RT期刊文章SR电子T1血管紧张素转换酶2和血管紧张素(1 - 7)轴在肺动脉高血压摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 1902416 10.1183/13993003.02416 -2019签证官56是1 A1桑多瓦尔,胡里奥A1 Del Valle-Mondragon,莱昂纳多A1美索,费利佩A1 Zayas,188bet官网地址Nayeli A1 Pulido, Tomás A1 Teijeiro, Ricardo A1 Gonzalez-Pacheco, Hector A1 Olmedo-Ocampo, Rossana A1 Sisniega, Carlos A1 Paez-Arenas, Araceli A1 Pastelin-Hernandez, Gustavo A1 Gomez-Arroyo, Jose A1 Voelkel，背景:在肺动脉高压(PAH)动物模型中，血管紧张素转换酶(ACE)2和血管紧张素(Ang)-(1-7)已被证明具有血管舒张、抗增殖、抗纤维化和抗肥厚的特性。然而，ACE2-Ang(1-7)轴在人类PAH中的地位和作用还不完全清楚。方法我们研究了85例诊断为肺动脉高压且有不同病因的患者。55名按年龄和性别配对的健康献血者作为对照。血液样本来自肺动脉高压患者在右心导管插管期间。两组均取外周血。Ang(1-7)和-II用区带毛细管电泳测定。采用ELISA法测定醛固酮、Ang(1-9)、AngA和ACE2，酶法测定ACE2活性。85例患者中，47例为特发性肺动脉高压，25例肺动脉高压与先天性心脏病相关，13例肺动脉高压与胶原血管疾病相关。 Compared to controls, patients with PAH had a higher concentration of AngII (median 1.03, interquartile range 0.72–1.88 pmol·mL−1 versus 0.19, 0.10–0.37 pmol·mL−1; p<0.001) and of aldosterone (88.7, 58.7–132 ng·dL−1 versus 12.9, 9.55–19.9 ng·dL−1; p<0.001). Conversely, PAH patients had a lower concentration of Ang(1–7) than controls (0.69, 0.474–0.91 pmol·mL−1 versus 4.07, 2.82–6.73 pmol·mL−1; p<0.001), and a lower concentration of Ang(1–9) and AngA. Similarly, the ACE2 concentration was higher than in controls (8.7, 5.35–13.2 ng·mL−1 versus 4.53, 1.47–14.3 ng·mL−1; p=0.011), whereas the ACE2 activity was significantly reduced (1.88, 1.08–2.81 nmol·mL−1 versus 5.97, 3.1–17.8 nmol·mL−1; p<0.001). No significant differences were found among the three different aetiological forms of PAH.Conclusions The AngII–ACE2–Ang(1–7) axis appears to be altered in human PAH and we propose that this imbalance, in favour of AngII, plays a role in the pathogenesis of the severe PAH. Further mechanistic studies are warranted.This study demonstrates that in patients with PAH of different aetiologies there are alterations of the ACE2-angiotensin (1–7)-MAS axis. Analysis of blood samples also demonstrates the presence of antibodies directed against ACE2 https://bit.ly/3alEbnJ