Essential hypertension is a major threat to public health, affecting over a billion people in the world and contributing to kidney and cardiovascular mortality and morbidity in 5 million people annually. Like other complex disorders, multiple genes with variant alleles and different environmental stresses are thought to contribute to the disease. Using a genome-wide association strategy, we recently identified the first essential hypertension susceptibility gene, STK39 (aka SPAK serine/threonine kinase), illuminating a newly described, multi-gene kinase network and a specific environmental trigger--dietary salt-- in the genesis of hypertension. Available evidence from our group and others suggests: 1) STK39 interacts with the products of the WNK genes, serine/threonine kinases that are mutated in a rare familial disorder of hypertension and hyperkalemia, to control kidney salt excretion and maintain blood pressure;2) Dietary sodium and potassium differently trigger signaling through the STK39/WNK pathway to regulate the activity of a key renal salt transport protein, the thiazide diuretic sensitive sodium chloride co- transporter (NCC);3) Aberrant gain-of-STK39 signaling causes an inappropriate increase in NCC activity, leading to sodium retention and hypertension. Here we bring together a mutlidisciplinary team to develop and apply novel transgenic animal models and reagents to test these exciting new ideas about gene-gene and gene-environment interactions in the development of hypertension, building on our recent discoveries. Development of these new tools and knowledge will shed light on the underlying molecular and genetic mechanisms of the disease. It also will provide much-needed models to study and identify new therapeutic strategies for intervention.

Public Health Relevance

Essential hypertension is a major threat to public health, affecting over a billion people in the world and contributing to kidney and cardiovascular mortality and morbidity in 5 million people annually. Like other complex disorders, multiple genes with variant alleles and different environmental stresses are thought to contribute to the disease. Here we bring together a mutlidisciplinary team of experts in the field to develop and apply novel transgenic animal models and reagents to test exciting new ideas about a multi-kinase gene network and a specific environmental trigger--dietary salt--in the genesis of hypertension, building on our recent GWA discovery of STK39 kinase as an essential hypertension susceptibility gene.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
NIH Challenge Grants and Partnerships Program (RC1)
Project #
5RC1DK086817-02
Application #
7938618
Study Section
Special Emphasis Panel (ZRG1-VH-D (58))
Program Officer
Ketchum, Christian J
Project Start
2009-09-25
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2012-07-31
Support Year
2
Fiscal Year
2010
Total Cost
$499,878
Indirect Cost
Name
University of Maryland Baltimore
Department
Physiology
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
Welling, Paul A (2014) Rare mutations in renal sodium and potassium transporter genes exhibit impaired transport function. Curr Opin Nephrol Hypertens 23:1-8
Welling, Paul A (2013) Regulation of potassium channel trafficking in the distal nephron. Curr Opin Nephrol Hypertens 22:559-65
Welling, Paul A (2013) Regulation of renal potassium secretion: molecular mechanisms. Semin Nephrol 33:215-28
Grimm, P Richard; Taneja, Tarvinder K; Liu, Jie et al. (2012) SPAK isoforms and OSR1 regulate sodium-chloride co-transporters in a nephron-specific manner. J Biol Chem 287:37673-90
Subramanya, Arohan R; Welling, Paul A (2011) Toward an understanding of hypertension resistance. Am J Physiol Renal Physiol 300:F838-9
Wade, James B; Fang, Liang; Coleman, Richard A et al. (2011) Differential regulation of ROMK (Kir1.1) in distal nephron segments by dietary potassium. Am J Physiol Renal Physiol 300:F1385-93
Welling, Paul A; Chang, Yen-Pei C; Delpire, Eric et al. (2010) Multigene kinase network, kidney transport, and salt in essential hypertension. Kidney Int 77:1063-9