失血性休克后肠淋巴液引流恢复小鼠肾组织ACE/ACE2平衡的作用

目的:观察失血性休克后肠淋巴液(PHSML)引流对失血性休克小鼠肾组织血管紧张素转换酶(ACE)/ACE2平衡的作用。方法:复制小鼠失血性休克模型,随机分为休克组与休克+引流组,行液体复苏;休克+引流组液体复苏后,引流肠淋巴液。在液体复苏后6 h,检测肾组织ACE、ACE2、血管紧张素II(Ang II)1型受体(AT1R)、Mas相关G蛋白偶联受体(MasR)的mRNA表达以及Ang II、Ang(1-7)含量。结果:失血性休克提高了肾组织ACE mRNA、AT1R mRNA和Ang II水平,降低了ACE2 mRNA、MasR mRNA和Ang(1-7)水平,PHSML引流抑制了失血性休克对ACE2和AT1R mRNA表达的影响;同时PHSML引流也降低了失血性休克增加ACE/ACE2、Ang II/Ang(1-7)和AT1R/MasR比值的作用。结论:PHSML引流恢复了失血性休克后肾组织的ACE/ACE2平衡,有利于减轻失血性休克所致的肾损伤。     

Role of angiotensin-converting enzyme 2 and angiotensin(1-7) in 17beta-oestradiol regulation of renal pathology in renal wrap hypertension in rats

17beta-Oestradiol (E2)-mediated inhibition of angiotensin-converting enzyme (ACE) protects the E2-replete kidney from the progression of hypertensive renal disease. Angiotensin-converting enzyme 2 (ACE2), a homologue of ACE, counters the actions of ACE by catalysing the conversion of angiotensin II (Ang II) to angiotensin(1-7) [Ang(1-7)]. We investigated E2 regulation of ACE2 in the renal wrap (RW) model of hypertension in rats. After 6 weeks on a high-sodium diet (4% NaCl), the activity of ACE2 was reduced in the renal cortex by 31%, which was mirrored by similar decreases in ACE2 protein (30%) and mRNA expression (36%) in the ovariectomized RW rat (RW-OVX); E2 replacement prevented these effects. The RW-OVX rats exhibited greater renal injury, including 1.7-fold more tubulointerstitial fibrosis and 1.6-fold more glomerulosclerosis than E2-replete females (RW-Intact and RW-OVX+E2). Angiotensin(1-7) infusion prevented these exacerbating effects of ovariectomy on renal pathology; no differences in indicators of renal injury were observed between RW-OVX-Ang(1-7) and RW-Intact rats. These renal protective effects of Ang(1-7) infusion were not attributable to increased ACE2 activity or to changes in heart rate or body weight, since these parameters were unchanged by Ang(1-7) infusion. Furthermore, Ang(1-7) infusion did not attenuate renal injury by reducing mean arterial pressure (MAP), since infusion of the peptide did not lower MAP but rather caused a slight increase during a 6 week chronic treatment for Ang(1-7). These results suggest that E2-mediated upregulation of renal ACE2 and the consequent increased Ang(1-7) production contribute to E2-mediated protection from hypertensive renal disease. These findings have implications for E2-deficient women with hypertensive renal disease and suggest that therapeutics targeted towards increasing ACE2 activity and Ang(1-7) levels will be renal protective.     

Differential regulation of renal angiotensin-converting enzyme (ACE) and ACE2 during ACE inhibition and dietary sodium restriction in healthy rats

