Angiotensin-converting enzyme

血管紧张素转换酶
  • 文章类型: Journal Article
    背景:据我们所知,消耗大麻种子蛋白(HSP)及其水解产物衍生的生物活性肽(HSP)对血压(BP)的影响尚未在人类中进行研究。
    目的:我们旨在研究与酪蛋白相比,HSP及其水解物的消耗如何调节24小时收缩压和舒张压BP(24-hrSBP和24-hrDBP)以及BP的血浆生物标志物。
    方法:在双盲中,随机化,交叉设计试验,35名患有轻度高血压的成年人,SBP在130至160毫米汞(mmHg)之间,招募DBP≤110mmHg。参与者被随机分配到三个6周治疗的不同序列,50克/天的酪蛋白,HSP,和HSP,45μg/d加HSP衍生的生物活性肽(HSP+),5g/d,间隔2周洗脱期。通过重复测量的线性混合模型评估治疗效果。
    结果:与酪蛋白相比,HSP+消耗后,24hrSBP和24hrDBP分别从135.1和80.0mmHg降至128.1±1.6(P<.0001)和76.0±1.4mmHg(P<.0001),而这些值分别为133.5±1.6和78.9±1.4HSP消耗后(P<.0001)。血浆血管紧张素转换酶(ACE)活性的HSP和HSP消耗之间没有差异,肾素或一氧化氮(NO)浓度。然而,与酪蛋白相比,这两种治疗方法能够降低ACE和肾素活性,并提高血浆中NO的浓度。
    结论:这些结果表明,大麻蛋白的消耗,以及与生物活性肽的组合,可能在高血压的饮食管理中发挥作用。该试验在clinicaltrials.gov注册为NCT03508895。
    The effects of consuming hemp seed protein (HSP) as well as its hydrolysate-derived bioactive peptide (HSP+) on blood pressure (BP) has not, to our knowledge, been investigated in humans.
    We aimed to investigate how consumption of HSP and its hydrolysate modulates 24-h systolic (SBP) and diastolic BP (DBP) and plasma biomarkers of BP compared with casein.
    In a double-blind, randomized, crossover design trial, 35 adults who had mild hypertension with SBP between 130 and 160 mmHg and DBP ≤110 mmHg were recruited. Participants were randomly assigned to varying sequences of 3 6-wk treatments, 50 g casein/d, 50 g HSP/d, or 45 g HSP plus 5 g HSP-derived bioactive peptides/d (HSP+), separated by a 2-wk washout period. Treatment effects were assessed with a linear mixed model with repeated measures.
    Compared with casein, after HSP+ consumption, 24-h SBP and 24-h DBP decreased from 135.1 and 80.0 mmHg to 128.1 ± 1.6 (P < 0.0001) and 76.0 ± 1.4 mmHg (P < 0.0001), respectively, whereas these values were 133.5 ± 1.6 and 78.9 ± 1.4 mmHg after HSP consumption (P < 0.0001). There were no differences between the HSP and HSP+ consumption in plasma angiotensin-converting enzyme (ACE) activity, renin, or nitric oxide (NO) concentrations. However, these 2 treatments were able to lower both ACE and renin activities and raise NO concentration in plasma compared with casein.
    These results suggest that hemp protein consumption, as well as in combination with bioactive peptides, may have a role in the dietary management of hypertension. This trial was registered at clinicaltrials.gov as NCT03508895.
