The role of complement in arterial hypertension and hypertensive end organ damage.

Increasing evidence indicates that hypertension and hypertensive end organ damage are not only mediated by hemodynamic injury but that inflammation also plays an important role. The complement system protects the host from a hostile microbial environment and maintains tissue and cell integrity through the elimination of altered or dead cells. As an important effector arm of innate immunity, it plays also central roles in the regulation of adaptive immunity. Thus, complement activation may drive the pathology of hypertension through its impact on innate and adaptive immune responses aside from direct effects on the vasculature. Recent experimental data strongly support a role for complement in all stages of arterial hypertension. The remarkably similar clinical and histopathological features of malignant nephrosclerosis and atypical hemolytic uremic syndrome suggest also a role for complement in the development of malignant nephrosclerosis. We herein review the role of complement in hypertension and hypertensive end organ damage.