Skin-specific mechanisms of body fluid regulation in hypertension

Chen, J. Y., Chew, K. S., Mary, S. , Boder, P., Bagordo, D., Rossi, G. P., Touyz, R. M. , Delles, C. and Rossitto, G. (2023) Skin-specific mechanisms of body fluid regulation in hypertension. Clinical Science, 137(3), pp. 239-250. (doi: 10.1042/CS20220609) (PMID:36648486)

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Increasing evidence suggests excess skin Na+ accumulation in hypertension; however, the role of skin-specific mechanisms of local Na+/water regulation remains unclear. We investigated the association between measures of sweat and trans-epidermal water loss (TEWL) with Na+ content in the skin ([Na+]skin) and clinical characteristics in consecutive hypertensive patients. We obtained an iontophoretic pilocarpine-induced sweat sample, a skin punch biopsy for chemical analysis, and measures of TEWL from the upper limbs. Serum Vascular Endothelial Growth Factor-c (VEGF-c) and a reflectance measure of haemoglobin skin content served as surrogates of skin microvasculature. In our cohort (n=90; age 21-86 years; females=49%) sweat composition was independent of sex and BMI. Sweat Na+ concentration ([Na+]sweat) inversely correlated with [K+]sweat and was higher in patients on ACEIs/ARBs (p<0.05). A positive association was found between [Na+]sweat and [Na+]skin, independent of sex, BMI, estimated Na+ intake and use of ACEi/ARBs (padjusted=0.025); both closely correlated with age (p<0.01). Office DBP, but not SBP, inversely correlated with [Na+]sweat independent of other confounders (padjusted=0.03). Total sweat volume and Na+ loss were lower in patients with uncontrolled office BP (padjusted<0.005 for both); sweat volume also positively correlated with serum VEGF-c and TEWL. Lower TEWL was paralleled by lower skin haemoglobin content, which increased less after vasodilatory pilocarpine stimulation when BMI was higher (p=0.010). In conclusion, measures of Na+ and water handling/regulation in the skin were associated with relevant clinical characteristics, systemic Na+ status and blood pressure values, suggesting a potential role of the skin in body-fluid homeostasis and therapeutic targeting of hypertension.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Rossitto, Dr Giacomo and Boder, Philipp and Samji, Dr Sheon and Delles, Professor Christian and Touyz, Professor Rhian
Authors: Chen, J. Y., Chew, K. S., Mary, S., Boder, P., Bagordo, D., Rossi, G. P., Touyz, R. M., Delles, C., and Rossitto, G.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Clinical Science
Publisher:Portland Press
ISSN (Online):1470-8736
Published Online:17 January 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in Clinical Science 137(3): 239-250
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.25430/

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science