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  • 文章类型: Journal Article
    低分子量食物衍生肽,高生物利用度,良好的吸收性已被用作血管紧张素转换酶(ACE)抑制剂。在本研究中,花生肽的体外抑制动力学,在硅片筛选中,ACE抑制活性的验证,分子动力学(MD)模拟,和HUVEC细胞进行系统鉴定ACE与花生肽相互作用的抑制机制。结果表明,FPHPP,FPHY,和FPHFD肽具有良好的热,pH值,和消化稳定性。MD轨迹阐明了肽和ACE之间的动态相关性,并验证了特异性结合相互作用。值得注意的是,FPHPP是最好的抑制剂,具有最强的结合亲和力,并显着增加NO,SOD生产,和AT2R表达式,并减少ROS,MDA,ET-1级,ACE,和AT1R在AngII损伤的HUVEC细胞中的积累。
    Food-derived peptides with low molecular weight, high bioavailability, and good absorptivity have been exploited as angiotensin-converting enzyme (ACE) inhibitors. In the present study, in-vitro inhibition kinetics of peanut peptides, in silico screening, validation of ACE inhibitory activity, molecular dynamics (MD) simulations, and HUVEC cells were performed to systematically identify the inhibitory mechanism of ACE interacting with peanut peptides. The results indicate that FPHPP, FPHY, and FPHFD peptides have good thermal, pH, and digestive stability. MD trajectories elucidate the dynamic correlation between peptides and ACE and verify the specific binding interaction. Noteworthily, FPHPP is the best inhibitor with a strongest binding affinity and significantly increases NO, SOD production, and AT2R expression, and decreases ROS, MDA, ET-1 levels, ACE, and AT1R accumulation in Ang II-injury HUVEC cells.
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  • 文章类型: Journal Article
    高血压是最典型的发病和死亡原因之一。本研究调查了芙蓉草药混合物提取物可能的抗高血压心血管作用,玉米丝,马郁兰,和洋甘菊.对从四种植物的地上部分及其混合物制备的水提取物进行HPLC分析以检测最主要的化合物。在功效研究之前进行安全性研究以确定剂量并确保提取物在雌性大鼠中的安全性。通过口服50mg/kgLName30天,在卵巢切除和非卵巢切除的大鼠中诱发高血压;将高血压大鼠分为非卵巢切除和未切除卵巢的未治疗组,给予卵巢切除和非卵巢切除高血压组的高剂量和低剂量混合物(150,300mg/kg)治疗组,以及接受血管紧张素转换酶抑制剂治疗的标准组。未治疗组血压明显升高,心率,胆固醇,甘油三酯,丙二醛,环磷酸腺苷,血管紧张素转换酶,C反应蛋白,并显著降低还原型谷胱甘肽,高密度脂蛋白,和内皮型一氧化氮合酶.治疗显著抵消了LName的影响。由于其高含量的类黄酮,该混合物提供了一种有前途的天然心血管调节补充剂。
    Hypertension is one of the most typical causes of morbidity and mortality. The present study investigated the possible antihypertensive cardiovascular effects of an herbal mixture extract of Hibiscus, Corn silk, Marjoram, and Chamomile. HPLC analysis of the water extract prepared from the aerial parts of four plants and their mixture was done to detect the most predominant compounds. A safety study was done prior to the efficacy study to determine the dose and ensure the extract\'s safety in female rats. Hypertension was induced in ovariectomized and non-ovariectomized rats by oral administration of 50 mg/kg of LName for 30 days; the hypertensive rats were classified into non-ovariectomized and ovariectomized untreated groups, treated groups with high and low doses of the mixture(150,300 mg/kg) given to ovariectomized and non-ovariectomized hypertensive groups and a standard group treated with angiotensin-converting enzyme inhibitor. The untreated group showed significant elevation of blood pressure, heart rate, cholesterol, triglycerides, malondialdehyde, cyclic adenosine monophosphate, angiotensin-converting enzyme, C-reactive protein, and significantly lowered reduced glutathione, high-density lipoprotein, and endothelial nitric oxide synthase. Treatment significantly counteracted the effects of L Name. The mixture provides a promising natural cardiovascular regulating supplement owing to its high contents of flavonoids.
