A novel role for myeloid endothelin-B receptors in hypertension

Eur Heart J. 2019 Mar 1;40(9):768-784. doi: 10.1093/eurheartj/ehy881.

Abstract

Aims: Hypertension is common. Recent data suggest that macrophages (Mφ) contribute to, and protect from, hypertension. Endothelin-1 (ET-1) is the most potent endogenous vasoconstrictor with additional pro-inflammatory properties. We investigated the role of the ET system in experimental and clinical hypertension by modifying Mφ number and phenotype.

Methods and results: In vitro, Mφ ET receptor function was explored using pharmacological, gene silencing, and knockout approaches. Using the CD11b-DTR mouse and novel mice with myeloid cell-specific endothelin-B (ETB) receptor deficiency (LysMETB-/-), we explored the effects of modifying Mφ number and phenotype on the hypertensive effects of ET-1, angiotensin II (ANG II), a model that is ET-1 dependent, and salt. In patients with small vessel vasculitis, the impacts of Mφ depleting and non-depleting therapies on blood pressure (BP) and endothelial function were examined. Mouse and human Mφ expressed both endothelin-A and ETB receptors and displayed chemokinesis to ET-1. However, stimulation of Mφ with exogenous ET-1 did not polarize Mφ phenotype. Interestingly, both mouse and human Mφ cleared ET-1 through ETB receptor mediated, and dynamin-dependent, endocytosis. Mφ depletion resulted in an augmented chronic hypertensive response to both ET-1 and salt. LysMETB-/- mice displayed an exaggerated hypertensive response to both ET-1 and ANG II. Finally, in patients who received Mφ depleting immunotherapy BP was higher and endothelial function worse than in those receiving non-depleting therapies.

Conclusion: Mφ and ET-1 may play an important role in BP control and potentially have a critical role as a therapeutic target in hypertension.

Keywords: Endothelin; Hypertension; Myeloid cell.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II / physiology*
  • Animals
  • Disease Models, Animal
  • Endocytosis / physiology
  • Endothelin-1 / physiology*
  • Humans
  • Hypertension / etiology
  • Hypertension / pathology*
  • Hypertension / physiopathology*
  • Macrophages / physiology*
  • Mice
  • Receptor, Endothelin A
  • Receptor, Endothelin B / physiology*

Substances

  • Endothelin-1
  • Receptor, Endothelin A
  • Receptor, Endothelin B
  • Angiotensin II