angiotensinogen

血管紧张素原
  • 文章类型: Journal Article
    胰腺腺癌(PAAD)是最致命的恶性肿瘤之一。和信使核糖核酸疫苗,它们构成了最新一代的疫苗技术,有望为胰腺癌的治疗带来新的思路。合并并分析癌症基因组图谱-PAAD和基因型-组织表达数据。使用加权基因共表达网络分析来鉴定与免疫和氧化应激相关的基因中与肿瘤突变负荷相关的基因模块。通过单因素Cox回归分析筛选差异表达的免疫相关氧化应激基因,这些基因通过非负矩阵分解进行分析。免疫浸润分析后,采用最小绝对收缩和选择算子回归结合Cox回归构建模型,并根据模型构建后的受试者工作特性曲线和决策曲线分析曲线预测模型的有用性。最后,使用基因集富集分析结合京都基因和基因组百科全书和基因本体论生物学过程分析进行代谢途径富集分析。该模型由ERAP2,间充质上皮转化因子(MET),与现有模型相比,CXCL9和血管紧张素原(AGT)基因可用于帮助更准确地预测胰腺癌患者的预后。ERAP2参与免疫激活,在癌症免疫逃避中起重要作用。MET与肝细胞生长因子结合,导致c-MET的二聚化和磷酸化。这激活了各种信号通路,包括MAPK和PI3K,为了调节增殖,入侵,和癌细胞的迁移。CXCL9过表达与不良患者预后相关,并减少PAAD肿瘤微环境中CD8细胞毒性T淋巴细胞的数量。AGT被肾素酶裂解以产生血管紧张素1,并且AGT转换酶裂解血管紧张素1以产生血管紧张素2。胰腺癌诊断后暴露于AGT转换酶抑制剂与提高生存率相关本研究中确定的4个基因-ERAP2,MET,CXCL9和AGT有望成为信使核糖核酸疫苗开发的靶标,需要进一步深入研究。
    Adenocarcinoma of the pancreas (PAAD) is one of the deadliest malignant tumors, and messenger ribonucleic acid vaccines, which constitute the latest generation of vaccine technology, are expected to lead to new ideas for the treatment of pancreatic cancer. The Cancer Genome Atlas-PAAD and Genotype-Tissue Expression data were merged and analyzed. Weighted gene coexpression network analysis was used to identify gene modules associated with tumor mutational burden among the genes related to both immunity and oxidative stress. Differentially expressed immune-related oxidative stress genes were screened via univariate Cox regression analysis, and these genes were analyzed via nonnegative matrix factorization. After immune infiltration analysis, least absolute shrinkage and selection operator regression combined with Cox regression was used to construct the model, and the usefulness of the model was predicted based on the receiver operating characteristic curve and decision curve analysis curves after model construction. Finally, metabolic pathway enrichment was analyzed using gene set enrichment analysis combined with Kyoto Encyclopedia of Genes and Genomes and gene ontology biological process analyses. This model consisting of the ERAP2, mesenchymal-epithelial transition factor (MET), CXCL9, and angiotensinogen (AGT) genes can be used to help predict the prognosis of pancreatic cancer patients more accurately than existing models. ERAP2 is involved in immune activation and is important in cancer immune evasion. MET binds to hepatocyte growth factor, leading to the dimerization and phosphorylation of c-MET. This activates various signaling pathways, including MAPK and PI3K, to regulate the proliferation, invasion, and migration of cancer cells. CXCL9 overexpression is associated with a poor patient prognosis and reduces the number of CD8 + cytotoxic T lymphocytes in the PAAD tumor microenvironment. AGT is cleaved by the renin enzyme to produce angiotensin 1, and AGT-converting enzyme cleaves angiotensin 1 to produce angiotensin 2. Exposure to AGT-converting enzyme inhibitors after pancreatic cancer diagnosis is associated with improved survival. The 4 genes identified in the present study - ERAP2, MET, CXCL9, and AGT - are expected to serve as targets for messenger ribonucleic acid vaccine development and need to be further investigated in depth.