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  • 文章类型: Journal Article
    背景:大多数致畸药物的风险缓解依赖于通过药物标签的风险沟通,产前暴露仍然很常见。有关产前暴露于具有致畸风险的药物的类型和风险因素的信息可以指导减少暴露的策略。
    目的:确定在怀孕期间通常使用的已知或潜在致畸风险的药物。
    方法:我们使用MarketScan®商业索赔和遭遇数据来识别活体或非活体妊娠发作(异位妊娠,自然流产和选择性流产,2011-2018年12至55岁人群的死产)结局。通过基于验证研究的适应性算法确定药物暴露的开始/结束日期和妊娠结局。我们要求从怀孕前90天到怀孕结束后30天连续进行健康计划登记。根据风险水平和证据质量(已知138种,潜在风险60种),从Teratogen信息系统(TERIS)和药物专著中选择具有已知或潜在致畸风险的药物。我们根据≥1次门诊药房索赔或在目标妊娠期间考虑药物风险状况的药物管理的医疗遭遇定义了产前暴露(例如,风险仅在妊娠早期或在一定剂量阈值)。性激素和激素类似物,流产和产后/流产出血治疗不被认为是致畸药物,因为不同妊娠相关适应症的挑战,如果阿片类药物的唯一致畸机制是体重减轻,则阿片类药物(由于复杂的风险-获益)或抗肥胖药物也不是。
    结果:在所有怀孕中,已知致畸风险和最高产前暴露的10种药物是磺胺甲恶唑/甲氧苄啶(SMX/TMP)(每100,000个妊娠年1,988),大剂量氟康唑(1248),托吡酯(351),赖诺普利(144),华法林(57),氯沙坦(56),卡马西平(50),丙戊酸盐(49),维多珠单抗(自2015年以来28个),缬沙坦(25)。在2011年至2018年期间,SMX/TMP的暴露率从每100,000个妊娠年2,346降至1,453,但自2015年批准以来,vedolizumab的暴露率增加了六倍。与活产妊娠相比,非活产妊娠的头三个月的产前暴露量较高,华法林的差异最大(非直播370与活产78),其次是丙戊酸盐(258vs.86)和托吡酯(1,728vs.674).产前暴露于具有潜在致畸风险的药物是低剂量氟康唑最普遍的(6,495),美托洛尔(1,325)和阿替洛尔(448)。非活产和活产妊娠之间最大的孕早期暴露差异是结石(242与89),加巴喷丁(1,639vs.653),和度洛西汀(1,914vs.860).在研究期间,观察到肼屈嗪和加巴喷丁暴露的稳定增长,而阿替洛尔暴露减少(561至280)。
    结论:在怀孕期间继续使用几种具有致畸风险的药物,这些药物有可能更安全的替代品。在某些致畸药物中观察到的产前暴露率的波动表明,需要定期重新评估风险缓解策略。未来的研究集中在了解药物使用的临床背景是必要的,以制定有效的策略来减少怀孕期间对具有致畸风险的药物的暴露。
    Risk mitigation for most teratogenic medications relies on risk communication via drug label, and prenatal exposures remain common. Information on the types of and risk factors for prenatal exposures to medications with teratogenic risk can guide strategies to reduce exposure.
    This study aimed to identify medications with known or potential teratogenic risk commonly used during pregnancy among privately insured persons.
    We used the Merative™ MarketScan® Commercial Database to identify pregnancies with live or nonlive (ectopic pregnancies, spontaneous and elective abortions, stillbirths) outcomes among persons aged 12 to 55 years from 2011 to 2018. Start/end dates of medication exposure and pregnancy outcomes were identified via an adapted algorithm based on validation studies. We required continuous health plan enrollment from 90 days before conception until 30 days after the pregnancy end date. Medications with known or potential teratogenic risk were selected from TERIS (Teratogen Information System) and drug monographs based on the level of risk and quality of evidence (138 with known and 60 with potential risk). We defined prenatal exposure on the basis of ≥1 outpatient pharmacy claim or medical encounter for medication administration during target pregnancy periods considering medication risk profiles (eg, risk only in the first trimester or at a certain dose threshold). Sex hormones and hormone analogs, and abortion and postpartum/abortion hemorrhage treatments were not considered as teratogenic medications because of challenges in separating pregnancy-related indications, nor were opioids (because of complex risk-benefit considerations) or antiobesity medications if their only teratogenic mechanism was weight loss.