Angiotensin-converting enzyme (ACE) 2 is thought to counterbalance ACE by breakdown of angiotensin (Ang) II and formation of Ang(1-7). Both enzymes are highly expressed in the kidney, but reports on their regulation differ. To enhance our understanding of the regulation of renal ACE and ACE2, we investigated renal ACE and ACE2 expression during conditions of physiological (low-sodium diet) and pharmacological changes (ACE inhibition) in activity of the renin-angiotensin-aldosterone system (RAAS). Healthy rats were treated with vehicle or lisinopril with either a control or a low-sodium diet, and renal ACE2, ACE and plasma angiotensins were studied. During vehicle treatment, low sodium reduced renal ACE mRNA and activity without affecting ACE2 mRNA or activity and plasma Ang(1-7) and Ang II balance. Lisinopril significantly reduced renal ACE activity without affecting renal ACE2 activity. During ACE inhibition, low sodium reduced both ACE and ACE2 mRNA without affecting ACE2 activity or further reducing ACE activity. Measurements of renal neprilysin activity revealed no significant differences between any of the treatment groups. Plasma Ang(1-7) and Ang II balance is positively shifted towards the beneficial vasopeptide Ang(1-7) by the ACE inhibitor lisinopril, especially during a low sodium intake. In conclusion, modulation of the RAAS, by low sodium intake or ACE inhibition, does not affect renal ACE2 despite major variations in renal ACE. Thus, ACE and ACE2 are differentially regulated by low sodium and ACE inhibition. Therefore, we propose that the beneficial effects of ACE inhibitors are predominantly mediated by modulation of ACE and not ACE2. Whether this also applies to renal disease conditions should be investigated in future studies.     

Renal ACE2 expression in human kidney disease

Angiotensin-converting enzyme 2 (ACE2) is a recently discovered homologue of angiotensin-converting enzyme (ACE) that is thought to counterbalance ACE. ACE2 cleaves angiotensin I and angiotensin II into the inactive angiotensin 1-9, and the vasodilator and anti-proliferative angiotensin 1-7, respectively. ACE2 is known to be present in human kidney, but no data on renal disease are available to date. Renal biopsies from 58 patients with diverse primary and secondary renal diseases were studied (hypertensive nephropathy n = 5, IgA glomerulopathy n = 8, minimal change nephropathy n = 7, diabetic nephropathy n = 8, focal glomerulosclerosis n = 5, vasculitis n = 7, and membranous glomerulopathy n = 18) in addition to 17 renal transplants and 18 samples from normal renal tissue. Immunohistochemical staining for ACE2 was scored semi-quantitatively. In control kidneys, ACE2 was present in tubular and glomerular epithelium and in vascular smooth muscle cells and the endothelium of interlobular arteries. In all primary and secondary renal diseases, and renal transplants, neo-expression of ACE2 was found in glomerular and peritubular capillary endothelium. There were no differences between the various renal disorders, or between acute and chronic rejection and control transplants. ACE inhibitor treatment did not alter ACE2 expression. In primary and secondary renal disease, and in transplanted kidneys, neo-expression of ACE2 occurs in glomerular and peritubular capillary endothelium. Further studies should elucidate the possible protective mechanisms involved in the de novo expression of ACE2 in renal disease.     

肾内血管紧张素系统在高血压性肾损害中的作用

目的:探讨血管紧张素II(AngII)及血管紧张素II受体(AT₁R)在缺血性肾损害时肾脏局部的作用。方法:采用放射免疫法及逆转录-聚合酶链反应(RT-PCR)技术,检测双肾动脉狭窄时大鼠血浆和肾脏的AngII含量和AT₁RmRNA的表达。结果:缺血性肾损害时大鼠血浆及肾组织AngII水平均高于对照组,P <0.0 5,而肾组织AT₁RmRNA的表达也较对照组高,P <0.0 1。结论:在双肾动脉狭窄缺血性肾损害时存在AngII及其AT₁R的异常,它们可参与肾脏损害作用.     

