scholarly journals Diet in Scleroderma: Is There a Need for Intervention?

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2118
Author(s):  
Alexandra Maria Burlui ◽  
Anca Cardoneanu ◽  
Luana Andreea Macovei ◽  
Ciprian Rezus ◽  
Lucian Vasile Boiculese ◽  
...  
Keyword(s):  
Weight Loss ◽  
Activity Index ◽  
Sodium Intake ◽  
Statistical Significance ◽  
Dietary Assessment ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
Dietary Factors ◽  
Nutritional Counseling ◽  
High Sodium

Systemic sclerosis (SSc) patients exhibit a plethora of risk factors for nutritional decline, including the presence of chronic inflammation and the progressive nature of disease-related multisystem involvement. The prevalence and consequences of nutritional decline in scleroderma are frequently underestimated, its management currently remaining a subject of debate. The main objective of the present study was to perform a detailed assessment of scleroderma patients’ diet as well as their eating habits and to describe the relationships with weight loss and malnutrition risk in the absence of professional nutritional counseling. Methods: We used a translated and validated version of the EPIC-Norfolk FFQ (European Prospective Investigation into Cancer and Nutrition Norfolk Food Frequency Questionnaire) to evaluate the patients’ diet and MUST (Malnutrition Universal Screening Tool) to investigate the risk of malnutrition. Disease activity was estimated using the EUSTAR-AI (European Scleroderma Trials and Research group Activity Index). Results: We included 69 patients with SSc, of which 42 underwent a detailed dietary assessment. Dietary factors were connected to body composition and digestive symptoms. We found high sodium intake and frequent suboptimal energy consumption in our study group, including patients with cardiopulmonary involvement. Liver transaminases were inversely correlated with the consumption of nuts and seeds. Malnutrition and weight loss were significantly associated with pulmonary hypertension, heart failure, albumin levels, and the extent of skin fibrosis, but not advanced age. Although the patients with EUSTAR-AI ≥ 2.5 were more frequently included in the moderate and high malnutrition risk categories, these results did not reach statistical significance. Conclusions: Currently, there is an unmet need for longitudinal and interventional research focusing on the long-term significance, ramifications, and management of nutritional impairment in SSc patients with various clinical manifestations. Our results indicate that scleroderma patients could benefit from personalized nutritional counseling in an interdisciplinary setting.

scholarly journals EFFECT OF NUTRITIONAL COUNSELING LEALEF MEDIA ON KNOWLEDGE, SODIUM, POTASIUM INTAKE IN PATIENTS HYPERTENSION

2021 ◽  
Vol 12 (1) ◽  
pp. 62-72
Author(s):  
Dina Dwi Aprilia ◽  
Jumiyati Jumiyati ◽  
Ayu Pravita Sari
Keyword(s):  
Test Data ◽  
Sodium Intake ◽  
Univariate Analysis ◽  
Community Health Center ◽  
P Value ◽  
Nutritional Counseling ◽  
High Sodium ◽  
Low Potassium ◽  
Post Test ◽  
Sodium And Potassium

ABSTRACK Hypertension actually is a disease that can be implified on sudden death. It's mostly caused by high blood pressure so that the risk of suffering complications is a big issue. It can be caused by many factors, one of that is high sodium and low potassium consumption as well. Based on 2015 WHO data, it shows that 1.13 billion people in the world have hypertension. Based on Riskesdas data the number of cases of hypertension in Indonesia is 63,309,620 people. In Bengkulu province In 2018 about province's health data, it was found that in 2018 the estimated number of sufferers ≥ 15 years reached 899,010 people. The highest hypertension was found in the Selebar Sub-District Puskesmas Basuki Rahmad about 7,464 .The purpose of this study determines the effect of nutritional counseling using modified leaflet media, knowledge of sodium and potassium intake in patients with hypertension in Basuki Rahmad Community Health Center in Bengkulu City in 2020.This research method is a pre-experimental research design with one group pretest and posttest term. Samples that were taken by purposive sampling of 25 people. Data collected includes pre test data first, namely knowledge, data, sodium intake, and potassium. After that post-test data, it is knowledge data about sodium and potassium consumption. Analysis of the data used is the univariate analysis and bivariate analysis.Based on the research from 25 samples given nutritional counseling, the results obtained knowledge about sodium and potassium consumption value of p-value 0,000.In the conclusion of this study is about the influence of nutritional counseling on sodium and potassium consumption that related to hypertension disease.