    Among all pregnancies, the 10 medications with known teratogenic risk and the highest prenatal exposures were sulfamethoxazole/trimethoprim (1988 per 100,000 pregnancy-years), high-dose fluconazole (1248), topiramate (351), lisinopril (144), warfarin (57), losartan (56), carbamazepine (50), valproate (49), vedolizumab (28 since 2015), and valsartan (25). Prevalence of exposure to sulfamethoxazole/trimethoprim decreased from 2346 to 1453 per 100,000 pregnancy-years from 2011 to 2018, but prevalence of exposure to vedolizumab increased 6-fold since its approval in 2015. Prenatal exposures in the first trimester were higher among nonlive pregnancies than among live-birth pregnancies, with the largest difference observed for warfarin (nonlive 370 vs live birth 78), followed by valproate (258 vs 86) and topiramate (1728 vs 674). Prenatal exposures to medications with potential teratogenic risk were most prevalent for low-dose fluconazole (6495), metoprolol (1325), and atenolol (448). The largest first-trimester exposure differences between nonlive and live-birth pregnancies were observed for lithium (242 vs 89), gabapentin (1639 vs 653), and duloxetine (1914 vs 860). Steady increases in hydralazine and gabapentin exposures were observed during the study years, whereas atenolol exposure decreased (561 to 280).
    Several medications with teratogenic risk for which there are potentially safer alternatives continue to be used during pregnancy. The fluctuating rates of prenatal exposure observed for select teratogenic medications suggest that regular reevaluation of risk mitigation strategies is needed. Future research focusing on understanding the clinical context of medication use is necessary to develop effective strategies for reducing exposures to medications with teratogenic risk during pregnancy.
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  • 文章类型: Journal Article
    放射性标记的神经降压素类似物已被开发为针对表达神经降压素亚型1受体(NTS1R)的癌症进行治疗的候选药物。然而,它们被两种主要的肽酶快速降解,脑啡肽(NEP)和血管紧张素转换酶(ACE),迄今为止,临床成功有限。我们最近发现[99mTc]Tc-[Lys7]DT1(DT1,N4-Gly-Arg-Arg-Pro-Tyr-Ile-Leu-OH,N4=6-(羧基)-1,4,8,11-四氮烷)导致完全稳定的[99mTc]Tc-DT9类似物,在人胰腺癌AsPC-1异种移植物中显示出高摄取,但在小鼠中不利的药代动力学。旨在提高[99mTc]Tc-DT1的体内稳定性,同时不影响药代动力学,我们现在介绍三种新的[99mTc]Tc-DT1模仿,在Lys7的ε-胺上携带不同的侧基:MPBA(4-(4-甲基苯基)丁酸)-[99mTc]Tc-DT10;MPBA通过PEG4-接头-[99mTc]Tc-DT11;或亲水性PEG6链-[99mTc]Tc-DT12。在NTS1R阳性细胞中研究了这些修饰对受体亲和力和内化的影响。在没有或在NEP/ACE抑制期间的小鼠中评估对稳定性和AsPC-1肿瘤摄取的影响。与[99mTc]Tc-DT10不同,长链修饰的[99mTc]Tc-DT11和[99mTc]Tc-DT12在体内显着稳定,与[99mTc]Tc-DT1相比,肿瘤摄取显着改善。发现[99mTc]Tc-DT11达到最高的AsPC-1肿瘤值和良好的药代动力学,没有或在NEP抑制期间,使用SPECT/CT对NTS1R阳性肿瘤患者进行进一步验证的资格。
    Radiolabeled neurotensin analogs have been developed as candidates for theranostic use against neurotensin subtype 1 receptor (NTS1R)-expressing cancer. However, their fast degradation by two major peptidases, neprilysin (NEP) and angiotensin-converting enzyme (ACE), has hitherto limited clinical success. We have recently shown that palmitoylation at the ε-amine of Lys7 in [99mTc]Tc-[Lys7]DT1 (DT1, N4-Gly-Arg-Arg-Pro-Tyr-Ile-Leu-OH, N4 = 6-(carboxy)-1,4,8,11-tetraazaundecane) led to the fully stabilized [99mTc]Tc-DT9 analog, displaying high uptake in human pancreatic cancer AsPC-1 xenografts but unfavorable pharmacokinetics in mice. Aiming to improve the in vivo stability of [99mTc]Tc-DT1 without compromising pharmacokinetics, we now introduce three new [99mTc]Tc-DT1 mimics, carrying different pendant groups at the ε-amine of Lys7: