Effect Of Aldosterone Level On The Number And Function Of Endothelial Progenitor Cells In Hypertensive Patients

Background:Numerous clinical trials have shown that the protection of endothelial cell function and the recovery of impaired endothelial function are critical to the prevention of coronary heart disease.Hypertension is one of the important risk factors for coronary heart disease and the damage of endothelial cells.The endothelial cell secretes growth factors to activate the mature endothelial cells of the blood vessels and maintain the normal function of blood vessels endothelium.EPCs in circulating also has a preference for the properties of blood vessel or tissue damage,and thus plays an important role in the regeneration of blood vessels and endothelial repair in damaged areas.As downstream factors of RAAS,aldosterone besides secreted by the adrenal cortex zona,also can be synthesized from heart,brain tissue and blood vessels,and previous studies have shown that these organs express aldosterone receptor.The study confirmed the gene expression of aldosterone receptors on EPCs,aldosterone can bind to its receptor and affect the number of EPCs in peripheral blood of patients with primary aldosterone.Thus speculated that patients with high blood pressure in the peripheral blood increased by aldosterone with EPCs aldosterone receptor,activation of oxidative stress and led to a decline in number of EPCs and function,thus affecting vascular endothelial function in patients with hypertension.Aims:The purpose of this study was to investigate the effect of aldosterone concentration to the number,adhesion,migration and other functions of human peripheral blood endothelial cell function(EPCs),clarify the aldosterone and its receptor regulate number and function of EPCs in patients with high blood pressure,explore the mechanism of mobilization and functional improvement of EPCs in patients with coronary heart disease(CHD),and to provide a new approach for the etiological study of coronary heart diseaseMethods:The experience group included 20 cases of hypertensive patients with elevated plasma aldosterone concentration.Human EPCs were isolated as previously described,and their phenotypes were confirmed by uptake of acetylated LDL and binding of ulex-lectin.Adhesion assays and migration assays were used to determine the function of EPCs.The expression level of MR,eNOS,CYP11B2 was detected by qRT-PCR and Western-blot.The concentration of SDF-1 in serum was determined by ELSA assays.Results:Serum SDF-1 level was decrease in hypertensive patients.The migration and adhesion abilities of EPCs were reduced in patients group as well.Consisted with the function assays,the expression level of MR,eNOS,CYP11B2 decreased in hypertensive patients,and the function of EPCs were improved after treated with aldosterone antagonist.Conclusion:The present study indicated that elevated aldosterone level causes reduction and dysfunction of endothelial progenitor cells in hypertensive patients,aldosterone antagonist such as Spironolactone can partly recovered the number and fuction of EPCs in hypertensive patients.