Vol 70, No 1 (2019)
Original paper
Published online: 2018-10-25

open access

Page views 2542
Article views/downloads 1086
Get Citation

Connect on Social Media

Connect on Social Media

Endothelin-1 (ET-1), N-terminal fragment of pro-atrial natriuretic peptide (NTpro-ANP), and tumour necrosis factor alpha (TNF-α) in children with primary hypertension and hypertension of renal origin

Beata Banaszak1, Elżbieta Świętochowska2, Paweł Banaszak3, Katarzyna Ziora1
Pubmed: 30359461
Endokrynol Pol 2019;70(1):37-42.

Abstract

Introduction: Hypertension is regarded as a condition of mild inflammation and endothelial imbalance. The aim of the study was to evaluate serum concentrations of biomarkers of inflammation and endothelial function: tumour necrosis factor alpha (TNF-α), endothelin-1 (ET-1), and N-terminal fragment of pro-atrial natriuretic peptide (NTpro-ANP) in hypertensive and normotensive children.
Material and methods: We studied 63 children aged 13.56 ± 3.73 years, divided into two groups: a group with primary hypertension (n = 50) and a group with renal hypertension (n = 13). The control group consisted of 34 normotensive children aged 12.76 ± 3.96 years. Biomarkers were measured with ELISA tests.
Results: ET-1 levels were significantly higher in primary hypertension (9.93 ± 1.73 pg/ml) and renal hypertension (10.77 ± 1.50 pg/ml) in comparison to controls (4.03 ± 0.97 pg/ml), (p < 0.001, p < 0.001, respectively). NT-pro ANP concentrations in primary hypertension (71.03 ± 10.02 pg/ml), and renal hypertension (84.78 ± 6.44 pg/ml) were significantly higher than in the control group (29.62 ± 5.56 pg/ml) (p < 0.001, p < 0.001, respectively). TNF-α concentrations in primary hypertension (8.36 ± 1.60 pg/ml) and renal hypertension (7.35 ± 0.93 pg/ml) significantly exceeded concentrations in controls (4.49 ± 0.93 pg/ml), (p < 0.001, p < 0.001, respectively). ET-1 and NT-pro ANP concentrations in renal hypertension significantly exceeded those in primary hypertension (p = 0.049, p < 0.001, respectively) while TNF-α levels in renal hypertension were significantly lower than in primary hypertension (p = 0.046).
Conclusions: The results of our study show that ET-1, NT-pro ANP, and TNF-a concentrations are increased in hypertension in children.
Our investigation indicates significant importance of inflammation and endothelial involvement in hypertension in youth.

