Chronic high blood pressure (hypertension) is the most common disease in the Unites States. While several classes of drugs exist to treat it, many patients (up to 10 million Americans) respond poorly to therapy, even when multiple classes are used. Recent evidence suggests that a significant portion of patients will always remain hypertensive despite maximum therapy with the drugs currently available. Therefore, there is a pressing need to develop novel anti-hypertensive agents. One limitation has been the identification of new targets, a limitation that has been overcome by recent insights into the mechanisms underlying monogenic forms of hypertension. The disease Familial Hyperkalemic Hypertension (FHHt) is caused by mutations in With-No-Lysine[K] (WNK) kinases 1 and 4, and in Cullin 3 and Kelch-like 3, components of an E3 ubiquitin ligase complex that promotes WNK kinase degradation. The study of the mechanisms by which this pathway regulates blood pressure has identified several candidates for the development of new anti-hypertensive agents. This pathway is particularly attractive since its inhibition may not only reduce renal reabsorption along multiple segments, but may also reduce vascular tone. Here, we will describe the mechanisms by which this pathway regulate blood pressure, and discuss the potential of targeting it to develop new antihypertensive drugs.
- Na+-Cl- cotransporter
- Copyright © 2016, American Journal of Physiology - Renal Physiology