Role of LOX-1 in Ang II-induced oxidative functional damage in renal tubular epithelial cells

The lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), plays an important role in angiotension II (Ang II)-induced hypertensive renal injury associated with pro-inflammatory responses, tubular functional damage and cellular apoptosis. In this study, we report on the role of LOX-1 in Ang II-induced oxidative functional damage and underlying signaling in human renal proximal tubular epithelial cells (HRPTEpiCs). The exposure to Ang II enhanced the expression of the NADPH oxidases (the p22phox, p47phox and Nox4 subunits), LOX-1 and the adhesion molecule, ICAM-1. It also promoted monocytic U937 cell adherences to HRPTEpiCs, increased reactive oxygen species formation and stimulated apoptosis, which was concomitant with an increase in the activation of p38 and p44/42 mitogen-activated protein kinases (MAPK). Furthermore, the Ang II treatment disturbed the balance of the Bcl-2 family proteins, destabilized mitochondrial membrane potential, and subsequently triggered the release of cytochrome c into the cytosol, causing the activation of caspase-3. The NADPH oxidase inhibitors and LOX-1 small interfering RNA markedly ameliorated these detrimental effects by reducing LOX-1 expression and MAPK activation. The p38 and p44/42MAPK inhibitors also inhibited the Ang II-induced functional damage without affecting LOX-1 expression in the HRPTEpiCs. These observations suggest that LOX-1 mediates Ang II-induced renal tubular epithelial dysfunction. In addition, MAPK pathway activation occurs downstream of the Ang II/reactive oxygen species/LOX-1 cascade.     

地塞米松抑制肾素-血管紧张素系统减轻大鼠急性肺损伤

目的：观察肾素-血管紧张素系统（RAS）在大鼠急性肺损伤中的作用及地塞米松（DEX）的影响。方法: 在大鼠失血性休克的基础上,腹腔注射内毒素（二次打击）造成急性肺损伤模型,直接插管法检测大鼠平均动脉血压（MAP）;逆转录聚合酶链式反应(RT-PCR)观察各组大鼠肺脏组织中血管紧张素转换酶（ACE）、血管紧张素原（AGT）、血管紧张素II 1型受体（AT1）和血管紧张素II 2型受体（AT2）mRNA的表达及测定大鼠血清血管紧张素I (AngⅠ)、血管紧张素II（AngⅡ）的变化。结果: 二次打击组（HL）大鼠平均动脉血压恢复很慢,而地塞米松治疗组（HLD）平均动脉血压恢复的速度较HL明显增快,且平均动脉血压水平的升高具有明显差异。与对照组（C）相比,HL组ACE、AGT mRNA表达水平明显增高,而HLD组明显低于HL组。AT1、AT2 mRNA各组表达水平则无明显差异。与C组相比,HL组AngⅡ的含量明显升高,HLD组大鼠血清AngⅡ的含量比HL组均明显减低,Ang I含量的变化不明显。结论: 失血性休克后LPS诱发的急性肺损伤可能与激活肺脏的肾素－血管紧张素系统有关,抑制肺脏的肾素－血管紧张素系统的激活是DEX轻这种急性肺损伤的机制之一。     

Interstitial fibroblast-like cells express renin-angiotensin system components in a fibrosing murine kidney

Recently, the renin-angiotensin system (RAS) was implicated in organ fibrosis. However, few studies have examined the localization of RAS components, such as angiotensin II receptors, renin (REN), angiotensinogen (AGTN), and angiotensin-converting enzyme (ACE), in the fibrosing kidney. To localize these components in the fibrosing kidney, we used a murine model of renal fibrosis that shows an enhanced expression of angiotensin II type 1A receptor (AT(1A)R) and AGTN. Our results indicate that the overall expression of angiotensin II type 2 receptor (AT(2)R) and ACE was attenuated in this model, whereas REN expression was unchanged. In addition to tubular epithelial cells that were positive for AT(1A)R, AT(2)R, REN, and AGTN, interstitial fibroblast-like cells expressed AT(1A)R, REN, AGTN, and ACE in the fibrosing kidney. The interstitial fibroblast-like cells that were positive for AT(1A)R mRNA were further characterized as positive for the expression of vimentin and transforming growth factor-beta1. These data provide strong evidence for a tubulointerstitial RAS within the fibrosing kidney, and a linkage between the RAS and renal fibrogenesis.     

