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2016 ; 11
(ä): 80-86
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Resistance to renal denervation therapy - Identification of underlying mechanisms
by analysis of differential DNA methylation
#MMPMID28616530
Emschermann F
; Zuern CS
; Patzelt J
; Rizas KD
; Jäger G
; Eick C
; Meuth SG
; Gawaz M
; Bauer A
; Langer HF
Int J Cardiol Heart Vasc
2016[Jun]; 11
(ä): 80-86
PMID28616530
show ga
BACKGROUND: Factors causing resistance to renal denervation (RDN) for treatment
of arterial hypertension are not known. In the current study, we sought to
determine mechanisms involved in responsiveness to renal denervation therapy in
patients with difficult-to-control and resistant hypertension. METHODS AND
RESULTS: We evaluated the differential CpG methylation of genes in blood samples
isolated from patients of a recently described cohort of responders or
non-responders to renal denervation using microarray technique and measured
protein levels of identified downstream effectors in blood samples of these
patients by ELISA. Our analysis revealed up to 6103 methylation sites differing
significantly between non-responders and responders to renal denervation therapy.
Software based analysis showed several of these loci to be relevant for arterial
hypertension and sympathetic nervous activity. Particularly, genes involved in
glutamate synthesis, degradation and glutamate signaling pathways were
differently methylated between both groups. For instance, genes for glutamate
dehydrogenase 1 and 2 central to glutamate metabolism, genes for ionotropic
(AMPA, NMDA) and metabotropic glutamate receptors as well as glutamate
transporters revealed significant differences in methylation correlating with
responsiveness to RDN. To underline their potential relevance for responsiveness
to RDN, we measured plasma protein levels of norepinephrine, a downstream
effector of the glutamate receptor pathway, which were significantly lower in
non-responders to RDN. CONCLUSIONS: The present study describes novel molecular
targets potentially contributing to reduction of blood pressure after RDN in some
patients. Identifying patients with a high responsiveness to RDN could contribute
to an individualized therapy in drug resistant hypertension.