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Targeting the immune system to treat hypertension: where are we?

Gooch, Jennifer L.; Sharma, Avadhesh C.

Current Opinion in Nephrology and Hypertension: September 2014 - Volume 23 - Issue 5 - p 473–479
doi: 10.1097/MNH.0000000000000052
PHARMACOLOGY AND THERAPEUTICS: Edited by Adam Whaley-Connell
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Purpose of review Research over the past decade has significantly deepened our understanding of mechanisms that drive the development of hypertension. In particular, a novel paradigm of inflammation as a common mediator of cardiovascular and kidney disease has emerged. This review will summarize the role of the immune system in cardiovascular disease, explore some of the most promising new therapeutic directions and consider their potential as new treatments for hypertension.

Recent findings Recent data continue to demonstrate that targeting the immune system can prevent hypertension in a variety of experimental models. Tempering the enthusiasm for a long-awaited new approach to treating hypertension is decades of clinical data, showing that classic immunosuppression regimens are associated with significant side-effects – including cardiovascular disease – that effectively preclude their use in the setting of chronic hypertension. New, more specific therapies are being developed that target cytokines including IL-17, IL-6 and TNFα.

Summary Preclinical data convincingly demonstrate a key role for the immune system and specific cytokine mediators. Several biotherapeutics targeting these pathways are on the market and more are in development. Side-effects, however, continue to resemble those of classic immunosuppressants, highlighting the challenge of translating these research advances into new therapies for hypertension.

Video abstract http://links.lww.com/CONH/A9

Supplemental Digital Content is available in the text

Department of Pharmaceutical Sciences, Philadelphia College of Osteopathic Medicine, School of Pharmacy, Suwanee, Georgia, USA

Correspondence to Jennifer L. Gooch, PhD, Philadelphia College of Osteopathic Medicine–School of Pharmacy, 625 Old Peachtree Rd NW, Suwanee, GA 30024, USA. Tel: +1 678 407 7357; fax: +1 678 407 7347; e-mail: jennifergooch@pcom.edu

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-nephrolhypertens.com).

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