Investigation of NRLP3, ASC, anda caspase 1 genes in the pathogenesis of childhood primary hypertension

Hypertension is a multifactorial disease that determine blood pressure. In the last 20 years, it has been recognized that low-grade inflammation plays a role in cardiovascular disease. Although there are different types of inflammasome structures, the inflammasome that has been reported to be associated with hypertension is the NOD-like receptor protein 3 (NLRP3) inflammasome. In this study; it was aimed to show the role of NLRP3 in hypertension by comparing NRLP3, ASC, caspase-1, IL-1β levels in children with and without primary hypertension. The study was conducted between September 2019 and April 2021 with 50 healthy children under the age of 18 who applied to the pediatric polyclinic of Manisa Celal Bayar University Faculty of Medicine, and 50 primary children under the age of 18 who applied to the pediatric nephrology polyclinic of Manisa Celal Bayar University Faculty of Medicine, conducted among patients with hypertension. All statistical analyzes were performed using the SPSS 23.0 package program. Fifty healthy controls and 50 children with hypertension between the ages of 9-18 were included in the study. When the background characteristics of the patients were questioned, no significant difference was found in the patient and control groups in terms of HR history and week of birth (p>0.05). However, birth weight was found to be significantly lower in the patient group (p<0.05). No significant difference was found between the two groups in terms of environmental exposure, cigarette use and nutritional characteristics (p>0.05). In terms of stress and daily activities, the patient group was found to be more stressed and more sedentary (p<0.05). When the familial characteristics of the patients were questioned, the presence of HT in the families of hypertensive children was found to be statistically more significant (p<0.05). When the treatment methods used by the patients were evaluated, it was found that 50% of them were treated with non-pharmacological methods, those who received pharmacological treatment were mostly under control with monotherapy, and the most commonly used drug group was ACEI. When the laboratory results of both groups were examined, the levels of UA, TC, LDL and TG were found to be significantly higher in the patient group (p>0.05). When patients with hypertension were examined in terms of end organ damage, renal and vascular damage was not observed in any of them, while LVH was found in 32% and HTRP in 26%. When the patient and control groups were compared in terms of NLRP3, ASC, CASP1 and IL-1B, an approximately 3-fold increase in NLRP3, ASC and IL-1B expression in the patient group compared to the control group and a 2-fold increase in CASP1 were found. In our study, a significant increase was found in the expression of NLRP3, ASC, CASP1 and IL-1B genes, which are parts of the NLRP3 inflammasome complex and thought to be responsible for chronic inflammation, compared to the control group. In the light of these findings, early diagnosis of HT in childhood can prevent future complications and contribute to the development of new treatment modalities.