Angiotensin converting enzyme 2 and angiotensin (1-7) axis in pulmonary arterial hypertension.


Journal

The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460

Informations de publication

Date de publication:
07 2020
Historique:
received: 08 11 2019
accepted: 21 03 2020
pubmed: 4 4 2020
medline: 22 6 2021
entrez: 4 4 2020
Statut: epublish

Résumé

In animal models of pulmonary arterial hypertension (PAH), angiotensin-converting enzyme (ACE)2 and angiotensin (Ang)-(1-7) have been shown to have vasodilatory, antiproliferative, antifibrotic and antihypertrophic properties. However, the status and role of the ACE2-Ang(1-7) axis in human PAH is incompletely understood. We studied 85 patients with a diagnosis of PAH of distinct aetiologies. 55 healthy blood donors paired for age and sex served as controls. Blood samples were obtained from the pulmonary artery in patients with PAH during right heart catheterisation. Peripheral blood was obtained for both groups. Ang(1-7) and -II were measured using zone capillary electrophoresis. Aldosterone, Ang(1-9), AngA and ACE2 were measured using ELISA, and ACE2 activity was determined enzymatically. Of the 85 patients, 47 had idiopathic PAH, 25 had PAH associated with congenital heart disease and 13 had PAH associated with collagen vascular disease. Compared to controls, patients with PAH had a higher concentration of AngII (median 1.03, interquartile range 0.72-1.88 pmol·mL 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.

Sections du résumé

BACKGROUND
In animal models of pulmonary arterial hypertension (PAH), angiotensin-converting enzyme (ACE)2 and angiotensin (Ang)-(1-7) have been shown to have vasodilatory, antiproliferative, antifibrotic and antihypertrophic properties. However, the status and role of the ACE2-Ang(1-7) axis in human PAH is incompletely understood.
METHODS
We studied 85 patients with a diagnosis of PAH of distinct aetiologies. 55 healthy blood donors paired for age and sex served as controls. Blood samples were obtained from the pulmonary artery in patients with PAH during right heart catheterisation. Peripheral blood was obtained for both groups. Ang(1-7) and -II were measured using zone capillary electrophoresis. Aldosterone, Ang(1-9), AngA and ACE2 were measured using ELISA, and ACE2 activity was determined enzymatically.
RESULTS
Of the 85 patients, 47 had idiopathic PAH, 25 had PAH associated with congenital heart disease and 13 had PAH associated with collagen vascular disease. Compared to controls, patients with PAH had a higher concentration of AngII (median 1.03, interquartile range 0.72-1.88 pmol·mL
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.

Identifiants

pubmed: 32241831
pii: 13993003.02416-2019
doi: 10.1183/13993003.02416-2019
pii:
doi:

Substances chimiques

Peptide Fragments 0
Angiotensin I 9041-90-1
Peptidyl-Dipeptidase A EC 3.4.15.1
Angiotensin-Converting Enzyme 2 EC 3.4.17.23
angiotensin I (1-7) IJ3FUK8MOF

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright ©ERS 2020.

Déclaration de conflit d'intérêts

Conflict of interest: J. Sandoval has nothing to disclose. Conflict of interest: L. Del Valle-Mondragón has nothing to disclose. Conflict of interest: F. Masso has nothing to disclose. Conflict of interest: N. Zayas has nothing to disclose. Conflict of interest: T. Pulido reports grants from and personal fees for advisory board work and lectures from Actelion and Bayer, grants from Lilly, Reata Pharmaceuticals and United Therapeutics, personal fees for advisory board work from Pfizer and Akros Pharma, outside the submitted work. Conflict of interest: R. Teijeiro reports grants from CONACYT (FOSISS project 2015-1-262511), during the conduct of the study. Conflict of interest: H. González-Pacheco has nothing to disclose. Conflict of interest: R. Olmedo-Ocampo has nothing to disclose. Conflict of interest: C. Sisniega has nothing to disclose. Conflict of interest: A. Paez-Arenas has nothing to disclose. Conflict of interest: G. Pastelin-Hernandez has nothing to disclose. Conflict of interest: J. Gómez-Arroyo has nothing to disclose. Conflict of interest: N.F. Voelkel has nothing to disclose.

Auteurs

Julio Sandoval (J)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico sandovalzarate@prodigy.net.mx.

Leonardo Del Valle-Mondragón (L)

Pharmacology Dept, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico.

Felipe Masso (F)

Physiology and Molecular Biology Dept of the "Ignacio Chávez", National Institute of Cardiology, Mexico City, Mexico.

Nayeli Zayas (N)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Tomás Pulido (T)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Ricardo Teijeiro (R)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Hector Gonzalez-Pacheco (H)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Rossana Olmedo-Ocampo (R)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Carlos Sisniega (C)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.

Araceli Paez-Arenas (A)

Physiology and Molecular Biology Dept of the "Ignacio Chávez", National Institute of Cardiology, Mexico City, Mexico.

Gustavo Pastelin-Hernandez (G)

Pharmacology Dept, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico.

Jose Gomez-Arroyo (J)

Cardiopulmonary Dept, Instituto Nacional de Cardiologia, Mexico City, Mexico.
Division of Pulmonary and Critical Care Medicine, University of Cincinnati, Cincinnati, OH, USA.

Norbert F Voelkel (NF)

Dept of Pulmonary Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

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Classifications MeSH