Article available in PDF format

View PDF Download PDF file

References

  1. Falkner B. Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol. 2010; 25(7): 1219–1224.
  2. Bautista LE. Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence. J Hum Hypertens. 2003; 17(4): 223–230.
  3. Mehaffey E, Majid DSA. Tumor necrosis factor-α, kidney function, and hypertension. Am J Physiol Renal Physiol. 2017; 313(4): F1005–F1008.
  4. Ramseyer VD, Garvin JL. Tumor necrosis factor-α: regulation of renal function and blood pressure. Am J Physiol Renal Physiol. 2013; 304(10): F1231–F1242.
  5. Virdis A, Schiffrin EL. Vascular inflammation: a role in vascular disease in hypertension? Curr Opin Nephrol Hypertens. 2003; 12(2): 181–187.
  6. Meyers KEC, Sethna C. Endothelin antagonists in hypertension and kidney disease. Pediatr Nephrol. 2013; 28(5): 711–720.
  7. Kostov K, Blazhev A, Atanasova M. Serum Concentrations of Endothelin-1 and Matrix Metalloproteinases-2, -9 in Pre-Hypertensive and Hypertensive Patients with Type 2 Diabetes. Int J Mol Sci. 2016; 17(8).
  8. Suzuki T, Yamazaki T, Yazaki Y. The role of the natriuretic peptides in the cardiovascular system. Cardiovasc Res. 2001; 51(3): 489–494.
  9. Mussalo H, Vanninen E, Ikäheimo R, et al. NT-proANP and BNP in renovascular and in severe and mild essential hypertension. Kidney Blood Press Res. 2003; 26(1): 34–41..
  10. Lurbe E, Agabiti-Rosei E, Cruickshank JK. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016; 34(10): 1887–1920.
  11. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(2 Suppl): 555–576.
  12. Kułaga Z, Litwin M, Grajda A, et al. Rozkłady wartości ciśnienia krwi w populacji referencyjnej dzieci i młodzieży w wieku szkolnym [Blood Pressure Trends in Children and Adolescents: Predictors of Blood Pressure Elevation in Children and Adolescents]. Standardy Medyczne Pediatria. 2010; 7(5/6): 853–864.
  13. Urbina E, Alpert B, Flynn J, et al. American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee. Ambulatory blood pressure monitoring in children and adolescents: recommendations for standard assessment: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the council on cardiovascular disease in the young and the council for high blood pressure research. Hypertension. 2008; 52(3): 433–451.
  14. Wühl E, Witte K, Soergel M. Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens. 2002; 20(10): 1995–2007.
  15. Kułaga Z, Litwin M, Tkaczyk M. Polish 2010 growth references for school-aged children and adolescents. Eur J Pediatr. 2011; 170(5): 599–609.
  16. Schwartz GJ, Muñoz A, Schneider MF. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009; 20(3): 629–637.
  17. Baumann H, Gauldie J. The acute phase response. Immunol Today. 1994; 15(2): 74–80.
  18. Wang TJ, Gona P, Larson MG. Multiple biomarkers and the risk of incident hypertension. Hypertension. 2007; 49(3): 432–438.
  19. Bautista LE, Vera LM, Arenas IA, et al. Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension. J Hum Hypertens. 2005; 19(2): 149–154.
  20. Głowińska B, Urban M. Wybrane cytokiny (IL-6, IL-8, IL-10, MCP-1, TNF-alpha) u dzieci i młodzieży obarczonych tradycyjnymi czynnikami ryzyka miażdżycy: otyłością, nadciśnieniem, cukrzycą [Selected cytokines (Il-6, Il-8, Il-10, MCP-1, TNF-alpha) in children and adolescents with atherosclerosis risk factors: obesity, hypertension, diabetes]. Wiad Lek. 2003; 56(3-4): 109–116.
  21. Paradis G, Lambert M, O'Loughlin J. Blood pressure and adiposity in children and adolescents. Circulation. 2004; 110(13): 1832–1838.
  22. Sarzani R, Salvi F, Dessì-Fulgheri P. Renin–angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. J Hypertens. 2008; 26(5): 831–843.
  23. Zhen H, Gui F. The role of hyperuricemia on vascular endothelium dysfunction. Biomed Rep. 2017; 7(4): 325–330.
  24. Riwanto M, Landmesser U. High density lipoproteins and endothelial functions: mechanistic insights and alterations in cardiovascular disease. J Lipid Res. 2013; 54(12): 3227–3243.
  25. Kohan DE, Rossi NF, Inscho EW. Regulation of blood pressure and salt homeostasis by endothelin. Physiol Rev. 2011; 91(1): 1–77.
  26. Dhaun N, Goddard J, Kohan DE, et al. Role of endothelin-1 in clinical hypertension: 20 years on. Hypertension. 2008; 52(3): 452–459.
  27. Dong F, Zhang X, Wold LE. Endothelin-1 enhances oxidative stress, cell proliferation and reduces apoptosis in human umbilical vein endothelial cells: role of ETB receptor, NADPH oxidase and caveolin-1. Br J Pharmacol. 2005; 145(3): 323–333.
  28. Demerath T, Staffel J, Schreiber A. Natriuretic peptides buffer renin-dependent hypertension. Am J Physiol Renal Physiol. 2014; 306(12): F1489–F1498.