EditorialH ypertension continues to be a significant worldwide health challenge contributing to the rates of morbidity and mortality related to heart failure, ischemic stroke, renal disease, atherosclerosis, and cardiac hypertrophy. Contributions to hypertension include multiple organs including the kidneys, peripheral vasculature, and the central and autonomic nervous systems. One of the most recent advances in our understanding of underlying factors that influence the development and prevalence of hypertension is the role of the inflammation and the immune system. 2 The role of T cells in the development of hypertension has been demonstrated in number of studies, 3,4 and both hypertensive humans and male animals models of hypertension have shown T-cell accumulation in the kidneys and vasculature.5-7 Furthermore, T cells have been shown to be required for the development of some forms of hypertension. In initial studies using the angiotensin II (Ang II) infusion model of hypertension and a male mouse model lacking lymphocytes because of a deficiency in the recombination activating gene (Rag-1 −/− ), when these mice were infused with Ang II, the level of hypertension was significantly less than that observed in wild-type male mice. 8 When the T cells from a male wild-type donor were given back to the male Rag-1 −/− mice, the hypertensive effects of Ang II were restored, suggesting that Ang II-induced hypertension requires the adaptive immune system and T cells in particular. It should be noted, however, that this effect of T cells to induce hypertension is not present in female animal models 7 and requires using T cells from male donors, 6 suggesting that there are clear sex differences in the role of the immune system in hypertension.
Article, see p 858A recent study by Shah et al 9 aimed at further exposing the role of the immune system and inflammation in the development of hypertension focused on the role of myeloid-derived suppressor cells (MDSCs). The MDSCs are a heterogeneous population of immature myeloid cells that are known to suppress the effects of the adaptive immune system and T-cell responses in particular.10,11 The role of MDSCs in suppressing inflammation-related diseases has a been demonstrated in patients with cancer, 12 autoimmune disease, 13 as well as chronic infection and inflammatory bowel disease.14 Given what we know now about the role of inflammation and T cells in the development of hypertension, this new study offers important and timely insight for the role of MDSCs in the development of hypertension.The study by Shah et al 9 offers a comprehensive and through examination of the effect of MDSCs in 3 different forms of hypertension including Ang II infusion induced hypertension, hypertension induced by giving mice l-n-nitroarginine methyl ester (L-NAME) supplements and also a high-salt model of hypertension. Importantly, all of the mice used in the study were male and so the results can only be extrapolated to the role of MDSCs in males. The authors measured the numbers of peripheral...