Endoplasmic Reticulum Stress in Hypertension and Salt Sensitivity of Blood Pressure

PURPOSE OF REVIEW

Hypertension is a principal risk factor for cardiovascular morbidity and mortality, with its severity exacerbated by high sodium intake, particularly in individuals with salt-sensitive blood pressure. However, the mechanisms underlying hypertension and salt sensitivity are only partly understood. Herein, we review potential interactions in hypertension pathophysiology involving the immune system, endoplasmic reticulum (ER) stress, the unfolded protein response (UPR), and proteostasis pathways; identify knowledge gaps; and discuss future directions.

RECENT FINDINGS

Recent advancements by our research group and others reveal interactions within and between adaptive and innate immune responses in hypertension pathophysiology. The salt-immune-hypertension axis is further supported by the discovery of the role of dendritic cells in hypertension, marked by isolevuglandin (IsoLG) formation. Alongside these broadened understandings of immune-mediated salt sensitivity, the contributions of T cells to hypertension have been recently challenged by groups whose findings did not support increased resistance of Rag-1-deficient mice to Ang II infusion. Hypertension has also been linked to ER stress and the UPR. Notably, a holistic approach is needed because the UPR engages in crosstalk with autophagy, the ubiquitin proteasome, and other proteostasis pathways, that may all involve hypertension. There is a critical need for studies to establish cause and effect relationships between ER stress and the UPR in hypertension pathophysiology in humans and to determine whether the immune system and ER stress function mainly to exacerbate or initiate hypertension and target organ injury. This review of recent studies proposes new avenues for future research for targeted therapeutic interventions.

LBODP004 The Impact Of Covid-19 On Obesity And Ultra-processed Food Intake In Adolescents And Young Adults: Interim Analysis From The PIE Study

Introduction

A 10% increase in the diet's proportion of ultra-processed foods is associated with a higher risk of abdominal obesity (OR 1. 07, 95% CI 1. 01 to 1.13) as well as visceral obesity (OR 1. 07, 95% CI 1. 02 to 1.13) (Neri, 2022). Given that ultra-processed food intake now comprises 67% of the adolescent diet (Wang, 2021), there is growing interest in the impact of COVID-19 on obesity and ultra-processed food intake in adolescents and young adults.

Methods

This paper presents an interim analysis of the Processed Intake Evaluation (PIE) study enrolling 1800 participants, aged 13-19 years, in the US. The interim data is presented for the first 452 participants in the PIE study. For these participants, we calculated a composite PIE score (Processed Intake Evaluation) score, a scale of 0-100) averaged for consumption of different ultra-processed foods (1) before COVID-19 prior to 2020 (2) during COVID-19 restrictions 2020-2021 (3) after easing of COVID-19 restrictions in 2022.

Results

The participants’ mean age was 16.6±1.1 years, with 53% females. The processed food intake (PIE score) decreased from 56.2 (before COVID-19) to 52.6 (during COVID-19 restrictions) to 48.1 (now with COVID-19 restrictions eased). The respective decrease was 57.9 to 55.5 to 49.1 in male participants and 54.1 to 50.6 to 47.4 in female participants. Next, the study analyzed a panel of 23 behavioral nutritional factors and identified that less processed food stocked at home and fewer opportunities to eat processed food with peers had the highest association with this decrease during COVID-19. Next, we analyzed participants in high/low-risk groups based on obesity and diabetes in the participant or family. The high-risk group showed a muted decrease in ultra-processed food consumption from 57.7 (prior COVID) to 53.3 (COVID restrictions) to 53. 0 (now). In contrast, the low-risk group showed a higher sustained decrease from 55.9 to 52.5 to 47.1. The differential decrease between the two groups was significant (-4.7 vs. -8.8 for the high/low-risk group, p<0. 01).