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  • 文章类型: Journal Article
    脓毒症心肌功能障碍(SIMD)是脓毒症的严重并发症。有越来越多的证据表明肾素-血管紧张素系统(RAS)在SIMD中被激活。血管紧张素原(AGT)是RAS的前体,和AGT的抑制可能有显著的心血管益处。但直到现在,尚无针对AGT的小分子药物的报道.在这项研究中,我们设计了一种基于启动子-荧光素酶的系统来筛选新型AGT抑制剂以缓解SIMD。作为高通量筛选的结果,从351个草药来源的天然化合物中发现总共5个化合物抑制AGT。18β-甘草次酸(18βGA)被进一步鉴定为AGT的有效抑制剂。体外实验,18βGA可以抑制HepG2细胞分泌AGT,减轻HepG2上清液共培养心肌细胞线粒体氧化应激水平的升高。在体内,18βGA延长了SIMD小鼠的存活率,增强心脏功能,并抑制线粒体功能和炎症的损伤。此外,结果表明,18βGA可能通过下调肝细胞核因子4(HNF4)来降低AGT转录,从而进一步缓解SIMD。总之,我们为AGT抑制剂提供了更有效的筛选策略,并扩展了18βGA作为一种有前景的先导化合物在挽救与RAS过度激活相关的心血管疾病方面的新作用.
    Sepsis induced myocardial dysfunction (SIMD) is a serious complication of sepsis. There is increasing evidence that the renin-angiotensin system (RAS) is activated in SIMD. Angiotensinogen (AGT) is a precursor of the RAS, and the inhibition of AGT may have significant cardiovascular benefits. But until now, there have been no reports of small molecule drugs targeting AGT. In this study, we designed a promoter-luciferase based system to screen for novel AGT inhibitors to alleviate SIMD. As a result of high-throughput screening, a total of 5 compounds from 351 medicinal herb-derived natural compounds were found inhibiting AGT. 18β-glycyrrhetinic acid (18βGA) was further identified as a potent suppressor of AGT. In vitro experiments, 18βGA could inhibit the secretion of AGT by HepG2 cells and alleviate the elevated level of mitochondrial oxidative stress in cardiomyocytes co-cultured with HepG2 supernatants. In vivo, 18βGA prolonged the survival rate of SIMD mice, enhanced cardiac function, and inhibited the damage of mitochondrial function and inflammation. In addition, the results showed that 18βGA may reduce AGT transcription by downregulating hepatocyte nuclear factor 4 (HNF4) and that further alleviated SIMD. In conclusion, we provided a more efficient screening strategy for AGT inhibitors and expanded the novel role of 18βGA as a promising lead compound in rescuing cardiovascular disease associated with RAS overactivation.
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  • 文章类型: Journal Article
    探讨东北地区人群AGT基因rs699、rs4762、rs1926723单核苷酸多态性与系统性红斑狼疮(SLE)易感性的相关性。同时还引入了一种早期检测SLE的新方法。纳入2020年1月至2022年12月在哈尔滨医科大学附属第一医院就诊的SLE患者和健康志愿者856例。在这项研究中,从参与者收集了临床信息和生物样本。采用SNaPshot测序技术对AGT基因中rs699、rs4762和rs1926723的碱基进行测序。通过Hardy-Weinberg(HWE)遗传平衡分析了SNP的遗传稳定性。该研究使用逻辑回归分析研究了遗传稳定的SNP与SLE易感性之间的相关性。Rs699不遵守HWE遗传平衡的原则(p<0.01)。相反,rs4762和rs1926723均符合HWE遗传平衡(p>.05)。然而,rs4762的基因型和等位基因频率在两组之间没有观察到显著差异(p>.05)。此外,AG的分布有显著差异,两组间rs1926723的GG基因型频率和G等位基因频率(p<.001)。具有AG和GG基因型和G等位基因的个体发生SLE的频率明显降低,提示针对SLE易感性的潜在遗传保护因素。SNPsrs1926723可能与SLE的易感性有关,而AG,GG基因型和G等位基因可能是东北地区SLE发病的重要保护因素。
    To investigate the correlation between susceptibility to systemic lupus erythematosus (SLE) and single nucleotide polymorphisms (SNPs) rs699, rs4762 and rs1926723 in the AGT gene in the population of Northeast China, while also introducing a new method for early detection of SLE. A total of 856 cases of SLE patients and healthy volunteers who attended the First Affiliated Hospital of Harbin Medical University from January 2020 to December 2022 were recruited. Clinical information and biood samples were collected from particpants in this study. SNaPshot sequencing technology was used to sequence the bases of the rs699, rs4762 and rs1926723 in the AGT gene. The genetic stability of SNPs was analysed by means of Hardy-Weinberg (HWE) genetic equilibrium. The study examined the correlation between genetically stable SNPs and susceptibility to SLE using logistic regression analysis. Rs699 did not adhere to the principles of the HWE genetic equilibrium (p < .01). Conversely, both rs4762 and rs1926723 conformed to the HWE genetic equilibrium (p > .05). However, no significant differences in genotypes and alleles frequencies of the rs4762 were observed between the two groups (p > .05). Furthermore, there was a significant difference in the distribution of AG, GG genotypes frequency and G allele frequency at the rs1926723 between the two groups (p < .001). Individuals with AG and GG genotypes and the G allele had a significantly lower frequency of SLE, indicating a potential genetic protective factor against susceptibility to the SLE. The SNPs rs1926723 may be linked to the susceptibility to SLE, and the AG, GG genotypes and the G allele may be important protective factors for the development of SLE in Northeast China.
