Salt Taste and Salt Sensitive Hypertension in HIV

Abstract

Purpose of Review:To provide a summary of current literature and propose potential mechanistic models to help us understand the role of HIV infection/antiretroviral therapy (ART), salt taste sensitivity (STS), and salt sensitivity of blood pressure (SSBP) in hypertension development. Recent Findings:The epithelial sodium channel (ENaC) is the main protein/sodium channel for recognizing Na + in the tongue and mediates preference to low-medium salt concentrations in animals and humans. Considering the pressor response to oral salt in individuals with SSBP, poor STS may worsen blood pressure. Specific genetic variants in ENaC are linked to salt taste perception and hypertension. HIV infection, some ART, and specific antihypertensive drugs are associated with reduced STS and an increased liking for salty foods. Summary: Persons with HIV (PWH) on ART may have a decreased STS and are at a higher risk of developing saltsensitive hypertension. Inflammation mediated by dietary salt is one of the drivers of poor STS and saltsensitive hypertension among PWH.Keywords (separated by '-') Salt taste sensitivity -Salt sensitivity of blood pressure -HIV -Hypertension -ENaC Footnote InformationThis article is part of the Topical Collection on Inflammation and Cardiovascular Diseases

Dendritic cell epithelial sodium channel induced inflammation and salt-sensitive hypertension

“…ENaC is also expressed in lingual epithelium and facilitates salt tasting, which may influence sodium intake [ 46 ]. In the colon, it facilitates sodium absorption [ 47 ].…”

“…While various factors contribute to cardiovascular disease in PWH, the relationship between HIV and salt sensitivity has emerged as an intriguing topic. Of note, almost all PWH with hypertension have salt sensitivity [ 46 ]. Although the effects of HIV on ENaC are not well understood, we recently showed that SSBP is more prominent in PWH [ 72 ], and hypothesized that ENaC contributes to vascular dysfunction in this patient population [ 73 ▪ ].…”

HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps

“…These channels in the tongues of both animals and humans are crucial for sensing Na + and influencing our preference for mild to moderate salt levels. 174 Recent evidence suggests that ENaCs may play an important role in increasing the risk for the development or pathogenesis of hypertension in PLWH. For example, one study reported that hypertensive PLWH possessed a high-salt sensitivity compared with normotensive PLWH and PWoH.…”

“…Additionally, anecdotal evidence suggests that certain drugs used in ART regimens may indirectly affect ENaC function. 174,292 While HIV and ART are known to induce oxidative stress, leading to RAAS activation, 126,174,236,[315][316][317] it is important to explore whether certain genetic variations play a role in upregulating ENaC in PLWH. Mutations in ENaC have been associated with both hypertension and hypotension in humans, highlighting its significance in blood pressure regulation.…”

Salt Sensitivity of Blood Pressure

“…SSBP exhibits a strongly heritable trait as evidenced from family studies. Many genetic variants including those in the taste receptor genes (SCNN1), TRPV1 (transient receptor potential cation channel, subfamily V, member 1), 10 genes for β2AR (β2 adrenergic receptor), ESR2 (estrogen receptor-2), SGK1 (serum-and glucocorticoid-inducible kinase-1), AGT (angiotensinogen) and genes involved in the renin-angiotensin aldosterone system, genes of the sympathetic nervous system, β3 subunit of G-protein, renal chloride channels, and genes expressing proteins that normally decrease and those that do not decrease renal sodium transport among others. 11,12 SSBP also depends strongly on inflammation responses.…”