ACE/ACE2在AGT-REN双转基因高血压小鼠肾组织的表达变化及意义

目的: 观察血管紧张素原(AGT)-肾素(REN)双转基因高血压小鼠肾脏组织病理改变及血管紧张素转化酶(ACE)/血管紧张素转化酶2(ACE2)的表达变化,探讨ACE和ACE2在高血压肾损伤中的作用。方法: 实验分为4组,随机选择10月龄野生型、AGT转基因、REN转基因以及AGT-REN双转基因雄性C57小鼠各6只。每组动物颈动脉插管检测平均动脉压(MAP),1 h后处死小鼠;左侧肾脏置于10%中性甲醛固定,常规HE染色方法观察肾脏组织病理改变,免疫组化法观察肾脏ACE及ACE2的表达变化;右侧肾脏取出后放入蛋白裂解液中,提取蛋白,进行Western blotting实验,观察肾组织中ACE和ACE2蛋白表达。结果: 与野生型小鼠相比,AGT转基因小鼠MAP无明显变化(P>0.05),REN转基因小鼠MAP降低约15 mmHg(P<0.05);AGT-REN双转基因小鼠MAP明显升高约30 mmHg(P<0.05)。与野生型小鼠相比,AGT转基因和REN转基因小鼠肾组织未见明显病理改变,AGT-REN双转基因小鼠肾组织可见肾小动脉内膜及管壁显著增厚、管腔狭窄、纤维素样坏死、玻璃样变等典型恶性高血压肾损伤病理改变。免疫组化结果显示,与野生型小鼠相比,AGT转基因和REN转基因小鼠肾组织ACE和ACE2表达无明显差异(P>0.05),AGT-REN双转基因鼠肾组织ACE表达明显增高(P<0.05),而ACE2表达明显降低(P<0.05)。Western blotting结果显示:与野生型小鼠相比,AGT转基因鼠肾组织ACE和ACE2表达无明显变化;REN转基因鼠肾组织ACE表达无明显变化,ACE2表达稍降低(P<0.05);双转基因鼠肾组织ACE蛋白表达明显增强, ACE2蛋白表达水平显著降低,ACE/ACE2表达显著失衡。结论: AGT-REN双转基因可致小鼠恶性高血压,导致肾脏严重损伤;ACE/ACE2的表达失衡与血压改变密切相关,降低ACE或提高ACE2的表达可能对防治高血压具有重要意义。     

血管紧张素II通过细胞外信号调节激酶1/2通路调控过氧化氢酶的表达及促进成纤维细胞表型转化*

 目的： 探讨细胞外信号调节激酶1/2(ERK1/2)在高血压大鼠模型动脉外膜血管重塑中的作用。方法: 利用血管紧张素II (Ang II)微泵灌注制备高血压大鼠模型,随机分为未处理组、生理盐水灌注组和Ang II灌注组。分别检测各组大鼠尾动脉收缩压及血管形态学改变;Western blotting技术检测外膜成纤维细胞过氧化氢酶(CAT)蛋白在未处理组、单纯Ang II、ERK1/2抑制剂PD98059和Ang II+PD98059培养下的表达。结果: 大鼠颈动脉HE染色和收缩压结果显示,与未处理组及生理盐水灌注组相比,Ang II组大鼠颈动脉中膜厚度和收缩压明显增加(P<0.01),动脉形态结构有明显改变,并且有显著的病理性血管重塑发生。Western blotting检测结果显示,PD98059作用下CAT比单纯Ang II明显增高(P<0.05),表明ERK1/2信号通路能够恢复Ang II诱导的CAT表达下调。结论: Ang II可能通过ERK1/2信号通路下调血管外膜CAT的表达,进而促进血管细胞表型转化,导致血管病理性重塑发生。     

Angiotensin-converting enzyme 2 and the kidney

Angiotensin-converting enzyme (ACE) 2 is a homologue of ACE with enzymatic activity that seems to counterbalance the angiotensin II-promoting effect of ACE. While ACE promotes angiotensin (Ang) II formation from Ang I, ACE2 degrades Ang II and Ang I. In this review, we discuss recent studies that have delineated the localization of ACE2 within the kidney, an organ that highly expresses this enzyme. In models of diabetic kidney, pharmacological ACE2 inhibition is associated with albuminuria and worsening of glomerular injury. Similarly, genetic ablation of ACE2 causes glomerular lesions in male mice and worsens the renal lesions seen in diabetic Akita mice. Taken together, these findings suggest that a decrease in ACE2 may be involved in diabetic kidney disease, possibly by disrupting the metabolism of angiotensin peptides in such a way that angiotensin II degradation within the glomerulus may be diminished.     

