TLR2 and TLR4 Gene Expression in Peripheral Monocytes in Nondiabetic Hypertensive Patients: The Effect of Intensive Blood Pressure-Lowering

Abstract

The activation of innate immune receptors, such as Toll-like receptors (TLRs), participates in the pathogenesis of cardiovascular diseases. The authors evaluated TLR2 and TLR4 gene expression in the peripheral monocytes of nondiabetic hypertensive patients compared with normotensive individuals and investigated the effect of intensive systolic blood pressure (SBP)-lowering. Included were 43 nondiabetic hypertensive patients with essential hypertension who were randomly assigned to an intensive treatment arm, with an SBP target of <130mmHg, or a standard arm, with an SBP target of <140mmHg. TLR2 and TLR4 messenger RNA (mRNA) levels in monocytes were estimated before and 12weeks after therapy initiation. Sixteen healthy individuals were included for comparison. Hypertensives revealed significantly higher TLR4 mRNA levels compared with normotensives (985±885 vs 554±234, P=.005). In contrast, no statistically significant difference was found in TLR2. Compared with standard treatment, intensive treatment significantly downregulated TLR2 and TLR4 mRNAs, expressed as fold induction (0.66±0.49 vs 1.38±1.65 and 0.62±0.3 vs 1.9±1.2, respectively; P