Background: Accumulating evidence indicates that the immune system plays a critical role in the pathogenesis of cardiovascular diseases including hypertension. T helper 17 (Th17) is a recently discovered subgroup of helper T cell characterized by the secretion of interleukin 17 (IL17). It is believed that Th17 may play a role in the pathogenesis of hypertension which is probably caused by the increased plasma IL-23.
Objective: The aim of the work was to assess Th17 cells and plasma IL23 level in patients with uncontrolled grade 2 hypertension.
Patients and method: This study was conducted on 45 subjects divided into 30 primary hypertensive patients (subdivided into Group A: 15 recently diagnosed/uncontrolled patients with grade 2 hypertensive episode, group B: 15 patients with controlled blood pressure) and 15 healthy volunteers.
Result: We found that the mean±SD of IL23 level showed a highly significant difference between the three groups being higher in uncontrolled grade 2 hypertension patients (group A) (3355.1±216.9 pg/ml) than the controlled hypertension group B (2207.5±135.8 pg/ml), and group B was higher than the normal healthy controls (1852.7±73.2 pg/ml) (p <0.0001). The mean±SD of Th17 cells% was highly significantly different between the three groups being higher in uncontrolled grade 2 hypertension patients (group A) (1.27±0.09 %) than the controlled hypertension group B (0.38±0.09%), which in turn was higher than the normal healthy controls (0.15±0.05 %) (p <0.0001).
Conclusion: We conclude that IL23/Th17 axis may be involved in the pathogenesis of hypertension, especially in patients with unexplained grade 2 hypertensive patients experiencing an acute episodes, suggesting a state of ongoing subclinical inflammation.