An update on ACE2 amplification and its therapeutic potential

The renin angiotensin system (RAS) plays an important role in the pathogenesis of variety of diseases. Targeting the formation and action of angiotensin II (Ang II), the main RAS peptide, has been the key therapeutic target for last three decades. ACE‐related carboxypeptidase (ACE2), a monocarboxypeptidase that had been discovered 20 years ago, is one of the catalytically most potent enzymes known to degrade Ang II to Ang‐(1‐7), a peptide that is increasingly accepted to have organ‐protective properties that oppose and counterbalance those of Ang II. In addition to its role as a RAS enzyme ACE2 is the main receptor for SARS‐CoV‐2. In this review, we discuss various strategies that have been used to achieve amplification of ACE2 activity including the potential therapeutic potential of soluble recombinant ACE2 protein and novel shorter ACE2 variants.     

Angiotensin AT1 receptors in paraventricular nucleus contribute to sympathetic activation and enhanced cardiac sympathetic afferent reflex in renovascular hypertensive rats

Sympathetic activity is enhanced in hypertension, which contributes to the pathogenesis of hypertension and progression of organ damage. The cardiac sympathetic afferent reflex (CSAR) is enhanced in renovascular hypertension and involved in the sympathetic activation. The present study was designed to investigate whether angiotensin II (Ang II) and Ang II type 1 (AT(1)) receptors in paraventricular nucleus (PVN) contribute to the enhanced CSAR and sympathetic outflow in experimental renovascular hypertensive rats. Hypertension was induced by the two-kidney one-clip (2K1C) method. The normotensive rats underwent sham operation (Sham). Acute experimentation was carried out at the end of the 4th week. Under urethane and α-chloralose anaesthesia, the renal sympathetic nerve activity (RSNA) and mean arterial pressure (MAP) were recorded in rats with sino-aortic denervation and cervical vagotomy. The AT(1) receptor expression was determined with Western blot. The CSAR was evaluated by the response of RSNA and MAP to epicardial application of 1.0 nmol of capsaicin. The AT(1) receptor expression in the PVN was increased, and Ang II in the PVN augmented the enhanced CSAR and RSNA in 2K1C rats. The effects of Ang II were abolished by pretreatment with the AT(1) receptor antagonist, losartan, in 2K1C rats. Losartan in the PVN normalized the enhanced CSAR and decreased the RSNA and MAP in 2K1C rats. These results indicate that the increased activity of AT(1) receptors in the PVN contributes to the enhanced CSAR and excessive sympathetic activation in renovascular hypertensive rats.     

Expression of angiotensin-converting enzyme 2 and its end product angiotensin 1-7 is increased in diabetic atheroma: implications for inflammation and neovascularization

AimsThe angiotensin-converting enzyme 2 (ACE2) and its end product angiotensin 1-7 (Ang1-7) are key counterregulatory proteins to offset the deleterious effects of angiotensin II. ACE2 is decreased in diabetic kidney disease but overexpressed in metabolically active atheroma. We tested the hypothesis that ACE2 is increased in diabetic peripheral atheroma, concomitantly with Ang1-7, angiotensin II receptor 1 (AT1R), proinflammatory cytokines, macrophage infiltration, and plaque neovascularization.Methods and ResultsPeripheral atherectomy plaques collected from 12 diabetic (DM) and 12 non-DM patients were immunostained for ACE2, Ang1-7, AT1R, and proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Macrophage infiltration and neovascularization were counted using double-label immunochemistry with CD68/CD3 and CD34, respectively. Quantification was performed blindly by randomly counting positively stained cells in 20 high-power fields using previously validated methods. Tissue content of ACE2, Ang1-7, and AT1R was increased in DM when compared to non-DM (P<.0001). IL-6 and TNF-α were also increased in DM when compared to non-DM (P<.0001), as well as macrophage infiltration score and neovessel counting (P<.0001).ConclusionExpression of ACE2 and its end product Ang1-7 is increased in DM atheroma, along with overexpression of AT1R, IL6, TNF-α, macrophage infiltration, and neovascularization. These results suggest that the renin–angiotensin system counterregulatory pathway may be preserved in metabolically active atheroma, offering potential targets for future therapies in diabetic atherosclerosis.     