scholarly journals P570 Prediction of achieving remission in Crohn’s disease patients by abdominal Imaging

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S528-S529
Author(s):  
H Meringer ◽  
R Tzadok ◽  
D Mercer ◽  
M Handler ◽  
S Barnes ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Activity Index ◽  
Statistical Significance ◽  
Unmet Need ◽  
Disease Activity Index ◽  
Abdominal Imaging ◽  
Local Inflammation ◽  
Prediction Of Response ◽  
Computed Tomography Enterography

Abstract Background Vedolizumab (VDZ) is an effective therapy in patients with Crohn’s disease (CD). Early prediction of response remains an unmet need. We aimed to evaluate whether abdominal imaging can predict response to VDZ. Methods Abdominal imaging [Computed tomography enterography (CTE) or magnetic resonance enterography (MRE)] of CD patients initiating therapy with VDZ was evaluated, up to 4 months before VDZ initiation. Response to VDZ was determined at week 26 using the Harvey–Bradshaw index (HBI) or the Crohn’s Disease Activity Index (CDAI), in cases no objective score was available it was defined based on the physician assessment. Results Thirty-three CD patients were included. At week 26, clinical response and remission were achieved in 20(60.6%) and 14(42.4%) patients, respectively. CRP and Calprotectin levels were available for 22/33 and 7/33 patients at week 26. As expected, levels trended lower in remission versus no remission- median CRP 2.41mg/L [IQR 1.3–4.5] vs 10.2[1.6–44.6], p=0.11 and 23.5 µg/g [5–42] vs 2002.8[191–2003], p=0.095, though this did not reach statistical significance. Clinical remission versus no remission was significantly associated with being biologic naïve, 8/14 vs 2/19 (p=0.01) and no prior CD surgeries, 10/14 vs 6/19 (p=0.04). Characteristics of local inflammation as mural edema, fibrofatty proliferation or lymphadenopathy were higher in patients achieving remission versus non-remission. The presence of either mural edema or fibro-fatty proliferation was significantly associated with remission (12/14 vs 9/19, p=0.03). The presence of stenosis in imaging was nominally higher in patients failing to achieve remission (14/19 vs 6/14, p=0.15). Number of diseased segments, length of inflammation or the maximal bowel thickness were similar in remission and no-remission. Conclusion Baseline imaging may help to predict remission based on the presence of either mural edema or fibrofatty proliferation and the absence of stenosis

THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Tubulointerstitial Lesions

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical

scholarly journals AB0381 THE UTILITY OF HYDROXYCHLOROQUINE (HCQ) THERAPY FOR TWO YEARS AS A SPARING CORTICOSTEROID AGENCY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1490.3-1491
Author(s):  
K. Inoue ◽  
K. Misaki ◽  
N. Dobashi ◽  
M. Miyazaki ◽  
Y. Mako ◽  
...  
Keyword(s):  
Adverse Events ◽  
Maintenance Therapy ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Statistical Significance ◽  
Disease Activity Index ◽  
Patient Characteristics ◽  
Serum Complement ◽  
Wbc Count ◽  
Study Dose

