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ResearchIn-Press PreviewCell biologyVascular biology Open Access | 10.1172/JCI203386

C/EBP-β-mediated upregulation of CaV1.2 calcium channel increases arterial constriction in mice with ibrutinib-associated hypertension

Ludan Zhang,1 Shumin Yin,1 Wei Hou,1 Dan Yang,1 Yiyuan Jia,1 Yun Liu,1 Yan Wang,1 Sirui Zhao,1 Xiaoyan Gao,2 Xiaolin Sun,2 Xiao Lu,3 Jianyong Li,4 Ming Chu,2 Xiaoqing Xiong,1 Huayuan Zhu,4 and Juejin Wang1

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Zhang, L. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Yin, S. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Hou, W. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Yang, D. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Jia, Y. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Liu, Y. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Wang, Y. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Zhao, S. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Gao, X. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Sun, X. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Lu, X. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Li, J. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Chu, M. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Xiong, X. in: PubMed | Google Scholar |

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Zhu, H. in: PubMed | Google Scholar

1Key Laboratory of Targeted Intervention of Cardiovascular Disease, Collaborative Innovation Center for Cardiovascular Disease Translational Medicine, Nanjing Medical University, Nanjing, China

2The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China

3Department of Rehabilitation, Jiangsu Province People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

4Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

Find articles by Wang, J. in: PubMed | Google Scholar

Published November 12, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI203386.
Copyright © 2026, Zhang et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published November 12, 2026 - Version history
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Abstract

Ibrutinib, a Bruton's tyrosine kinase inhibitor, is indicated for treating chronic lymphocytic leukemia (CLL), but hypertension is a common cardiovascular adverse event. Previous studies have linked ibrutinib to cardiac events through dysregulated intracellular calcium handling, but the mechanisms underlying ibrutinib-associated hypertension remain largely unknown. Here, we followed up 225 CLL patients receiving ibrutinib or managed with watch-and-wait strategy, and identified ibrutinib as an independent risk factor for hypertension. In mice, ibrutinib elevated arterial blood pressure (BP) without structural remodeling of small arteries, and it potentiated K+-induced vasoconstriction. In vascular smooth muscle cells (VSMCs), ibrutinib upregulated CaV1.2 channel expression and function, as evidenced by enhanced CaV1.2 currents and K+-triggered-[Ca2+]i elevation. Mechanistically, ibrutinib suppressed casein kinase 2 (CK2)-mediated HSP90β phosphorylation, and stabilized C/EBP-β, which bound to the promoter of Cacna1c gene and drove CaV1.2 transcription. Significantly, C/EBP-β knockdown attenuated ibrutinib-induced CaV1.2 hyperactivity and vasoconstriction. Collectively, these findings reveal a CK2-HSP90β-C/EBP-β-CaV1.2 signaling cascade through which ibrutinib enhances vascular Ca2+ influx and vasoconstriction, thereby elevating arterial BP. Thus, this study nominates C/EBP-β as a therapeutic target for ibrutinib-associated hypertension.

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