Renal TLR-7/ TNF-α pathway as a potential female-specific mechanism in the pathogenesis of autoimmune-induced hypertension

Background: Hypertension is prevalent in patients with systemic lupus erythematosus (SLE). The goal of the current study is to track the pathogenesis of hypertension and renal injury in SLE, identify contributory mechanisms, and highlight differences in disease development amongst sexes. Methods: Mean arterial pressure was measured in conscious male and female SLE (NZBWF1) and control (NZW) mice at 34-35 weeks of age using indwelling arterial catheters. Measures of renal injury, renal inflammation, and renal hemodynamics were used to monitor the potential contributors to latent sex differences. Results: Both male and female SLE mice were hypertensive at 35 weeks of age and the hypertension was linked to renal injury in females, but not in males. A known contributor of renal pathology in SLE, toll-like receptor (TLR)-7, and its downstream effector, the pro-inflammatory cytokine tumor necrosis factor (TNF)-α, were lower in male SLE mice compared to females. Male SLE mice also had higher glomerular filtration rate (GFR) and lower renal vascular resistance (RVR) than females. Conclusion: Our data suggest that while the hypertension in female SLE mice is associated with renal mechanisms, hypertension in male SLE mice may develop independent of renal changes. Future studies will continue to dissect sex-specific factors that should be considered when treating hypertensive patients with underlying chronic inflammation and/or autoimmunity.

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