Background:Prednisolone (PSL) and HCQ are key drugs in the therapy of SLE. However, since PSL induce many harmful adverse events, PSL is preferred to be reduced especially in the maintenance therapy. The efficacy of HCQ for reducing the dose of PSL has not been revealed yet. So, we focused on the cessation of PSL under the treatment of HCQ with conventional SLE therapy.Objectives:The aim of this study is to evaluate the efficacy and the safety of HCQ as co-treatment in the standard therapy of SLE.Methods:SLE patients (n=30) under the maintenance therapy were enrolled in this study. Dose of PSL, titer of anti-DNA antibody, WBC count, serum complement and SLE disease activity index (SLEDAI) were examined retrospectively at 0 and 12 months after administration of HCQ.Results:Baseline patient-characteristics are as follows (mean±S.E); the age of patients was 54.4±3.2 years old, 21 patients (70%) were female, the disease duration was 108.5±25.2 months, SLEDAI was 4.0±0.9, the dose of PSL was 10.3±1.7 mg/day, the titer of anti-DNA antibody was 7.3±1.8 IU/ml, C3 was 85±4.3 mg/dl and C4 was 18±1.6 mg/dl.The mean dose of PSL was reduced with statistically significance (pre-administration of HCQ:10.3±1.7 mg/day, 24 months after administration of HCQ:2.2±0.3 mg/day,p<0.0001). Furthermore, in this observation period, 6 patients could achieve the cessation of PSL.SLEDAI was also significantly reduced (4.0±0.9 vs 1.0±0.3,p<0.01).There was no statistical significance between before treatment by HCQ and after treatment in the titer of anti-DNA antibody (7.3±1.8 vs 2.8±1.6 IU/ml,p=0.06), WBC count (6208±4.9 vs 5096±3.3 /μl,p=0.06) and serum complement level (C3 85±4.3 mg/dl vs 89±4.0 mg/dl,p=0.52, C4 18±1.6 mg/dl vs 19±1.4 mg/dl,p=0.45). Relapse of SLE was clarified in only one patient.As for adverse events (AEs), Severe bacterial infection (n=4), herpes zoster (n=1) and patellar tendon rupture (n=1) were revealed. All cases of the AEs were fully recovered.Conclusion:Our study suggested that co-treatment with HCQ on standard SLE therapy could be enable to prevent the flare of SLE and reduce the dose of PSL with statistical significance. In some cases, we could achieve the cessation of PSL treatment.References:None.Disclosure of Interests:None declared

scholarly journals The Main Challenges in Systemic Lupus Erythematosus: Where Do We Stand?

2021 ◽  
Vol 10 (2) ◽  
pp. 243
Author(s):  
Matteo Piga ◽  
Laurent Arnaud
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Systemic Lupus ◽  
Major Step ◽  
Damage Accrual

Systemic lupus erythematosus (SLE) is an immune-mediated multi-systemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares. Despite significant advances in the understanding of the pathophysiology and optimization of medical care, patients with SLE still have significant mortality and carry a risk of progressive organ damage accrual and reduced health-related quality of life. New tools allow earlier classification of SLE, whereas tailored early intervention and treatment strategies targeted to clinical remission or low disease activity could offer the opportunity to reduce damage, thus improving long-term outcomes. Nevertheless, the early diagnosis of SLE is still an unmet need for many patients. Further disentangling the SLE susceptibility and complex pathogenesis will allow to identify more accurate biomarkers and implement new ways to measure disease activity. This could represent a major step forward to find new trials modalities for developing new drugs, optimizing the use of currently available therapeutics and minimizing glucocorticoids. Preventing and treating comorbidities in SLE, improving the management of hard-to-treat manifestations including management of SLE during pregnancy are among the remaining major unmet needs. This review provides insights and a research agenda for the main challenges in SLE.

scholarly journals Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 739
Author(s):  
Ronald B. Brown
Keyword(s):  
Polycystic Ovary ◽  
Sodium Intake ◽  
Dietary Factors ◽  
Nutritional Epidemiology ◽  
Dietary Sodium ◽  
Ovary Syndrome ◽  
Nasal Sinus ◽  
Lower Socioeconomic ◽  
Sodium Toxicity ◽  
Nutritional Immunology

Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple sclerosis, systemic sclerosis, and polycystic ovary syndrome. This article synthesizes evidence from epidemiology, pathophysiology, immunology, and virology literature linking sodium toxicological mechanisms to COVID-19 and SARS-CoV-2 infection. Sodium toxicity is a modifiable disease determinant that impairs the mucociliary clearance of virion aggregates in nasal sinuses of the mucosal immune system, which may lead to SARS-CoV-2 infection and viral sepsis. In addition, sodium toxicity causes pulmonary edema associated with severe acute respiratory syndrome, as well as inflammatory immune responses and other symptoms of COVID-19 such as fever and nasal sinus congestion. Consequently, sodium toxicity potentially mediates the association of COVID-19 pathophysiology with SARS-CoV-2 infection. Sodium dietary intake also increases in the winter, when sodium losses through sweating are reduced, correlating with influenza-like illness outbreaks. Increased SARS-CoV-2 infections in lower socioeconomic classes and among people in government institutions are linked to the consumption of foods highly processed with sodium. Interventions to reduce COVID-19 morbidity and mortality through reduced-sodium diets should be explored further.

