抗AT_1和α_1受体自身抗体与高血压病合并肾损害的关系

Relationship between autoantibodies against AT_1 and α_1 receptors and hypertension with renal failure

目的：探讨抗血管紧张素Ⅱ受体1型（AT1-受体）和α1-肾上腺素受体（α-受体）自身抗体是否与高血压病合并肾损害有关．方法：以合成的AT1和α1受体多肽片段为抗原，应用酶联免疫吸附测定（ELISA）技术，检测61例高血压病合并肾损害患者和60例高血压病无肾损害患者及40例正常人，血清中抗G-蛋白偶联型AT1受体（165～191），和α1受体（192～218）自身抗体．用放射免疫法，测定血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）和醛固酮（ALD）浓度，用荧光分析法测定儿茶芬胺：肾上腺素（E）和去甲肾上腺素（NE）．结果：高血压病合并肾损害组抗AT1和α1受体抗体阳性率分别为59．0％和54．1％，明显高于高血压组的13．3％和10．0％及正常对照组10．0％和7．5％（P〈0．01）．神经内分泌激素指标（PRA，AngⅡ，ALD，E，NE），高血压病合并肾损害组，明显高于高血压组及正常对照组．结论：抗G-蛋白偶联型AT1和α1受体自身抗体可能与高血压病合并肾损害发病有关，同时伴有神经内分泌激活．

AIM： To study the role of the autoantibodies against angiotensin Ⅱ type 1 receptor （AT1 receptor） and α1-adrenergic receptor（α1 receptor） in the development of hypertension combined with renal failure. METHODS： The epitopes of the second extracellular loop of AT1 receptor （ 165 - 191 ） and α1 receptor （192 -218 ） were synthesized and used respectively to screen sera autoantibodies from patients with hypertension and renal failure （ n = 61 ）, patients with hypertension but without renal failure （n =60） and healthy blood donors （n = 40, control） by ELISA and to screen the hormones of nerve and endocrine by RIA and by FIA. RESULTS： The positive rates of the autoantibodies against AT1 receptor （ 59. 0% ） and α1 receptor （ 54. 1% ） in patients with hypertension and renal failure were higher than those in patients with hypertension but without renal failure （ 13.3% and 10.0% respectively） （P 〈 0.01 ） and they were also higher than those of healthy donors （ 10.0% and 7.5% respectively） （P〈0. 01）. The hormones of nerve and endocrine （PRA, Ang Ⅱ , ALD, E, NE） in patients with hypertension and renal failure were higher than those of patients with hypertension but without renal failure and they were also higher than those in healthy donors （P 〈0.05, P 〈0.01 ）. CONCLUSION： Autoantibodies against AT1 receptor and α1 receptor may play some important roles in the pathogenesis of the hypertension combined with renal failure and activate accordingly the hormones of nerve and endocrine system in oatients with the disease.