All ETDs from UAB

Advisory Committee Chair

Jennifer S Pollock

Advisory Committee Members

Craig L Maynard

Anupam Agarwal

James F George

Robinna G Lorenz

David M Pollock

Document Type

Dissertation

Date of Award

2022

Degree Name by School

Doctor of Philosophy (PhD) Heersink School of Medicine

Abstract

Homeostatic departure is a central feature across all diseases and disease processes. Currently, the average individual in the US consumes an inordinate quantity of salt. However, it is unclear if only individuals that have proven blood pressure elevation with an acute load of salt should be wary. Here we demonstrate, alongside a growing body of science, that the canonical definition of salt-sensitivity is insufficient. We show that salt-resistant mice demonstrate salt-sensitivity in non-blood pressure focused phenomena, such as the acute activation of CD4+ T cells to mobilize and induce a defective effector cytokine program with high salt. We demonstrate that the homeostatic regulator AHR contributes to sustaining effector T cell stability, and activating AHR provides multi-system benefits, including prevention of hypertension in salt-sensitive mice. Somewhat similarly, individuals with sickle cell disease experience life-long homeostatic instability due to polymer development within their own red blood cells simply due to a single nucleotide polymorphism. In untreated patients, a cascade of events ultimately leads to organ failure and a shortened lifespan. Novel approaches that target the cellular source of endothelin 1, an active participant in maintaining pathology in SCD, provides protection against progression of sickle cell nephropathy, a leading cause of mortality in patients with sickle cell disease. Ultimately, it is imperative to re-establish and sustain homeostasis, whether immunologically or through blood pressure regulation.

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