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  • 文章类型: Meta-Analysis
    由于各种研究的结果不一致,肾素-血管紧张素系统中的基因多态性在影响心肌病发展中的作用尚不清楚.在这项研究中,我们进行了系统评价和荟萃分析,以总结有关血管紧张素转换酶(ACE)I/D的影响的发现,血管紧张素原(AGT)M235T,心肌病患者血管紧张素II1型受体(AGTR1)A1166C基因多态性。我们对几个电子数据库进行了全面搜索,包括PubMed,Embase,Cochrane图书馆,和WebofScience,涵盖从数据库创建到2023年4月17日发布的文章。包括与心肌病相关的肾素-血管紧张素系统相关基因的遗传多态性评估研究。主要结果是心肌病。使用纽卡斯尔-渥太华量表评估偏倚风险。荟萃分析包括19项研究,包括4,052例病例和5,592例对照。发现ACEI/D多态性与心肌病相关(等位基因模型DvsI:OR=1.29,95CI%=1.08-1.52;显性模型DDIDvsII:OR=1.43,95CI%=1.01-2.02;隐性模型DDvsIDII:OR=0.79,95CI%=0.64-0.98)。AGTM235T多态性与心肌病无显著相关性(等位基因模型TvsM:OR=1.26,95CI%=0.96-1.66;显性模型TT+MTvsMM:OR=1.30,95CI%=0.98-1.73;隐性模型TTvsMT+MM:OR=0.63,95CI%=0.37-1.07)。在等位基因模型AvsC(OR=0.69,95CI%=0.46-1.03)和隐性模型AAvsCACC(OR=0.89,95CI%=0.34-2.30)下,AGTR1多态性与心肌病无明显相关性。但在主要模型AA+CAvsCC下(OR=0.51,95CI%=0.38-0.68)。目前的荟萃分析显示,ACEI/D的多态性可能是心肌病的遗传危险因素。在特定模型下,AGTR1基因多态性与心肌病风险之间存在关联。
    Due to the inconsistent findings from various studies, the role of gene polymorphisms in the renin-angiotensin system in influencing the development of cardiomyopathy remains unclear. In this study, we conducted a systematic review and meta-analysis to summarize the findings regarding the impact of angiotensin converting enzyme (ACE) I/D, angiotensinogen (AGT) M235T, and angiotensin II Type 1 receptor (AGTR1) A1166C gene polymorphisms in patients with cardiomyopathy. We performed a comprehensive search of several electronic databases, including PubMed, Embase, the Cochrane Library, and Web of Science, covering articles published from the time of database creation to April 17, 2023. Studies on the assessment of genetic polymorphisms in genes related to the renin-angiotensin system in relation to cardiomyopathy were included. The primary outcome was cardiomyopathy. Risk of bias was assessed using the Newcastle-Ottawa Scale scale. The meta-analysis includes 19 studies with 4,052 cases and 5,592 controls. The ACE I/D polymorphisms were found to be associated with cardiomyopathy (allelic model D vs I: OR = 1.29, 95CI% = 1.08-1.52; dominant model DD+ID vs II: OR = 1.43, 95CI% = 1.01-2.02; recessive model DD vs ID+II: OR = 0.79, 95CI% = 0.64-0.98). AGT M235T polymorphism and cardiomyopathy were not significantly correlated (allelic model T vs M: OR = 1.26, 95CI% = 0.96-1.66; dominant model TT+MT vs MM: OR = 1.30, 95CI% = 0.98-1.73; recessive model TT vs MT+MM: OR = 0.63, 95CI% = 0.37-1.07). AGTR1 polymorphism and cardiomyopathy were not significantly associated under allelic model A vs C (OR = 0.69, 95CI% = 0.46-1.03) and recessive model AA vs CA+CC (OR = 0.89, 95CI% = 0.34-2.30), but under the dominant model AA+CA vs CC (OR = 0.51, 95CI% = 0.38-0.68). The current meta-analysis reveals that polymorphisms in ACE I/D may be a genetic risk factor for cardiomyopathy. There is an association between AGTR1 gene polymorphisms and risk of cardiomyopathy under the specific model.