Inhibition of p53 function prevents renin-angiotensin system activation and stretch-mediated myocyte apoptosis

To determine whether stretch-induced activation of p53 is necessary for the up-regulation of the local renin-angiotensin system and angiotensin II (Ang II)-induced apoptosis, ventricular myocytes were infected with an adenoviral vector carrying mutated p53, Adp53m, before 12 hours of stretch. Noninfected myocytes and myocytes infected with AdLacZ served as controls. Stretching of Adp53m-infected myocytes prevented stimulation of p53 function that conditioned the expression of p53-dependent genes; quantity of angiotensinogen (Aogen), AT(1), and Bax decreased, whereas Bcl-2 increased. Ang II generation was not enhanced by stretch. Conversely, stretch produced opposite changes in noninfected and AdLacZ-infected myocytes: Aogen increased twofold, AT(1) increased 2. 1-fold, Bax increased 2.5-fold, and Ang II increased 2.4-fold. These responses were coupled with 4.5-fold up-regulation of wild-type p53. Stretch elicited comparable adaptations in p53-independent genes, in the presence or absence of mutated p53; renin increased threefold, angiotensin-converting enzyme increased ninefold, and AT(2) increased 1.7-fold. Infection with Adp53m inhibited myocyte apoptosis after stretch. Conversely, stretch increased apoptosis by 6.2-fold in myocytes with elevated endogenous wild-type p53. Thus, a competitor of p53 function interfered with both stretch-induced Ang II formation and apoptosis, indicating that p53 is a major modulator of myocyte renin-angiotensin system and cell survival after mechanical deformation.     

Angiotensin II-induced MMP-2 activity and MMP-14 and basigin protein expression are mediated via the angiotensin II receptor type 1-mitogen-activated protein kinase 1 pathway in retinal pigment epithelium: implications for age-related macular degeneration

Accumulation of various lipid-rich extracellular matrix (ECM) deposits under the retinal pigment epithelium (RPE) has been observed in eyes with age-related macular degeneration (AMD). RPE-derived matrix metalloproteinase (MMP)-2, MMP-14, and basigin (BSG) are major enzymes involved in the maintenance of ECM turnover. Hypertension (HTN) is a systemic risk factor for AMD. It has previously been reported that angiotensin II (Ang II), one of the most important hormones associated with HTN, increases MMP-2 activity and its key regulator, MMP-14, in RPE, inducing breakdown of the RPE basement membrane, which may lead to progression of sub-RPE deposits. Ang II exerts most of its actions by activating the mitogen-activated protein kinase (MAPK) signaling pathway. Herein is explored the MAPK signaling pathway as a potential key intracellular modulator of Ang II-induced increase in MMP-2 activity and MMP-14 and BSG protein expression. It was observed that Ang II stimulates phosphorylation of extracellular signal-regulated kinase (ERK) and p38 MAPK in RPE cells and ERK/p38 and Jun N-terminal kinase (JNK) in mice. These effects were mediated by Ang II type 1 receptors. Blockade of ERK or p38 MAPK abrogated the increase in MMP-2 activity and MMP-14 and BSG proteins in ARPE-19 cells. A better understanding of the molecular events by which Ang II induces ECM dysregulation is of critical importance to further define its contribution to the progression of sub-RPE deposits in AMD patients with HTN.