Open AccessSKIN LYMPHATIC SYSTEM IN THE PATHOGENESIS OF ARTERIAL HYPERTENSION – REVIEW AND CRITIQUE
Author(s) -
Angelika Chachaj,
Andrzej Szuba
Publication year - 2021
Publication title -
lymphology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.21
H-Index - 46
eISSN - 2522-7963
pISSN - 0024-7766
DOI - 10.2458/lymph.4662
Subject(s) - lymphatic system , lymphangiogenesis , homeostasis , pathogenesis , blood pressure , tonicity , medicine , vascular endothelial growth factor c , lymphedema , immunology , lymphatic endothelium , endocrinology , biology , microbiology and biotechnology , vascular endothelial growth factor , vascular endothelial growth factor a , vegf receptors , cancer , breast cancer , metastasis
Although numerous studies have confirmed the relationship between high salt intake and elevated blood pressure, the exact molecular mechanisms of this relationship are still unclear. There is growing evidence that skin interstitium, as well as the skin lymphatic system, are important regulators of both sodium (Na+) balance and blood pressure. Skin is in itself a large reservoir of Na+ ions which are stored in an osmotically inactive form on glycosaminoglycans (GAGs). Local hypertonicity due to extensive accumulation of Na+ within the skin as a result of a high-salt diet was demonstrated to induce macrophages to express a transcription factor termed tonicity-responsive enhancer binding protein (TonEBP) and subsequently to secrete vascular endothelial growth factor-C (VEGF-C), activating lymphangiogenesis within the skin. This regulatory axis seems to be adaptive in maintaining blood pressure in high salt-load states. Recent studies have added new insights into the functioning of lymphatic vessels and the pathogenesis of salt-sensitive hypertension as well as questioned the classic view of Na+ homeostasis. This review aims to summarize recent findings pertaining to the involvement of the skin lymphatic system in Na+ and blood pressure regulation.