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  • 文章类型: Journal Article
    背景:急性肾损伤(AKI)是脓毒症最严重的并发症之一。本研究旨在分析尿中性粒细胞明胶酶相关脂质运载蛋白(uNGAL)的作用。尿肾损伤分子-1(uKIM-1),尿血管紧张素原(uAGT)在脓毒性AKI早期诊断和死亡率预测中的应用.
    方法:前瞻性研究纳入了80名ICU脓毒症患者和100名健康个体,并将患者分为AKI组和非AKI组。uNGAL,uKIM-1,uAGT,血清肌酐/降钙素原/C反应蛋白,并确定了其他指标,并记录临床预测评分。uNGAL的敏感性和特异性,通过受试者操作特征(ROC)曲线和曲线下面积(AUC)分析uKIM-1和uAGT在诊断和死亡率预测中的作用。
    结果:uNGAL,脓毒症患者的uKIM-1和uAGT水平高于健康对照组,AKI患者高于非AKI患者,AKI-2和AKI-3患者高于AKI-1患者。入院后0小时,3项指标在感染性AKI诊断中的联合疗效(ROC-AUC:0.770;敏感性:82.5%;特异性:70.0%)优于单一指标.在24小时,uNGAL,在脓毒症非存活者中uKIM-1和uAGT水平高于存活者,在脓毒症非存活者中uKIM-1和uAGT水平高于脓毒症AKI存活者。3项指标联合预测脓毒症/脓毒症AKI死亡率(ROC-AUC:0.828/0.847;敏感性:71.4%/100.0%;特异性:82.7%/66.7%)优于单一指标。
    结论:uNGAL,uKIM-1和uAGT水平在化脓性AKI中升高,它们的组合有助于早期诊断和死亡率预测。
    BACKGROUND: Acute kidney injury (AKI) is one of the most severe complications of sepsis. This study was conducted to analyze the role of urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary kidney injury molecular-1 (uKIM-1), and urinary angiotensinogen (uAGT) in the early diagnosis and mortality prediction of septic AKI.
    METHODS: The prospective study enrolled 80 sepsis patients in the ICU and 100 healthy individuals and divided patients into an AKI group and a non-AKI group. uNGAL, uKIM-1, uAGT, serum creatinine/procalcitonin/C-reaction protein, and other indicators were determined, and clinical prediction scores were recorded. The sensitivity and specificity of uNGAL, uKIM-1, and uAGT in diagnosis and mortality prediction were analyzed by the receiver operator characteristic (ROC) curve and the area under the curve (AUC).
    RESULTS: uNGAL, uKIM-1, and uAGT levels were higher in sepsis patients than healthy controls, higher in AKI patients than non-AKI patients, and higher in AKI-2 and AKI-3 patients than AKI-1 patients. At 0 h after admission, the combined efficacy of three indicators in septic AKI diagnosis (ROC-AUC: 0.770; sensitivity: 82.5%; specificity: 70.0%) was better than a single indicator. At 24 h, uNGAL, uKIM-1, and uAGT levels were higher in sepsis non-survivals than survivals and higher in septic AKI non-survivals than septic AKI survivals. The combined efficacy of three indicators in the prediction of sepsis/septic AKI mortality (ROC-AUC: 0.828/0.847; sensitivity: 71.4%/100.0%; specificity: 82.7%/66.7%) was better than a single indicator.
    CONCLUSIONS: uNGAL, uKIM-1, and uAGT levels were increased in septic AKI, and their combination helped the early diagnosis and mortality prediction.
