The Association of Low-Grade Systemic Inflammation with Hypertensive Retinopathy

Çoban, Erkan; Nizam, Ilknur; Topal, Cansu; Akar, Yusuf

doi:10.3109/10641963.2010.496519

Cited by 25 publications

(16 citation statements)

References 17 publications

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“…This is confirmed by Grunwald and others [7]. Coban and others also suggest a relationship between an inflammatory process and hypertensive retinopathy [13]. Although the pathogenesis of hypertensive retinopathy remains unclear, Coban and others showed a relationship between hypertensive retinopathy and serum levels of Creactive protein, which in turn may be related to low-grade systemic inflammation [13].…”

Section: Hypertensive Crisissupporting

confidence: 59%

“…Coban and others also suggest a relationship between an inflammatory process and hypertensive retinopathy [13]. Although the pathogenesis of hypertensive retinopathy remains unclear, Coban and others showed a relationship between hypertensive retinopathy and serum levels of Creactive protein, which in turn may be related to low-grade systemic inflammation [13]. Arterial sclerosis characterized by "arterio-venous nicking" as described by Gunn, "silver wire arterioles, " and "copper wire arterioles" are signs of chronic hypertension.…”

Section: Hypertensive Crisismentioning

confidence: 99%

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Hypertensive Crisis-A Serious Problem in Medical Practice

Pociej‐Marciak¹,

Karska‐Basta²

2016

J Clin Exp Ophthalmol

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There has recently been a considerable increase in interest in hypertensive crisis-a life-threatening condition. Recent publications indicate that hypertensive crisis is a problem not only in general medicine but also in ophthalmology. Visual disturbances may be the initial symptoms of severe hypertension and can reflect severe systemic changes. It seems appropriate to conduct further studies on the pathogenesis of vascular hypertensive changes, and particularly any associated inflammatory reactions. It also seems justified to introduce screening for hypertensive changes on the eye fundus photographs in emergency departments.Keywords: Hypertensive crisis; Hypertensive urgency; Hypertensive emergency; Hypertensive choroidopathy; Hypertensive retinopathy Hypertensive CrisisHypertensive crisis is a life-threatening condition in which the diastolic pressure usually exceeds 120 mmHg [1,2]. The condition may occur as a hypertensive emergency with target organ damage (brain, heart, kidneys and eyes) or it may occur without target organ damage (hypertensive urgency) [3,4]. Treatment involves lowering blood pressure with antihypertensive agents [3,4].Arriozola-Rodríguez and others presented a twenty-three-year-old patient with sudden bilateral vision loss and hypertensive retinopathy. The patient was diagnosed with hypertensive crisis (his blood pressure was 220/140 mmHg) secondary to chronic renal disease and underwent renal transplantation from a relative [5]. This case was similar to ours of a twenty-five-year-old patient who presented with sudden bilateral reduction in vision associated with chronic kidney failure [1]. This patient was also qualified for a kidney transplant. Aarriozola-Rodríguez and others emphasized that changes in the retinal vasculature may be similar to those in other organs [5,6]. The vascular changes within the kidneys, heart, and retina may have a similar pathogenesis that involves disturbances in endothelial function leading to circulatory dysfunction and reduction of vascular reactivity [5,7]. In our paper, we cited Kovach who described an eighteen-yearold female treated for renal disease secondary to focal segmental glomerulonephritis who developed sudden bilateral visual loss [8]. Kovach reported that glomerulonephritis may be an autoimmune disease although the fundi showed only hypertensive changes and absence of any inflammatory signs [1,8]. However, it should be underlined that clinicopathologic correlations between tissue findings in various organs, including the eyes and kidneys, have already been well-documented. D'Souza and Short claim that the association between high blood pressure and renal and retinal dysfunction is well recognized [9,10]. Both the glomeruli and retina include tiny nets of capillaries. Izzedine and others state that several factors, such as the epithelial growth factor or integrins, which were observed in mouse ocular and renal organogenesis, may later be proven to be important in the development of human eyes and kidneys [11]. Consequently, the authors ...

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Section: Hypertensive Crisissupporting

confidence: 59%

Section: Hypertensive Crisismentioning

confidence: 99%

Hypertensive Crisis-A Serious Problem in Medical Practice

Pociej‐Marciak¹,

Karska‐Basta²

2016

J Clin Exp Ophthalmol

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“…Indeed, exposure of rats to HFD or hypertension, or their combination, significantly triggered retinal TXNIP expression, retinal lipid peroxides and NY levels, the footprint of PN formation, implicating endothelial dysfunction compared with controls (Figs 1, 2). Increased lipid peroxidation and PN generation and endothelial dysfunction were also reported in patients with hypertension-related microvascular changes [36, 37] and in retinas from BBZ rats, an obese and noninsulin-dependent model of diabetes [38], as well as coronary endothelial cells in response to HFD [39, 40]. Nevertheless, this is the first report to demonstrate increases in retinal TXNIP expression in HFD rats, SHR, or their combination.…”

