原发性高血压与心脏β_2、α_1及AT_1受体自身抗体的关系

Study of Autoantibodies Against the G-protein-coupled β_2-and α_1-adrenergic and AT_1 receptors in Patients with Primary Hypertension

目的探讨抗G-蛋白偶联型β2、α1及AT1受体的自身抗体在原发性高血压病程中的分布情况。方法应用酶联免疫吸附测定(ELISA)技术,以细胞外第二环表位肽段的合成肽作为抗原,检测50例高血压心脏病、40例单纯高血压和40例正常人血清中抗G-蛋白偶联家族中β2、α1和AT1受体的自身抗体。结果高血压心脏病患者血清中抗G-蛋白偶联型β2、α1和AT1受体自身抗体的阳性率明显高于单纯高血压和正常组(P<0.05);高血压心脏病自身抗体阳性的平均几何滴度与单纯性高血压比较无明显差异(P>0.05),但两组阳性抗体的平均几何滴度均明显高于正常组。高血压心脏病抗β2受体自身抗体阳性患者中,81.0%同时具有α1受体的自身抗体,76.2%同时具有AT1受体的自身抗体,52.4%存在上述3种受体的自身抗体。结论抗G-蛋白偶联型β2、α1及AT1受体的自身抗体参与原发性高血压的病理生理过程,可能与心肌和血管重构有关。

Objective To determine whether autoantibodies against the cardiac G-protein-coupledβ 2 -andα 1 -adrenergic and AT 1 receptors are related to patients with primary hypertension.Methods Synthetic peptides corresponding to amino acid sequences of the second extracellular loops of theβ 2 -andα 1 -adrenergic and AT 1 receptors were respectively used as antigens to screen sera from patients with hypertensive heart diseases(n=50)as well as simple hypertension(n=40)and healthy blood donors(n=40)using ELISA test.Results The positive ratio of autoantibodies againstβ 2 andα 1 and AT 1 receptors in patients with hypertensive heart diseases were significantly higher than patients with simple hypertension and healthy donors.The geometric mean titers of autoantibodies againstβ 2 -andα 1 -adrenergic and AT 1 receptors had no difference between the patients with hypertensive heart diseases and the patients with simple hypertension,but the geometric mean titers of two groups were higher than healthy donors.In the patients with hypertensive heart diseases,81.0%of the patients with autoantibodies againstβ 2 -adrenergic receptor had autoantibodies againstα 1 -adrenergic receptor and76.2%had autoan tibodies against AT 1 receptors.The percent of the autoantibodies against three receptors in patients with hyperte n-sive heart diseases were52.4%.Conclusions Autoantibodies againstβ 2 -andα 1 -adrenergic and AT 1 receptors play an important role in the pathophysiological changes of primary hypertension,and may participate myocardial and vessel remodeling.