Hamet
Programmed cell death in vascular disease and hypertension
16th Scientific Meeting of the International Society of Hypertension
ISH Abstract Book (Jun) 16: 1996

This was an excellent lecture made by a first class investigator. Apoptosis, an insidious, physiological type of cell death similar to leaves, is followed by phagocytosis of neighboring cells. Apoptosis probably starts with cell volume shrinkage and cytoskeleton rigidification by g-glutamyl transferase, leading to DNA breakdown via either Ca2+-dependent or Ca2+-independent H+-activated endonucleases. The pro- and antiapoptotic gene pathway involves interleukin-1 b-converting enzyme and p53, balancing the survival signals provided by growth factors such as bcl-2 and v-abl.

Many abnormalities of cell growth have been revealed in hypertension, several of them in the neonatal stage, including heart and kidney hyperplasia (Walter SV. Hypertension, 8: 520, 1986). In vivo, these growth abnormalities are at best exemplified by rarefaction of capillaries and remodeling of vessels. Since an understanding of these processes requires the study of apoptosis in hypertension, Hamet investigated the problem in various animal models and demonstrated an increase of apoptosis in the heart, kidney and brain of genetically-hypertensive rats and mice. Affected cells were myocardiocytes in the heart and in the kidney glomerular mesangial cells. Apoptosis and growth could be dissociated, as demonstrated by g-irradiation which inhibits growth while stimulating apoptosis. Furthermore, apoptotic process could precede hypertrophy. Such a window of apoptosis has been observed after aortic occlusion with an immediate short-lived peak preceding cardiac hypertrophy, specifically in cardiomyocytes.

Comment: This review convincingly shows that the study of apoptosis may substantially contribute to a better understanding of remodeling, rarefaction and hyperplasia which occur in cardiovascular pathology. In addition, investigation of apoptotic pathways will help in the development of new therapeutic targets in hypertension and cardiovascular diseases (Carmine Zoccali, M.D, Reggio Calabria, Italy).

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16th Scientific Meeting of the International Society of Hypertension
H: Pathophysiology : Vascular pathology
H: Pathophysiology : Heart in hypertension