新研究成果呼应首都医科大高血压病因发现

虽然高血压被确定为心血管疾病的重要危险因素已近50年，但如何预防及有效控制依然是世界性难题，其主要障碍是95%以上的高血压为病因不明的原发性高血压，因此难以进行有效的早期预防和治疗。来自欧洲的研究人员发表了题为“Relation of high cytomegalovirus antibody titers to blood pressure and brachial artery flow-mediated dilation in young men”的文章，又以更大的样本量发现了类似的结果，证明HCMV抗体滴度与收缩压和舒张压都独立相关。

　　

生物通报道：虽然高血压被确定为心血管疾病的重要危险因素已近50年，但如何预防及有效控制依然是世界性难题，其主要障碍是95%以上的高血压为病因不明的原发性高血压，因此难以进行有效的早期预防和治疗。来自首都医科大学附属北京朝阳医院，汕头大学，德国慕尼黑工业大学等处的研究人员在Circulation上发表文章，首次揭示了病毒感染与原发性高血压的关系，而近期在Clinical & Experimental Immunology杂志，来自欧洲的研究人员发表了题为“Relation of high cytomegalovirus antibody titers to blood pressure and brachial artery flow-mediated dilation in young men”的文章，又以更大的样本量发现了类似的结果，证明HCMV抗体滴度与收缩压和舒张压都独立相关。

在首都医科大的研究论文中，研究人员通过临床病例对照研究，首次发现人巨细胞病毒（HCMV）及其编码的microRNA与原发性高血压相关。他们发现，HCMV编码的hcmv-miR-UL112在高血压组较健康对照组上调3倍，并且在另一个独立样本（194名高血压患者和97名健康人）上也得到证实。

进一步研究显示，hcmv-miR-UL112可以抑制下游靶基因干扰素调节因子（interferon regulatory factor 1，IRF-1）和主要组织相容性复合体B（major histocompatibility complex class I polypeptide-related chain B，MICB）的表达，是HCMV感染导致血管损伤和高血压的关键调节分子，也是HCMV病毒能够实现免疫逃逸、在体内长期存活的关键。该课题第一次系统研究了高血压病人的microRNA表达异常，同时也是第一次将病毒microRNA与心血管疾病联系起来，这些证据表明控制病原微生物感染可能为高血压的预防和治疗提供一种新的策略。

这一研究组还将进行全国多中心、大样本前瞻性临床研究，以回答HCMV与高血压病之间的因果关系。另外，由于存在人种的差异，该项研究结果还需要在不同种族间进行验证。

来自欧洲的研究人员使用更大的样本量已发现类似的结果，证明HCMV抗体滴度与收缩压和舒张压都独立相关，该方向的研究提示，高血压病毒病因学研究将对发展新的高血压预防策略和治疗手段具有重要意义。

高血压是我国居民健康的主要威胁，目前全国高血压患者已达2亿人。另外还有3.6亿的高血压前期人群。高血压病也是世界范围的常见病，美国心脏学会（AHA）预计2025年全球高血压病人总数将达15个亿。

（生物通：万纹）

原文摘要：

Relation of high cytomegalovirus antibody titers to blood pressure and brachial artery flow-mediated dilation in young men

Summary
Background: Human cytomegalovirus (CMV) infection is associated with a higher risk of cardiovascular disease in immunocompromised organ transplant patients. It has been linked with the pathogenesis of elevated arterial blood pressure. However, controversy exists whether CMV infection is associated with endothelial function, and little is known about its role as a potential risk factor for early atherosclerosis development at a young age. We aimed to discover if CMV antibody titers are associated with early vascular changes (carotid intima-media thickness, carotid artery distensibility and brachial artery flow-mediated dilation), blood pressure elevation or other traditional cardiovascular risk factors.

Methods: CMV antibody titers were measured in 1,074 women and 857 men (aged 24-39 years) taking part in the Cardiovascular Risk in Young Finns study.

Results: CMV antibody titers were significantly higher in women compared to men. In men, high CMV antibody titers were directly associated with age (p < 0.001) and systolic (p = 0.053) and diastolic (p = 0.002) blood pressure elevation, and inversely associated with flow-mediated dilation (p = 0.014). In women, CMV antibody titers did not associate with any of the analysed parameters. In a multivariate regression model, which included traditional atherosclerotic risk factors, CMV antibody titers were independent determinants for systolic (p = 0.029) and diastolic (p = 0.004) blood pressure elevation and flow-mediated dilation (p = 0.014) in men.

Conclusions: High CMV antibody titers are independently associated with blood pressure and brachial artery flow-mediated dilation in young men. This association supports the hypothesis that common CMV infection and/or an immune response to CMV may lead to impaired vascular function at a young age.