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  • 文章类型: Journal Article
    下颌下腺(SMG)和舌下腺(SLG)是哺乳动物的三个主要唾液腺中的两个,包含浆液和粘液腺泡细胞。这两个腺体共有一些功能特性,这在很大程度上取决于腺泡细胞的类型。近年来,而具有10倍平台的ScRNA-seq(单细胞测序)已用于探索唾液腺中的分子标记,很少有研究检查SMG和SLG之间的腺泡异质性和独特的分子标记。本研究旨在鉴定SLG和SMG中腺泡细胞的分子标志物。我们在4周龄(W)的小鼠中进行了ScRNA-seq分析,并使用RT-qPCR验证了筛选的分子标记,免疫组织化学,和免疫荧光。我们的结果显示了显著的异质性腺泡细胞,尽管在4W时两个腺体之间的簇组成有很大的相似性。此外,我们证明Agt是SMG浆液性腺泡细胞的特异性标记,而Gal是SLG粘液腺泡细胞的特异性标志物。轨迹推断表明,Agt和Gal代表了成人晚期发育过程中两种类型的差异腺泡细胞簇。因此,我们揭示了先前未知的唾液腺泡细胞多样性的特异性标记,这对他们进一步的功能研究具有广泛的意义。
    The submandibular gland (SMG) and sublingual gland (SLG) are two of three major salivary glands in mammals and comprise serous and mucous acinar cells. The two glands share some functional properties, which are largely dependent on the types of acinar cells. In recent years, while ScRNA-seq (single-cell sequencing) with a 10 × platform has been used to explore molecular markers in salivary glands, few studies have examined the acinar heterogeneity and unique molecular markers between SMG and SLG. This study aimed to identify the molecular markers of acinar cells in the SLG and SMG. We performed ScRNA-seq analyses in 4-week-old mice and verified the screened molecular markers using reverse transcription-quantitative real-time PCR, immunohistochemistry, and immunofluorescence. Our results showed prominently heterogeneous acinar cells, although there was great similarity in the cluster composition between the two glands at 4 weeks. Furthermore, we demonstrated that Agt is a specific marker of SMG serous acinar cells, whereas Gal is a specific marker of SLG mucous acinar cells. Trajectory inference revealed that Agt and Gal represent two types of differential acinar cell clusters during late development in adults. Thus, we reveal previously unknown specific markers for salivary acinar cell diversity, which has extensive implications for their further functional research.
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  • 文章类型: Journal Article
    Ca2+/钙调蛋白依赖性蛋白激酶II(CaMKII)上调有助于心血管疾病的发病机制,包括高血压.表达人血管紧张素原基因[TGR(hAGT)L1623]的转基因大鼠是一种新型的人源化高血压模型,与心脏收缩功能和β-肾上腺素能受体(AR)储备的下降有关。分子机制尚不清楚。我们检验了在TGR(hAGT)L1623大鼠中,左心室(LV)心肌细胞CaMKIIδ和β3-AR上调,但β1-AR下调,是导致心功能不全和β-AR脱敏的重要原因。
    我们比较了左心室肌细胞CaMKIIδ,CaMKIIδ磷酸化(在Thr287处)(pCaMKIIδ),以及β1-和β3-AR的表达,并确定了使用CaMKII抑制剂预处理和不预处理心肌细胞对β-AR刺激的心肌细胞功能和[Ca2]I瞬时([Ca2]iT)反应,KN-93(10-6米,30分钟)在雄性SpragueDawley(SD;N=10)对照和TGR(hAGT)L1623(N=10)成年大鼠中。
    TGR(hAGT)L1623大鼠的高血压伴随着LV心肌细胞β3-AR蛋白水平的显着升高和β1-AR蛋白水平的降低。CaMKIIδ磷酸化(在Thr287),pCaMKIIδ显著增加35%。这些变化伴随着显著降低的基底细胞收缩(dL/dtmax),弛豫(dR/dtmax),和[Ca2+]iT。异丙肾上腺素(10-8M)在dL/dtmax中产生明显较小的增加,dR/dtmax,和[Ca2+]iT。此外,仅在TGR(hAGT)L1623大鼠中,用KN-93(10-6M,30分钟)完全恢复了正常的基础和异丙肾上腺素刺激的心肌细胞收缩,放松,和[Ca2+]iT。
    LV心肌细胞CaMKIIδ过度激活以及β3-AR和β1-AR的相关对比变化可能是这种人源化高血压模型中异常收缩表型和β-AR脱敏的关键分子机制。
    UNASSIGNED: Upregulation of Ca2+/calmodulin-dependent protein kinase II (CaMKII) contributes to the pathogenesis of cardiovascular disease, including hypertension. Transgenic rats expressing the human angiotensinogen gene [TGR (hAGT)L1623] are a new novel humanized model of hypertension that associates with declines in cardiac contractile function and β-adrenergic receptor (AR) reserve. The molecular mechanisms are unclear. We tested the hypothesis that in TGR (hAGT)L1623 rats, left ventricular (LV) myocyte CaMKIIδ and β3-AR are upregulated, but β1-AR is down-regulated, which are important causes of cardiac dysfunction and β-AR desensitization.
