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Angiotensin II, interstitial inflammation, and the pathogenesis of salt-sensitive hypertension

Martha Franco,¹ Flavio Martínez,⁴ Bernardo Rodríguez-Iturbe,² Richard J. Johnson,³ José Santamaría,¹ Angélica Montoya,⁴ Tomas Nepomuceno,¹ Rocío Bautista,¹ Edilia Tapia,¹ and Jaime Herrera-Acosta^1,

¹Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City; ²Hospital Universitario, Instituto de Investigaciones Biomédicas, Universidad del Zulia, Maracaibo, Venezuela; ³Division of Nephrology, Hypertension and Transplantation, University of Florida, Gainesville, Florida; and ⁴Department of Pharmacology, Universidad Autonoma de San Luis Potosi, San Luis Potosi, Mexico

Submitted 16 June 2006 ; accepted in final form 21 July 2006

Transient administration of ANG II causes persistent salt-sensitive hypertension associated with arteriolopathy, interstitial inflammation, and cortical vasoconstriction; blocking the vascular and inflammatory changes with mycophenolate mofetil (MMF) prevents vasoconstriction. While infiltrating leukocytes during the salt-sensitive hypertension phase express ANG II, the functional role of ANG II during this phase is not known. We examined the acute effect of candesartan on renal hemodynamics during the established salt-sensitive hypertensive phase and related these findings to direct measurement of intrarenal ANG II and inflammatory cells in rats previously exposed to ANG II with or without MMF treatment. Sham controls were also examined. The administration of ANG II, followed by exposure to high-salt diet, resulted in hypertension, cortical vasoconstriction, an increase in interstitial inflammatory cells (44.8 ± 1.3 lymphocytes/mm², and 30.8 ± 1.2 macrophages/mm² ANG II vs. 19.6 ± 2 lymphocytes/mm², and 22 ± 0.7 macrophages/mm² Sham), and increase in renal ANG II levels (1,358 ± 74.6 pg/ml ANG II vs. 194 ± 9.28 pg/ml Sham). Treatment with MMF during the administration of exogenous ANG II resulted in reduction in renal interstitial inflammation (19.7 ± 0.9 lymphocytes/mm² and 15.9 ± 0.8 machophages/mm²), ANG II levels (436.9 ± 52.29 pg/ml), cortical vasoconstriction, and stable blood pressure levels during the subsequent challenge with a high-salt diet. Acute administration of candesartan similarly reduced renal vasoconstriction and blood pressure. We conclude that the cortical vasoconstriction occurring with salt-sensitive hypertension following exposure to ANG II is mediated by intrarenal ANG II, related, at least in part, to the interstitial inflammation.

renal hemodynamics; candesartan; AT₁ angiotensin II receptor blockade

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