Conclusion

This study suggests that the ultra-processed food consumption in adolescents has decreased markedly during COVID-19. Further, the decrease has been sustainable and continued its downward trend even after easing pandemic restrictions. This downward trend related to COVID-19 will be confirmed in the final analysis of 1800 patients, however, this early data provides an encouraging signal that expanded research into COVID-19 impact on reduction in ultra-processed foods consumption and obesity may be warranted, and presents a window of opportunity to strengthen further nutritional and behavioral interventions targeted at adolescents and young adults for reducing obesity-related risk factors.

Presentation: No date and time listed

Abstract 111: Proposing A New ‘Gateway Food Model’ For Adolescent Eating Behavior And Its Implications For Modifiable Hypertension Risk Factors

Background: During COVID-19, this study examined data on adolescents' eating habits. It proposes a new 'gateway food model' for ultra-processed foods (UPF). This model shows that certain UPFs when increased (decreased) drive consumption of other UPFs as well. This has important implications for managing hypertension risk factors since studies show that those in the highest tertile of UPF consumption have a higher risk of hypertension (adjusted HR, 1.21; CI, 1.06, 1.37; p = 0.004) (Mendonca, 2016).

Methods: The study enrolled 315 participants aged 13-19 years in Florida, U.S. Participants' PIE scores (Processed Intake Evaluation scores, scale 0-100), were calculated based on averaged consumption of 12 ultra-processed food products. PIE scores, before COVID-19 in 2019, and after COVID-19 restrictions were eased in 2022, were assessed in the study.

Results: The participants’ mean age was 16.2±1.4 years. The study classified participants into UPF+ (n=135) and UPF- (n=180) groups according to whether they increased or decreased their UPF intake during COVID-19. For both groups, a stepwise regression was employed to identify significant factors for change in UPF intake. In the UPF+ group, increased intake of candy, store pastries, or frozen desserts was associated with increased UPF intake across all other UPFs as well (+31.2, +12.0, or +10.5 respective change in PIE score, p<0.01). Correspondingly, in the UPF- group, reduced intake of biscuits, white bread, or processed meat was associated with decreased overall UPF intake across all other UPFs as well (-9.6, -9.4, -8.6 respective change in PIE score, p<0.01).

Conclusions: Hypertension can begin during childhood and may be mediated by a focus on modifiable risk factors such as high UPF intake. These results indicate that for adolescents whose consumption of UPFs has not yet been established, certain gateway UPFs (candy, store pastries, and frozen desserts) should be given priority for preventive dietary interventions since increased intake in these UPFs leads to consumption of all other UPFs as well. In contrast, if an adolescent's UPF eating is already established, other UPFs (biscuits, white bread, or processed meat) can be targeted by dietary interventions as they decrease intake across all other UPFs.

In vitro evaluation of combination of polyenes with EDTA against Aspergillus spp. by different methods (FICI and CI Model)

AIMS

We investigated in vitro activity of polyene drugs (amphotericin B, Amp B; and nystatin, NYS;) in combination with ethylene diamine tetra acetic acid (EDTA) against 8 pathogenic isolates of Aspergillus spp.

METHODS AND RESULTS

The intensity of the drug interactions was assessed using Fractional Inhibitory Concentration Index (FICI) model and Combination Index (CI) model. The interactions were further confirmed by time-kill curve study. The best combination ratio was subjected for toxicity analysis by MTT and haemolytic assay. A significant synergy was found between each of two polyenes with EDTA against Aspergillus fumigatus and Aspergillus flavus at one ratio four. The FICI ranged from 0·29 to 0·38 against A. fumigatus and A. flavus. The FICI value ranged from 0·78 to 1·26 showed no interaction against Aspergillus niger. The CI value (0·21-0·30) and time-kill curve analysis also confirmed synergistic interaction. Antagonism was not detected. There was reduction in toxicity of Amp B and NYS when used with EDTA.

CONCLUSIONS

Subsequently, the chelating agent (EDTA) can be used in combination with Amp B and NYS with increased antifungal potential and reduced toxicity.

SIGNIFICANCE AND IMPACT OF THE STUDY

To emphasize new development in antifungal drug discovery, combination therapy can be used as a tool box to expand drug development.