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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Abstract
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 |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| 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: | 0143-5221 |
| 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/researchdata.cab.unipd.it.00000700 |
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