MPBA (4-(4-methylphenyl)butyric acid)-[99mTc]Tc-DT10; MPBA via a PEG4-linker-[99mTc]Tc-DT11; or a hydrophilic PEG6 chain-[99mTc]Tc-DT12. The impact of these modifications on receptor affinity and internalization was studied in NTS1R-positive cells. The effects on stability and AsPC-1 tumor uptake were assessed in mice without or during NEP/ACE inhibition. Unlike [99mTc]Tc-DT10, the longer-chain modified [99mTc]Tc-DT11 and [99mTc]Tc-DT12 were significantly stabilized in vivo, resulting in markedly improved tumor uptake compared to [99mTc]Tc-DT1. [99mTc]Tc-DT11 was found to achieve the highest AsPC-1 tumor values and good pharmacokinetics, either without or during NEP inhibition, qualifying for further validation in patients with NTS1R-positive tumors using SPECT/CT.
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  • 文章类型: Journal Article
    自从发现ACE基因中的插入/缺失(I/D)多态性以来,D等位基因已被鉴定为与心血管疾病有关。已发现这种多态性与多种心血管危险因素有显著关联.最近的发现表明,发展中国家农村人口中代谢紊乱的患病率正在上升。关于健康问题的研究主要集中在城市人口,相对较少关注他们的农村同行,因此,本研究试图在印度农村Yadav人群中评估ACE基因I/D多态性的患病率,并探讨其与各种心血管危险因素的关系.在本研究中,Yadav社区的207名(男性47名,女性160名)成员参加了横断面研究。所有的社会人口因素,躯体测量(人体测量)变量,收集静脉血液和生理(血压),和生化(空腹血糖和血脂分布)参数测量由美国心脏协会推荐,进行ACE基因I/D多态性的等位基因特异性PCR,在2%琼脂糖凝胶电泳上对PCR产物进行基因分型,并分析ACE基因多态性与各种心血管危险因素的相关性.在被分析的个体中,34人(16.4%)被发现具有II基因型,58(28.0%)具有ID基因型,和115(55.6%)具有DD基因型。发现I等位基因的等位基因频率为0.31,D等位基因的频率为0.69。发现DD基因型的频率在具有高TC的个体中显著较高,高TG,和低的非HDL水平(p值<0.05)。当集体考虑时,这项研究的结果与以下假设一致:在该人群中,ACE多态性的DD基因型与心血管疾病危险因素存在相关性.
    The D allele has been identified as being linked to cardiovascular disease since the discovery of an insertion/deletion (I/D) polymorphism in the ACE gene, this polymorphism has been found to have significant associations with a variety of cardiovascular risk factors. Recent findings indicate a rising prevalence of metabolic disorders among rural populations in developing nations. Research on health matters has been predominantly focused on urban populations, with relatively less attention given to their rural counterparts Hence, the present study attempts to estimate the prevalence of ACE gene I/D polymorphism and explore its association with various cardiovascular risk factors among Rural Yadav population from India. In the present study, 207 (Male 47, Female 160) members of the Yadav community participated in the cross-sectional study. All the socio-demographic factors, somatometric (anthropometric) variables, and the intravenous blood was collected and Physiological (blood pressure), and biochemical (fasting glucose and lipid profile) parameters were measured as recommended by the American Heart Association, allele-specific PCR of the ACE gene I/D polymorphism was carried out, the PCR products were genotyped on 2% agarose gel Electrophoresis and ACE gene polymorphism was analysed for its association with various cardiovascular risk factors. Among the analysed individuals, 34 (16.4%) were found to have the II genotype, 58 (28.0%) had the ID genotype, and 115 (55.6%) had the DD genotype. The allele frequency of the I allele was found to be 0.31, and the frequency of the D allele was 0.69. The frequency of the DD genotype was found to be significantly higher among individuals with high TC, high TG, and low non-HDL levels (p value < 0.05). When considered collectively, the findings of this study are consistent with the hypothesis that the DD genotype of ACE polymorphism represents a correlation with cardiovascular disease risk factors in this population.