    UNASSIGNED: We compared LV myocyte CaMKIIδ, CaMKIIδ phosphorylation (at Thr287) (pCaMKIIδ), and β1-and β3-AR expressions and determined myocyte functional and [Ca2+]I transient ([Ca2+]iT) responses to β-AR stimulation with and without pretreatment of myocytes using an inhibitor of CaMKII, KN-93 (10-6 M, 30 min) in male Sprague Dawley (SD; N = 10) control and TGR (hAGT)L1623 (N = 10) adult rats.
    UNASSIGNED: Hypertension in TGR (hAGT)L1623 rats was accompanied by significantly increased LV myocyte β3-AR protein levels and reduced β1-AR protein levels. CaMKIIδ phosphorylation (at Thr287), pCaMKIIδ was significantly increased by 35%. These changes were followed by significantly reduced basal cell contraction (dL/dtmax), relaxation (dR/dtmax), and [Ca2+]iT. Isoproterenol (10-8 M) produced significantly smaller increases in dL/dtmax, dR/dtmax, and [Ca2+]iT. Moreover, only in TGR (hAGT)L1623 rats, pretreatment of LV myocytes with KN-93 (10-6 M, 30 min) fully restored normal basal and isoproterenol-stimulated myocyte contraction, relaxation, and [Ca2+]iT.
    UNASSIGNED: LV myocyte CaMKIIδ overactivation with associated contrast changes in β3-AR and β1-AR may be the key molecular mechanism for the abnormal contractile phenotype and β-AR desensitization in this humanized model of hypertension.
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  • 文章类型: Meta-Analysis
    子痫前期(PE)的病因机制尚不清楚,因此,我们试图研究先兆子痫易感性与肾素-血管紧张素-醛固酮系统(RAAS)基因多态性之间的关联,以从遗传学角度探讨其病因。在电子数据库中进行了系统搜索,以确定相关研究。最终纳入了73项研究,优势比由5个遗传模型生成.在总体分析中,AGTM235T检测到显著关联,AT1RA1166C和CYP11B2C344T,而AGTT174M则呈负相关。按种族和地理分层,AGT235T等位基因和AT1R1166C等位基因增加先兆子痫风险,AGTT174M与先兆子痫无关。我们的荟萃分析表明,AGT235T等位基因和AT1R1166C等位基因增加,CYP11B2344T等位基因降低了先兆子痫的风险,而AGTT174M多态性并未改变先兆子痫的风险。因此,携带高危基因型的孕妇需要加强管理,以预防和早期识别先兆子痫。
    The aetiological mechanism of preeclampsia (PE) is unclear exactly, so we attempted to investigate the association between susceptibility to preeclampsia and renin-angiotensin-aldosterone system (RAAS) gene polymorphisms to explore the aetiology in terms of genetics. A systematic search was performed in electronic databases to identify relevant studies. Eventually 73 studies were enrolled, odds ratios were generated by 5 genetic models. In overall analysis, significant associations were detected for AGT M235T, AT1R A1166C and CYP11B2 C344T whereas negative correlation was shown for AGT T174M. As stratified by race and geography, AGT 235T allele and AT1R 1166C allele increased preeclampsia risk and AGT T174M was justified uncorrelated with preeclampsia. Our meta-analysis illustrated that AGT 235T allele and AT1R 1166C allele increased and CYP11B2 344T allele decreased preeclampsia risk while AGT T174M polymorphism did not change preeclampsia risk. Hence, pregnant women carrying high-risk genotypes need strengthened management to prevent and early identification of preeclampsia.