Section: Discussionmentioning

confidence: 70%

Thioredoxin-interacting protein is required for endothelial NLRP3 inflammasome activation and cell death in a rat model of high-fat diet

et al. 2013

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Aims/hypothesis Obesity and hypertension, known pro-inflammatory states, are identified determinants for increased retinal microvascular abnormalities. However, the molecular link between inflammation and microvascular degeneration remains elusive. Thioredoxin-interacting protein (TXNIP) is recognised as an activator of the NOD-like receptor pyrin domain containing-3 (NLRP3) inflammasome. This study aims to examine TXNIP expression and elucidate its role in endothelial inflammasome activation and retinal lesions. Methods Spontaneously hypertensive (SHR) and control Wistar (W) rats were compared with groups fed a high-fat diet (HFD) (W+F and SHR+F) for 8–10 weeks. Results Compared with W controls, HFD alone or in combination with hypertension significantly induced formation of acellular capillaries, a hallmark of retinal ischaemic lesions. These effects were accompanied by significant increases in lipid peroxidation, nitrotyrosine and expression of TXNIP, nuclear factor κB, TNF-α and IL-1β. HFD significantly increased interaction of TXNIP–NLRP3 and expression of cleaved caspase-1 and cleaved IL-1β. Immunolocalisation studies identified TXNIP expression within astrocytes and Müller cells surrounding retinal endothelial cells. To model HFD in vitro, human retinal endothelial (HRE) cells were stimulated with 400 μmol/l palmitate coupled to BSA (Pal-BSA). Pal-BSA triggered expression of TXNIP and its interaction with NLRP3, resulting in activation of caspase-1 and IL-1β in HRE cells. Silencing Txnip expression in HRE cells abolished Pal-BSA-mediated cleaved IL-1β release into medium and cell death, evident by decreases in cleaved caspase-3 expression and the proportion of live to dead cells. Conclusions/interpretation These findings provide the first evidence for enhanced TXNIP expression in hypertension and HFD-induced retinal oxidative/inflammatory response and suggest that TXNIP is required for HFD-mediated activation of the NLRP3 inflammasome and the release of IL-1β in endothelial cells.

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“…Some studies have explored the risk factors for HR, including endothelial dysfunction [10], oxidative stress [11], and low-grade systemic inflammation [12]. However, other risk factors, such as serum triglyceride levels, serum uric acid (SUA) and metabolic syndrome, have been studied with relatively inconclusive results.…”

Section: Introductionmentioning

confidence: 99%

Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive chinese adults

Chen

Meng

et al. 2017

BMC Ophthalmol

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BackgroundThis cross sectional investigation included 12,966 subjects with hypertension, a cohort of the China Stroke Primary Prevention Trial (CSPPT), a randomized, multicenter clinical trial. This study aimed to explore the correlation between serum uric acid (SUA) concentration and hypertensive retinopathy in hypertensive adults.MethodsDiagnosis of hypertensive retinopathy was determined by non-mydriatic fundus photography and classified with Keith-Wagener-Barker (KWB) system. The correlation of SUA levels with hypertensive retinopathy prevalence and severity was assessed by statistical analysis.Results9848 (75.95%) subjects were diagnosed with hypertensive retinopathy with the following retinopathy grade distribution: grade 1: 58.80%, grade 2: 14.81%, and grade 3–4: 2.34%. SUA levels were significantly associated with hypertensive retinopathy prevalence. Patients with hypertensive retinopathy had higher SUA levels than those without hypertensive retinopathy. Patients in the highest uric acid quartile had an odds ratio for hypertensive retinopathy of 1.21 compared to patients in the lowest uric acid quartile (OR = 1.21, 95% CI: 1.05–1.40, P = 0.008). When compared to the non-hyperuricemia group, those in the hyperuricemia group had an odds ratio for hypertensive retinopathy of 1.18(OR = 1.18, 95% CI: 1.05–1.33, P = 0.004). Every 1 mg/dl increase in uric acid concentration was significantly associated with a 6% higher odds of hypertensive retinopathy (OR = 1.06, 95% CI: 1.02–1.10, P = 0.002).ConclusionsThe prevalence of hypertensive retinopathy was high (75.95%) among hypertensives in our patients cohort. In addition, SUA concentration was significantly associated with hypertensive retinopathy.

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The Association of Low-Grade Systemic Inflammation with Hypertensive Retinopathy

Cited by 25 publications

References 17 publications

Hypertensive Crisis-A Serious Problem in Medical Practice

Hypertensive Crisis-A Serious Problem in Medical Practice

Thioredoxin-interacting protein is required for endothelial NLRP3 inflammasome activation and cell death in a rat model of high-fat diet

Serum uric acid concentration is associated with hypertensive retinopathy in hypertensive chinese adults

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