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  • 文章类型: Journal Article
    背景:肾素-血管紧张素系统(RAS)与炎症性肠病(IBD)有关,支持RAS阻断剂的翻译相关性。研究设计/结果的可比性是数据分析/讨论的基础。
    目的:我们旨在评估方案和结果之间的异质性,以研究血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂在IBD中的作用。
    方法:本研究是根据Cochrane建议和PRISMA(PROSPERO-CRD42022323853)进行和报告的。在PubMed中进行了系统搜索,Scopus和WebofScience选择符合纳入标准的研究。使用SYRCLES的动物研究偏倚风险工具对研究进行质量评估。
    结果:纳入了35项临床前研究和6项临床研究。化学诱导结肠炎是最常用的模型,但报告了不同剂量的诱导剂。所有研究都报告了至少一个疾病活动指数,宏观分数,或组织学评估,但是这些评分在方法上是异质的,并且针对不同的特征进行了报道.在药物干预中也发现了巨大的异质性。评估为结果的炎症标志物在研究中不同。
    结论:研究中方案和结果缺乏标准化,威胁到RAS阻滞剂如何影响IBD结局的证据。
    BACKGROUND: The renin-angiotensin system (RAS) has been associated with inflammatory bowel disease (IBD), supporting translational relevance of RAS blockers. Comparability of study design/outcomes is fundamental for data analysis/discussion.
    OBJECTIVE: We aimed at evaluating the heterogeneity among protocols and outcomes to study the effect of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in IBD.
    METHODS: This study was performed and reported in accordance with the Cochrane recommendations and PRISMA (PROSPERO-CRD42022323853). Systematic searches were performed in PubMed, Scopus and Web of Science. Studies that met the inclusion criteria were selected. Quality assessment of the studies was done with the SYRCLES\'s risk of bias tools for animal studies.
    RESULTS: Thirty-five pre-clinical studies and six clinical studies were included. Chemical induction of colitis was the most used model, but variable doses of the induction agent were reported. All studies reported at least a disease activity index, a macroscopic score, or a histologic assessment, but these scores were methodologically heterogeneous and reported for different characteristics. Great heterogeneity was also found in drug interventions. Inflammatory markers assessed as outcomes were different across studies.
    CONCLUSIONS: Lack of standardization of protocols and outcomes among studies threatens the evidence on how RAS blockers influence IBD outcomes.