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  • 文章类型: English Abstract
    目的:探讨肾动脉阻力指数(RRI)和尿血管紧张素原(UAGT)在脓毒症患者急性肾损伤(AKI)早期诊断中的价值。
    方法:进行前瞻性研究。选择2021年1-9月宁夏医科大学总医院重症医学科收治的78例脓毒症患者。观察患者在1周内发生AKI。一般数据[性别,年龄,体重指数(BMI),主要感染部位和危重疾病相关评分],实验室指标[平均动脉压(MAP),中心静脉压(CVP),降钙素原(PCT),动脉血乳酸(Lac),等。],记录机械通气时间和重症监护病房(ICU)住院时间.患者血流动力学稳定后,在入住ICU后24小时内进行肾脏超声检查以测量RRI.诊断后立即采集尿样,酶联免疫吸附试验(ELISA)检测UAGT水平。比较两组的上述参数。采用多因素Logistic回归分析脓毒症患者发生AKI的危险因素。绘制受试者操作特征曲线(ROC曲线),分析相关指标对脓毒症AKI的预测价值。
    结果:最终共纳入78例患者,其中45例发生AKI,33例未发生。与非AKI组相比,血管活性药物的使用率,28天死亡率,序贯器官衰竭评估(SOFA)评分,急性生理学和慢性健康评估II(APACHEII)评分,PCT,Lac,RRI和UAGT在AKI组中显著升高[血管活性药物使用率:68.9%vs.39.4%,28天死亡率:48.9%vs.24.2%,SOFA得分:12.0(10.5,14.0)vs.8.0(7.0,10.0),APACHEII评分:22.0(18.0,27.5)vs.16.0(15.0,18.5),PCT(μg/L):12.5±2.6vs.10.9±2.8,Lac(mmol/L):2.6(1.9,3.4)与1.9(1.3,2.6),RRI:0.74±0.03vs.0.72±0.02,UAGT(μg/L):75.16±19.99vs.46.28±20.75,均P<0.05],机械通气的持续时间和ICU住院时间显着延长[机械通气的持续时间(天):8.0(7.0,12.0)vs.5.0(4.0,6.0),ICU住院时间(天):14.0(10.0,16.0)vs.9.0(8.0,11.5),两者P<0.01],并且MAP显着降低[mmHg(1mmHg≈0.133kPa):68.5±11.2vs.74.2±12.8,P<0.05。其他参数两组间差异无统计学意义。多因素Logistic回归分析显示,SOFA评分[比值比(OR)=2.088,95%置信区间(95CI)为1.322-3.299],APACHEII评分(OR=1.447,95CI为1.134-1.845),RRI(OR=1.432,95CI为1.103-1.859),UAGT(OR=1.077,95CI为1.035~1.121)是脓毒症并发AKI的独立危险因素(均P<0.01)。ROC曲线分析显示,SOFA评分,APACHEII得分,RRI和UAGT对脓毒症患者AKI有一定的预测价值,ROC曲线下面积(AUC)为0.814(95CI为0.716-0.912),0.804(95CI为0.708-0.901),0.789(95CI为0.690-0.888),和0.840(95CI为0.747-0.934),分别,RRI联合UAGT的AUC为0.912(95CI为0.849-0.974),优于上述单项指标(均P<0.05)。
    结论:RRI联合UAGT对脓毒症AKI有较高的早期预测价值。
    OBJECTIVE: To investigate the value of renal artery resistance index (RRI) and urinary angiotensinogen (UAGT) in the early diagnosis of acute kidney injury (AKI) in patients with sepsis.
    METHODS: A prospective study was conducted. Seventy-eight patients with sepsis admitted to the department of critical care medicine of General Hospital of Ningxia Medical University from January to September 2021 were enrolled. Patients were observed for the development of AKI within 1 week. General data [gender, age, body mass index (BMI), major infection sites and critical illness related scores], laboratory indicators [mean arterial pressure (MAP), central venous pressure (CVP), procalcitonin (PCT), arterial blood lactic acid (Lac), etc.], duration of mechanical ventilation and length of intensive care unit (ICU) stay were recorded. After hemodynamic stabilization of the patients, renal ultrasound was performed to measure the RRI within 24 hours after ICU admission. Urine samples were taken immediately after diagnosis, and the level of UAGT was detected by enzyme-linked immunosorbent assay (ELISA). The above parameters were compared between the two groups. Multivariate Logistic regression was used to analyze the risk factors of AKI in patients with sepsis. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of related indicators for AKI in sepsis.
