS and Replication Analysis of Apparent Treatment-Resistant Hypertension. 明显难治性高血压的GWAS和复制分析。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.25719
Joseph E Ebinger,Anni Kauko,Felix Vaura,Paul Hage,Johan Sundström,Sandy Y Joung,Susan Cheng,Teemu Niiranen,
BACKGROUNDResistant hypertension (RH), in which blood pressure remains elevated on ≥3 medications or controlled on ≥4 medications, increases the risk of adverse cardiovascular events nearly 50% more than primary hypertension. We sought to identify genetic drivers of RH in a reliable and generalizable manner.METHODSWe utilized FinnGen (discovery) and UKBB (UK Biobank, replication) data sets to identify potential genetic drivers of RH. Using standard RH definitions, we developed cohorts in each data set and performed genome-wide (genome-wide association studies) and transcriptome-wide association studies, as well as Mendelian randomization analysis to evaluate potential causal associations.RESULTSWe replicated 5 genetic loci in CASZ1, WNT2B, KCNK3, LSP1, and near the EVX1/EVX1AS locus for RH. Of these, CASZ1 and WNT2B are strongly associated with aldosterone homeostasis, while KCNK3 and LSP1 are associated with pathways mediating vasodilation. EVX1/EVX1AS are involved in mesendodermal lineage differentiation during gastrulation. Gene- and pathway-based analyses identified associations with vascular and cardiac developmental pathways in addition to aldosterone synthesis and secretion pathways. Transcriptome-wide association study analyses identified 37 genes, of which the genetically regulated expression is associated with RH, with particularly strong tissue-specific associations with KCNK3. Finally, Mendelian randomization identified possible causal association for 4 vascular risk factors (CRP [C-reactive protein]), triglycerides, waist circumference, and body mass index) with RH, with strong associations with identified lead variants.CONCLUSIONSWe identified distinct genetic variants associated with RH, including those implicating the role of hyperaldosteronism, highlighting distinct pathways and targets for more effectively treating RH.
背景:顽固性高血压(RH),即在使用≥3种药物时血压保持升高或在使用≥4种药物时血压得到控制,其不良心血管事件发生的风险比原发性高血压高近50%。我们试图以可靠和可推广的方式确定RH的遗传驱动因素。方法利用FinnGen (discovery)和UKBB (UK Biobank, replication)数据集来确定RH的潜在遗传驱动因素。使用标准RH定义,我们在每个数据集中建立了队列,并进行了全基因组(全基因组关联研究)和转录组关联研究,以及孟德尔随机化分析来评估潜在的因果关系。结果我们在RH的CASZ1、WNT2B、KCNK3、LSP1和EVX1/EVX1AS位点附近复制了5个基因座。其中,CASZ1和WNT2B与醛固酮稳态密切相关,而KCNK3和LSP1与介导血管舒张的途径相关。EVX1/EVX1AS参与原肠胚形成过程中中胚层谱系的分化。基于基因和通路的分析发现除了醛固酮合成和分泌途径外,还与血管和心脏发育途径有关。转录组关联研究分析鉴定了37个基因,其中基因调控表达与RH相关,与KCNK3具有特别强的组织特异性关联。最后,孟德尔随机化确定了4种血管危险因素(CRP [c -反应蛋白])、甘油三酯、腰围和体重指数)与RH之间可能的因果关系,这些因素与已确定的铅变异有很强的相关性。结论:我们发现了与RH相关的不同遗传变异,包括那些涉及高醛固酮增多症的基因变异,强调了更有效治疗RH的不同途径和靶点。
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引用次数: 0
Like a Rolling Tone: Ablating LRRC8A Eases Inflammation and Keeps Vessels Moving. 像一个滚动的声音:消融LRRC8A缓解炎症并保持血管流动。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.26261
Stanislovas S Jankauskas,Urna Kansakar,Pasquale Mone,Fahimeh Varzideh,Gaetano Santulli
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引用次数: 0
Kininogen Deficiency Elevates Blood Pressure in Mice. 运动原缺乏会使小鼠血压升高。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.26043
Yusuke Ohnaka,Ryusho Kariya,Satoshi Tsukamoto,Michiko Hamada-Kanazawa,Masaoki Takano
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引用次数: 0
What It Takes for Food to Be Medicine: Lessons From the Rice Diet Era. 如何让食物成为药物:大米饮食时代的教训。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.26151
Olivier Steichen
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引用次数: 0
Pointing Care for Preeclampsia in the Right Direction. 子痫前期的指向性护理。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.25649
Elizabeth Lemoine,Ravi Thadhani
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引用次数: 0
Professor Graham A. MacGregor, CBE, MBBS, FRCP, FMedSci (1941-2025). Graham A. MacGregor教授,CBE, MBBS, FRCP, FMedSci(1941-2025)。
IF 8.3 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2025-12-17 DOI: 10.1161/hypertensionaha.125.26182
Pauline A Swift,Feng J He,Mark J Caulfield
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引用次数: 0
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Hypertension
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