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  • 文章类型: Journal Article
    背景:严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是2019年冠状病毒病(COVID-19)的病因,这导致了全球大流行。方法:我们使用两步聚合酶链反应检测ACE基因型,ELISA试剂盒检测细胞因子。我们还使用蛋白质组学鉴定了与ACE蛋白表达相关的免疫途径。结果:在这项研究中,我们发现,在中国人群中,血管紧张素转换酶(ACE)缺失多态性与COVID-19易感性呈风险依赖性.COVID-19疾病组的D/D基因型分布高于对照组(轻度组的D/D比值比为3.87(p值<0.0001),中度为2.59(p值=0.0002),严重症状为4.05(p值<0.0001),逻辑回归分析。此外,在ACE缺失多态性患者中发现基因型特异性细胞因子风暴和免疫反应丰富,提示对COVID-19易感性的贡献。最后,我们通过肺和血浆蛋白质组学鉴定了与患者ACE蛋白表达相关的免疫途径如补体系统。结论:我们的结果表明,在人群中考虑基因多态性对于发现基于宿主的COVID-19疫苗和预防和精准医学的药物设计非常重要。
    Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19), which has resulted in a global pandemic. Methodology: We used a two-step polymerase chain reaction to detect the ACE genotype and ELISA kits to detect the cytokine factor. We also used proteomics to identify the immune pathway related to the ACE protein expression. Result: In this study, we found that the angiotensin-converting enzyme (ACE) deletion polymorphism was associated with the susceptibility to COVID-19 in a risk-dependent manner among the Chinese population. D/D genotype distributions were higher in the COVID-19 disease group than in the control group (D/D odds ratio is 3.87 for mild (p value < 0.0001), 2.59 for moderate (p value = 0.0002), and 4.05 for severe symptoms (p value < 0.0001), logic regression analysis. Moreover, genotype-specific cytokine storms and immune responses were found enriched in patients with the ACE deletion polymorphism, suggesting the contribution to the susceptibility to COVID-19. Finally, we identified the immune pathway such as the complement system related to the ACE protein expression of patients by lung and plasma proteomics. Conclusion: Our results demonstrated that it is very important to consider gene polymorphisms in the population to discover a host-based COVID-19 vaccine and drug design for preventive and precision medicine.
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  • 文章类型: Journal Article
    背景:血管紧张素转换酶抑制剂(ACEis)或血管紧张素受体阻滞剂(ARB)阻断肾素-血管紧张素系统(RAS)对2019年冠状病毒病(COVID-19)易感性的影响,死亡率和严重程度描述不充分.我们在一个基于人群的高血压患者(HTN)队列中检查了RAS阻断与COVID-19诊断和预后之间的关系。
    方法:这是一项使用区域健康记录的队列研究。我们从加泰罗尼亚(西班牙)的主要健康提供者的87个医疗保健参考区域中确定了所有年龄在18-95岁的人,根据初级保健记录有HTN病史。数据与COVID-19测试结果相关,医院,2020年3月1日至2020年8月14日的药房和死亡率记录。我们将RAS阻滞剂的暴露定义为在COVID-19诊断前3个月或2020年3月1日期间分配ACEi/ARB。主要结果是:COVID-19住院患者的COVID-19感染和严重进展(需要有创呼吸支持或死亡的复合)。对于这两个结果和每个感兴趣的暴露(RAS封锁,ACEi或ARB)我们估计了年龄-,sex-,医疗保健领域-和倾向得分匹配的样本。
    结果:从1365215名居民的队列中,我们确定了305972名具有HTN病史的患者。最近在HTN患者中使用ACEi/ARBs与COVID-19诊断的6个月累积发生率{3.78%[95%置信区间(CI)3.69-3.86%]和4.53%(95%CI4.40-4.65%);P<0.001}。在12344例COVID-19感染患者中,使用ACEi/ARBs与需要有创呼吸支持或死亡的住院风险无关[OR=0.91(0.71~1.15);P=0.426].
    结论:HTN患者的RAS阻断与更高的COVID-19感染风险或更严重的疾病进展无关。
    BACKGROUND: The effect of renin-angiotensin system (RAS) blockade either by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) susceptibility, mortality and severity is inadequately described. We examined the association between RAS blockade and COVID-19 diagnosis and prognosis in a large population-based cohort of patients with hypertension (HTN).
    METHODS: This is a cohort study using regional health records. We identified all individuals aged 18-95 years from 87 healthcare reference areas of the main health provider in Catalonia (Spain), with a history of HTN from primary care records. Data were linked to COVID-19 test results, hospital, pharmacy and mortality records from 1 March 2020 to 14 August 2020. We defined exposure to RAS blockers as the dispensation of ACEi/ARBs during the 3 months before COVID-19 diagnosis or 1 March 2020. Primary outcomes were: COVID-19 infection and severe progression in hospitalized patients with COVID-19 (the composite of need for invasive respiratory support or death). For both outcomes and for each exposure of interest (RAS blockade, ACEi or ARB) we estimated associations in age-, sex-, healthcare area- and propensity score-matched samples.