    RESULTS: A total of 78 patients were finally enrolled, of which 45 developed AKI and 33 did not. Compared with the non-AKI group, the rates of vasoactive drugs use, 28-day mortality, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation II (APACHE II) score, PCT, Lac, RRI and UAGT were significantly higher in the AKI group [rates of vasoactive drugs use: 68.9% vs. 39.4%, 28-day mortality: 48.9% vs. 24.2%, SOFA score: 12.0 (10.5, 14.0) vs. 8.0 (7.0, 10.0), APACHE II score: 22.0 (18.0, 27.5) vs. 16.0 (15.0, 18.5), PCT (μg/L): 12.5±2.6 vs. 10.9±2.8, Lac (mmol/L): 2.6 (1.9, 3.4) vs. 1.9 (1.3, 2.6), RRI: 0.74±0.03 vs. 0.72±0.02, UAGT (μg/L): 75.16±19.99 vs. 46.28±20.75, all P < 0.05], the duration of mechanical ventilation and the length of ICU stay were significantly prolonged [duration of mechanical ventilation (days): 8.0 (7.0, 12.0) vs. 5.0 (4.0, 6.0), length of ICU stay (days): 14.0 (10.0, 16.0) vs. 9.0 (8.0, 11.5), both P < 0.01], and MAP was significantly lowered [mmHg (1 mmHg ≈ 0.133 kPa): 68.5±11.2 vs. 74.2±12.8, P < 0.05]. There was no significant difference in other parameters between the two groups. Multivariate Logistic regression analysis showed that SOFA score [odds ratio (OR) = 2.088, 95% confidence interval (95%CI) was 1.322-3.299], APACHE II score (OR = 1.447, 95%CI was 1.134-1.845), RRI (OR = 1.432, 95%CI was 1.103-1.859), and UAGT (OR = 1.077, 95%CI was 1.035-1.121) were independent risk factors for sepsis complicated with AKI (all P < 0.01). ROC curve analysis showed that SOFA score, APACHE II score, RRI and UAGT had certain predictive value for AKI in septic patients, the area under the ROC curve (AUC) were 0.814 (95%CI was 0.716-0.912), 0.804 (95%CI was 0.708-0.901), 0.789 (95%CI was 0.690-0.888), and 0.840 (95%CI was 0.747-0.934), respectively, and the AUC of RRI combined with UAGT was 0.912 (95%CI was 0.849-0.974), which was better than the above single index (all P < 0.05).
    CONCLUSIONS: RRI combined with UAGT has a high early predictive value for septic AKI.
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  • 文章类型: Journal Article
    背景:人们认为遗传因素可能在冠状动脉疾病(CAD)的发展中起重要作用。一些研究报道AGT多态性与CAD易感性有关,但是这些结果与其他研究的结果相矛盾,在东亚人群中的相关性尚不清楚。因此,进行荟萃分析以评估这种关系。
    方法:使用出版物数据库搜索符合条件的相关研究,并从符合纳入标准的研究中提取有效数据。随后,具有95%置信区间(CI)的优势比(OR),用于评估AGT多态性与CAD风险之间的关联强度。
    结果:本荟萃分析中纳入了7项仅以英文发表的合格研究。在东亚人口中,在杂合子模型下,CAD易感性与AGTM235T相关(OR=0.19)。分层分析表明,在等位基因下,AGTM235T与中国CAD风险之间存在显着关系(OR=1.34)。显性(OR=1.43),和杂合子(OR=1.62)模型。结果表明,在东亚人群中,T174M多态性与隐性(OR=2.28)和纯合子(OR=2.37)模型的CAD风险显着相关。
    结论:在东亚人口中,尤其是中国人,AGT的M235T与CAD易感性相关。T174M多态性与东亚人群的CAD风险相关。
    BACKGROUND: It is thought that genetic factors may play an important role in the development of coronary artery disease (CAD). Several studies report that AGT polymorphism is implicated in CAD susceptibility, but these results contradict those of the other studies with the associations being unclear in the Eastern Asian population. Therefore, meta-analysis was performed to evaluate this relationship.
    METHODS: Publication databases were used to search for eligible relevant studies and valid data were extracted from studies meeting the inclusion criteria. Subsequently, odds ratios (ORs) with 95 % confidence intervals (CIs), were used to assess the strength of the association between AGT polymorphism and CAD risk.
    RESULTS: Seven eligible studies published only in English were included in the present meta-analysis. In the Eastern Asian population, CAD susceptibility was shown to be related to AGT M235T under the heterozygote model (OR = 0.19). Stratified analysis indicated there was a significant relationship between AGT M235T and CAD risk in China under allelic (OR = 1.34), dominant (OR = 1.43), and heterozygote (OR = 1.62) models. The results showed that the T174M polymorphism was significantly associated with CAD risk in recessive (OR = 2.28) and homozygote (OR = 2.37) models in the Eastern Asian population.
    CONCLUSIONS: In the Eastern Asian population, especially the Chinese, the M235T of AGT is associated with CAD susceptibility. The T174M polymorphisms were associated with CAD risk in the Eastern Asian population.
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