The applicant, Dr. Madhur, is a new Assistant Professor in the Divisions of Clinical Pharmacology and Cardiology at Vanderbilt University. She obtained her MD/PhD degrees from the University of Virginia Medical Scientist Training Program and completed her Internal Medicine residency at Duke University followed by a research track Cardiology Fellowship at Emory University. During her post-doctoral fellowship at Emory, in the laboratory of Dr. David Harrison, she became interested in the role of the immune system in hypertension. Emerging evidence indicates that hypertension is an inflammatory disease. Dr. Madhur was the first to demonstrate a critical role for the pro-inflammatory cytokine, interleukin 17A (IL17A), in angiotensin II induced hypertension and vascular dysfunction. Moreover, she showed that serum levels of IL17A were increased in humans with hypertension compared to normotensive individuals. There are 6 isoforms of IL17, designated IL17A through F, of which IL17A and F are most closely related in terms of structure, function, and expression. IL17F levels are increased in IL17A deficient mice, suggesting coordinate regulation, yet the role of IL17F in hypertension is unknown. As an Assistant Professor, under the continued mentorship of Dr. Harrison, the applicant plans to further investigate the role of the interleukin 17 pathway in hypertension and the associated end organ dysfunction using a combination of genetic knockout mice and neutralizing antibodies to IL17 and related cytokines. She has preliminary data that IL17F, contrary to IL17A, may serve a protective role in hypertension and the associated inflammatory response. This finding is exciting and has important therapeutic implications in terms of identifying specific antibody based drug targets for hypertension. One focus of the current proposal is to determine the effect of IL17 isoforms on renal dysfunction in hypertension. To assist in this aspect of the project, she has chosen a co-mentor, Dr. Raymond Harris, who is the Chief of Nephrology at Vanderbilt and has expertise in mechanisms of acute and chronic kidney injury. The studies outlined in this proposal will expand our understanding of the pathophysiology of hypertension and potentially lead to the identification of novel therapeutic targets for this widespread disease. Dr. Madhur's current academic appointment provides 80% protected research time as well as laboratory space, start-up funds, and access to core resources and support personnel to carry out the proposed studies. She has hired a post-doctoral fellow who will be assisting her on the projects outlined in this grant. Vanderbilt offers an exceptional research and intellectual environment for early career development. The applicant's training plan includes didactic courses, lab meetings, university seminars, national meetings, participation in Vanderbilt societies to promote the retention and tenure of junior faculty members, a mentoring committee, and one-on-one mentorship and guidance from both mentors. Dr. Madhur's long-term career goal is to establish herself as an independent clinician-investigator bridging the fields of hypertension and immunology.

Public Health Relevance

Hypertension is a leading cause of morbidity and mortality worldwide with current treatments providing suboptimal control of blood pressure in the general population. There is emerging evidence that hypertension is an inflammatory disorder characterized by abnormal activation and infiltration of immune cells. By identifying the key players of the immune system and their products, this project will provide new insight into the cause of hypertension and lead to novel therapies for this widespread disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HL121671-02
Application #
8792549
Study Section
Special Emphasis Panel (ZHL1-CSR-K (O2))
Program Officer
Wang, Wayne C
Project Start
2014-02-01
Project End
2019-01-31
Budget Start
2015-02-01
Budget End
2016-01-31
Support Year
2
Fiscal Year
2015
Total Cost
$125,415
Indirect Cost
$9,290
Name
Vanderbilt University Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Alexander, Matthew R; Norlander, Allison E; Elijovich, Fernando et al. (2018) Human monocyte transcriptional profiling identifies IL-18 receptor accessory protein and lactoferrin as novel immune targets in hypertension. Br J Pharmacol :
Laroumanie, Fanny; Korneva, Arina; Bersi, Matthew R et al. (2018) LNK deficiency promotes acute aortic dissection and rupture. JCI Insight 3:
Norlander, Allison E; Madhur, Meena S; Harrison, David G (2018) The immunology of hypertension. J Exp Med 215:21-33
Tong, Carl W; Madhur, Meena S; Rzeszut, Anne K et al. (2017) Status of Early-Career Academic Cardiology: A Global Perspective. J Am Coll Cardiol 70:2290-2303
Laroumanie, Fanny; Dale, Bethany L; Saleh, Mohamed A et al. (2017) Intracellular Staining and Flow Cytometry to Identify Lymphocyte Subsets within Murine Aorta, Kidney and Lymph Nodes in a Model of Hypertension. J Vis Exp :
Norlander, Allison E; Saleh, Mohamed A; Pandey, Arvind K et al. (2017) A salt-sensing kinase in T lymphocytes, SGK1, drives hypertension and hypertensive end-organ damage. JCI Insight 2:
Itani, Hana A; Xiao, Liang; Saleh, Mohamed A et al. (2016) CD70 Exacerbates Blood Pressure Elevation and Renal Damage in Response to Repeated Hypertensive Stimuli. Circ Res 118:1233-43
Dale, Bethany L; Madhur, Meena S (2016) Linking inflammation and hypertension via LNK/SH2B3. Curr Opin Nephrol Hypertens 25:87-93
Wu, Jing; Saleh, Mohamed A; Kirabo, Annet et al. (2016) Immune activation caused by vascular oxidation promotes fibrosis and hypertension. J Clin Invest 126:50-67
Itani, Hana A; McMaster Jr, William G; Saleh, Mohamed A et al. (2016) Activation of Human T Cells in Hypertension: Studies of Humanized Mice and Hypertensive Humans. Hypertension 68:123-32

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