    RESULTS: From a cohort of 1 365 215 inhabitants we identified 305 972 patients with HTN history. Recent use of ACEi/ARBs in patients with HTN was associated with a lower 6-month cumulative incidence of COVID-19 diagnosis {3.78% [95% confidence interval (CI) 3.69-3.86%] versus 4.53% (95% CI 4.40-4.65%); P < 0.001}. In the 12 344 patients with COVID-19 infection, the use of ACEi/ARBs was not associated with a higher risk of hospitalization with need for invasive respiratory support or death [OR = 0.91 (0.71-1.15); P = 0.426].
    CONCLUSIONS: RAS blockade in patients with HTN is not associated with higher risk of COVID-19 infection or with a worse progression of the disease.
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  • 文章类型: Journal Article
    在这篇文章中,研究了几种含酪氨酸的二肽对ACE(血管紧张素转换酶)的N和C结构域的选择性抑制作用,分子对接模拟了ACE与抑制剂的相互作用模式。MTT法检测二肽对人脐静脉内皮细胞(HUVEC)的影响。结果表明,食物来源的二肽AY(Ala-Tyr),LY(Leu-Tyr),和在C末端含有酪氨酸的IY(Ile-Tyr)是选择性抑制ACEC结构域的有利结构。这些二肽表现出竞争性和混合抑制模式,而二肽EY(Glu-Tyr),RY(Arg-Tyr),FY(Phe-Tyr),SY(Ser-Tyr)表现出非竞争性抑制。含有酪氨酸的食物来源的二肽对HUVEC细胞没有细胞毒性,为食品来源的酪氨酸二肽作为降压肽的应用提供了依据。本研究为探索含酪氨酸残基的ACE抑制肽的选择性抑制机制提供了理论依据。实际应用:血管紧张素转换酶(ACE)是一种双结构域二肽基羧肽酶,这是调节血压的关键酶。ACE有两个活跃的网站,C域和N域,具有较高的催化活性。尽管两个活性位点的氨基酸序列具有60%的相似性,在结构和功能上存在一些差异。应明确ACE域的作用机制。抑制剂与ACE结构域的构效关系尚未得到系统的研究。这项研究的目的是确定食物来源的酪氨酸二肽对ACE结构域的选择性抑制作用。这为寻找副作用较小的新型降压药物提供了新思路。
    In this article, the selective inhibition of several tyrosine-containing dipeptides on N and C domain of ACE (angiotensin-converting enzyme) was studied, and the interaction mode of ACE and inhibitors was simulated by molecular docking. MTT assay was used to detect the effect of dipeptide on human umbilical vein endothelial cells (HUVEC). The results showed that the food-derived dipeptides AY (Ala-Tyr), LY (Leu-Tyr), and IY (Ile-Tyr) containing tyrosine at the C-terminal were favorable structures for selective inhibition of ACE C-domain. These dipeptides showed competitive and mixed inhibition patterns, while the dipeptides EY (Glu-Tyr), RY (Arg-Tyr), FY (Phe-Tyr), and SY (Ser-Tyr) showed noncompetitive inhibition. Food-derived dipeptides containing tyrosine have no cytotoxicity on HUVEC cells, which provides a basis for the application of food-derived tyrosine dipeptides as antihypertensive peptides. This study provides a theoretical basis for exploring the selective inhibition mechanism of ACE inhibitory peptides containing tyrosine residue. PRACTICAL APPLICATIONS: Angiotensin-converting enzyme (ACE) is a two-domain dipeptidyl carboxypeptidase, which is a key enzyme to regulate blood pressure. ACE has two active sites, C- and N-domain, which have high catalytic activity. Although the amino acid sequences of the two active sites have 60% similarity, there are some differences in structure and function. The action mechanism of ACE domain should be clarified, and the structure-activity relationship between inhibitors and ACE domain has not been systematically studied. The aim of this study was to identify the selective inhibitory effect of food-derived tyrosine dipeptides on the domain of ACE. This provides a new idea for finding new antihypertensive drugs with less side effects.
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