scholarly journals Is socio-demographic status, body mass index, and consumption of food away from home associated with high sodium intake among adults in Malaysia?: findings from the Malaysian Community Salt Survey (MyCoSS)

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Ruhaya Salleh ◽  
Shubash Shander Ganapathy ◽  
Norazizah Ibrahim Wong ◽  
Siew Man Cheong ◽  
Mohamad Hasnan Ahmad ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Sodium Intake ◽  
Daily Intake ◽  
Dietary Sodium ◽  
Cooking Methods ◽  
High Sodium ◽  
High Sodium Intake ◽  
Meal Consumption

Abstract Background Studies have shown that having away from home meals contributes to high sodium intake among young people and those who lived in urban areas. This study aimed to determine the association between dietary sodium intake, body mass index, and away from home meal consumption behaviour among Malaysian adults. Methods MyCoSS was a cross-sectional household survey involving 1440 adults age 18 years and above. This study utilized stratified cluster sampling to obtain a nationally representative sample. Data was collected between October 2017 and March 2018. Socio-demographic information, dietary assessment using food frequency questionnaire (FFQ), and away from home meal consumption were assessed through a face-to-face interview by trained health personnel. Descriptive analysis and logistic regression were applied to identify the association of socioeconomic status and away from home meal consumption with dietary sodium intake. Results A total of 1032 participants completed the FFQ, with a mean age of 48.8 + 15.6 years. Based on the FFQ, slightly over half of the participants (52.1%) had high sodium intake. Results showed that 43.6% of participants consumed at least one to two away from home meals per day, while 20.8% of them had their three main meals away from home. Participants aged less than 30 years old were the strongest predictor to consume more sodium (adjusted OR: 3.83; 95%CI: 2.23, 6.58) while those of Indian ethnicity had significantly lower sodium intake. Surprisingly, having three away from home meals per day was not associated with high dietary sodium intake, although a significant association (crude OR; 1.67, 95% CI: 1.19, 2.35) was found in the simple logistic regression. Obese participants were less likely to have high dietary sodium intake compared with the normal BMI participants in the final model. Conclusion Over half of the participants consumed sodium more than the recommended daily intake, especially those who consumed three away from home meals. However, there was no significant association between high sodium intake and having three away from home meals per day. The promotion of healthy cooking methods among the public must continue to be emphasized to reduce the dietary sodium intake among Malaysian adults.

Elevated levels of IL-24 in systemic lupus erythematosus patients

Lupus ◽  
2019 ◽  
Vol 28 (6) ◽  
pp. 748-754 ◽  
Author(s):  
R C Li ◽  
J Guo ◽  
L C Su ◽  
A F Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Inflammatory Cytokine ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Mrna Levels ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Good Ability

Objective This study aimed to assess IL-24 levels and their association with clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods There were 75 patients with SLE and 58 healthy controls recruited in this study. Serum levels of IL-24 were measured by enzyme-linked immunosorbent assays, and mRNA levels of IL-24 were tested by quantitative real-time polymerase chain reaction . The area under the curve of the receiver operating characteristic (ROC) curve was used for diagnostic ability of the inflammatory cytokine. Results Serum IL-24 levels were significantly higher in SLE patients than that in healthy controls. SLE patients with nephritis had higher IL-24 levels than those without nephritis. Active SLE patients showed higher expression of IL-24 as compared to less active disease patients. The mRNA levels of IL-24 were much higher in SLE patients. Correlation analysis showed significant correlation between serum IL-24 levels and SLE disease activity index. In addition, ROC analysis may suggest good ability of serum IL-24 in differentiating SLE. Conclusion The inflammatory cytokine correlated with SLE disease activity, and may be involved in this disease pathogenesis.

scholarly journals The therapeutic efficacy of mesenchymal stromal cells on experimental colitis was improved by the IFN-γ and poly(I:C) priming through promoting the expression of indoleamine 2,3-dioxygenase

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Ji-Young Lim ◽  
Byung-Su Kim ◽  
Da-Bin Ryu ◽  
Tae Woo Kim ◽  
Gyeongsin Park ◽  
...  
Keyword(s):  
Weight Loss ◽  
Disease Activity ◽  
Stromal Cells ◽  
Therapeutic Efficacy ◽  
Activity Index ◽  
Disease Activity Index ◽  
Experimental Colitis ◽  
Poly I:C ◽  
Colon Tissue ◽  
Ifn Γ

Abstract Background Inflammatory bowel disease is a chronic and excessive inflammation of the colon and small intestine. We previously reported that priming of mesenchymal stromal cells (MSCs) with poly(I:C) induced them to express indoleamine 2,3-dioxygenase (IDO). We tried to find out whether the IFN-γ and poly(I:C)-primed MSCs have better therapeutic efficacy on the experimental colitis in the IDO1-dependent manner. Methods To compare the therapeutic effects between the unstimulated MSCs and primed MSCs on murine colitis, mice (C57BL6) were administered with 2.5% dextran sodium sulfate (DSS) in drinking water for 5 days and injected with MSCs intraperitoneally on days 1 and 3 following DSS ingestion. The disease activity index score and body weight loss were assessed daily until day 9. Results Mice receiving the IFN-γ and poly(I:C)-primed MSCs showed a reduced disease activity index and less weight loss. Colon tissue from the same mice presented attenuated pathological damage, increased Paneth cells, increased IDO1-expressing cells, and better proliferation of enterocytes. The primed MSC treatment upregulated the mRNA expression of intestinal stem cell markers (Lgr5, Olfm4, and Bmi1), enterocyte differentiation markers (Muc2, Alpi, Chga, and occludin), and regulatory T (Treg) cells (Foxp3). The same treatment decreased inflammatory cell infiltration to lymphoid organs and the level of pro-inflammatory cytokines (IL-1β, TNF-α, IL-6, and MCP-1) in colon tissue. Notably, in vivo pharmacologic inhibition of the IDO1 activity blocked the Foxp3 upregulation in colon tissue and diminished the protective effects of the primed MSC. Conclusions The priming of MSCs with the IFN-γ and poly(I:C) is a promising new strategy to improve the therapeutic efficacy of MSC and is worth further research.

scholarly journals High Na intake increases renal angiotensin II levels and reduces expression of the ACE2-AT2R-MasR axis in obese Zucker rats

2012 ◽  
Vol 303 (3) ◽  
pp. F412-F419 ◽  
Author(s):  
Preethi Samuel ◽  
Quaisar Ali ◽  
Rifat Sabuhi ◽  
Yonnie Wu ◽  
Tahir Hussain
Keyword(s):  
Sodium Intake ◽  
Zucker Rats ◽  
Kidney Cortex ◽  
Complex Nature ◽  
Ang Ii ◽  
Pronounced Increase ◽  
High Sodium ◽  
High Sodium Intake ◽  
Obese Rats ◽  
Obese Zucker Rats

High sodium intake is known to regulate the renal renin-angiotensin system (RAS) and is a risk factor for the pathogenesis of obesity-related hypertension. The complex nature of the RAS reveals that its various components may have opposing effects on natriuresis and blood pressure regulation. We hypothesized that high sodium intake differentially regulates and shifts a balance between opposing components of the renal RAS, namely, angiotensin-converting enzyme (ACE)-ANG II-type 1 ANG II receptor (AT1R) vs. AT2-ACE2-angiotensinogen (Ang) (1–7)-Mas receptor (MasR), in obesity. In the present study, we evaluated protein and/or mRNA expression of angiotensinogen, renin, AT1A/BR, ACE, AT2R, ACE2, and MasR in the kidney cortex following 2 wk of a 8% high-sodium (HS) diet in lean and obese Zucker rats. The expression data showed that the relative expression pattern of ACE and AT1BR increased, renin decreased, and ACE2, AT2R, and MasR remained unaltered in HS-fed lean rats. On the other hand, HS intake in obese rats caused an increase in the cortical expression of ACE, a decrease in ACE2, AT2R, and MasR, and no changes in renin and AT1R. The cortical levels of ANG II increased by threefold in obese rats on HS compared with obese rats on normal salt (NS), which was not different than in lean rats. The HS intake elevated mean arterial pressure in obese rats (27 mmHg) more than in lean rats (16 mmHg). This study suggests that HS intake causes a pronounced increase in ANG II levels and a reduction in the expression of the ACE2-AT2R-MasR axis in the kidney cortex of obese rats. We conclude that such changes may lead to the potentially unopposed function of AT1R, with its various cellular and physiological roles, including the contribution to the pathogenesis of obesity-related hypertension.

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