Angiotensin-converting enzyme 2 alleviates liver fibrosis through the renin-angiotensin system

The present letter to the editor is related to the study titled‘Angiotensin-converting enzyme 2 improves liver fibrosis in mice by regulating autophagy of hepatic stellate cells’.Angiotensin-converting enzyme 2 can alleviate liver fibrosis by regulating autophagy of hepatic stellate cells and affecting the renin-angiotensin system.

Extracellular vesicles and angiotensin-converting enzyme 2 in COVID-19 disease

Extracellular vesicles(EVs)are membranous vesicular structures released from almost all eukaryotic cell types under different physiological or pathological conditions.Growing evidence demonstrates that EVs can serve as mediators of intercellular communication between donor and recipient cells or microorganism-infected and noninfected cells.Coronavirus disease 2019(COVID-19)disease is caused by infection of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)of host cells in the respiratory system and various extra-pulmonary tissue/organs,resulting in complications of multiple organ systems.As the cell surface receptor,angiotensin-converting enzyme 2(ACE2)mediates cellular entry of SARS-CoV-2 into the host cells in patients with COVID-19.Recent studies have found that ACE2 can be released with EVs,which have been shown to interfere with the entry of the virus into host cells and thus may be involved in COVID-19 pathophysiology.In addition,ACE2,neprilysin(NEP),and thimet oligopeptidase(TOP)are the key enzymes that regulate angiotensin metabolism by converting angiotensin II or angiotensin I to angiotensin 1-7,the latter of which has protective effects in counterbalancing the harmful effects of angiotensin II in COVID-19 disease.This review summarizes the recent research progress regarding EV-associated ACE2,NEP,and TOP and the perspectives of their potential involvement in the pathophysiology of COVID-19 disease.

Inetetamab combined with tegafur as second-line treatment for human epidermal growth factor receptor-2-positive gastric cancer: A case report

BACKGROUND Human epidermal growth factor receptor-2(HER-2)plays a vital role in tumor cell proliferation and metastasis.However,the prognosis of HER2-positive gastric cancer is poor.Inetetamab,a novel anti-HER2 targeting drug independently developed in China,exhibits more potent antibody-dependent cell-mediated cytotoxicity than trastuzumab,which is administered as the first-line treatment for HER2-positive gastric cancer in combination with chemotherapy.In this case,the efficacy and safety of inetetamab combined with tegafur was investigated as a second-line treatment for HER2-positive gastric cancer.CASE SUMMARY A 52-year-old male patient with HER2-positive gastric cancer presented with abdominal distension,poor appetite,and fatigue two years after receiving six cycles of oxaliplatin combined with tegafur as first-line treatment after surgery,followed by tegafur monotherapy for six months.The patient was diagnosed with postoperative recurrence of gastric adenocarcinoma.He received 17 cycles of a combination of inetetamab,an innovative domestically developed anti-HER2 monoclonal antibody,and tegafur chemotherapy as the second-line treatment(inetetamab 200 mg on day 1,every 3 wk combined with tegafur twice daily on days 1–14,every 3 wk).Evaluation of the efficacy of the second-line treatment revealed that the patient achieved a stable condition and progression-free survival of 17 months.He tolerated the treatment well without exhibiting any grade 3-4 adverse events.CONCLUSION Inetetamab combined with chemotherapy for the treatment of metastatic HER2-positive gastric cancer demonstrates significant survival benefits and acceptable safety.

利用受体配体亲和技术筛选黄芩中血管紧张素转换酶2和二肽基肽酶4抑制剂

目的筛选中药黄芩中血管紧张素转换酶2(ACE2)和二肽基肽酶4(DPP-4)抑制剂。方法以ACE2和DPP-4作为靶蛋白,利用受体配体亲和超滤和液质联用技术,对黄芩中与ACE2和DPP-4亲和的化合物进行筛选和分析,以筛选具有同时抑制ACE2和DPP-4的化合物。结果从黄芩中筛选出了5,7,2′,6′-4羟基黄酮、5,7,2′,5′-4羟基-8,6′-二甲氧基黄酮、白杨素-7-O-葡萄糖醛酸苷、黄芩素-6-O-葡萄糖醛酸苷、千层纸素A-7-O-葡萄糖醛酸苷、汉黄芩苷、白杨素、千层纸素A,可以同时亲和抑制ACE2和DPP-4,具有潜在的抗新型冠状病毒的作用。结论从黄芩中筛选出与新型冠状病毒肺炎有关的靶蛋白抑制剂,具备潜在开发价值。

注意缺陷多动障碍患儿血清ACE2,TWEAK和CCL5水平检测及诊断价值研究

目的 探究血清血管紧张素转换酶2(angiotensin-converting enzyme 2,ACE2),细胞因子肿瘤坏死因子样细胞凋亡弱诱导因子(tumor necrosis factor-like weak inducer of apoptosis,TWEAK)和CC趋化因子配体5(CC motif chemokine ligand 5,CCL5)水平在注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患儿诊断、病情严重程度评估中的价值。方法 选取2022年10月~2023年10月在河北省儿童医院就诊的125例ADHD患儿记为ADHD组,另选105例在河北省妇幼保健中心体检的健康儿童为对照组,根据临床总体印象严重程度量表(CGI-S)将患儿分为轻中度组(n=83)和重度组(n=42)。ELISA方法检测血清ACE2,TWEAK,CCL5,促黄体生成素(LH)和催乳素(PRL)水平,联合型瑞文测验(CRT)和Conners父母症状问卷(PSQ)对患儿认知和行为状况进行评分。Spearman相关性分析重度组血清ACE2,TWEAK,CCL5与CGI-S,CRT,PSQ评分的相关性;受试者工作特征(ROC)曲线分析ACE2,TWEAK,CCL5对ADHD及严重程度的诊断价值。结果 ADHD患儿血清ACE2(284.35±92.34 pg/ml),TWEAK(2.56±0.76 pg/ml)水平低于对照组(379.23±106.28 pg/ml,3.52±1.12 pg/ml),CCL5水平(7.36±2.37ng/ml)高于对照组(5.24±1.63 ng/ml),差异具有统计学意义(t=7.244,7.703,7.753,均P<0.05);重度组患儿CRT,血清ACE2,TWEAK水平低于轻中度组(t=5.318,6.686,6.490),而PSQ,CCL5水平较高于轻中度组(t=5.220,6.134),差异具有统计学意义(均P<0.05);Spearman相关性分析结果显示,重度组患儿血清ACE2,TWEAK水平与CGI-S,PSQ评分负相关(r=-0.432,-0.453;-0.421,-0.426,均P<0.001),与CRT评分呈正相关(r=0.427,0.418,均P<0.001);CCL5与CGI-S,PSQ评分呈正相关(r=0.421,0.433,均P<0.001),与CRT评分呈负相关(r=-0.446,P<0.001)。血清ACE2,TWEAK和CCL5诊断ADHD发生的AUC分别为0.814,0.803和0.807,三者联合诊断的AUC为0.945,优于各自单独诊断(Z=5.439,4.258,5.576,均P<0.001);血清ACE2,TWEAK,CCL5诊断重度ADHD的AUC分别为0.853,0.796和0.805,三者联合诊断的AUC为0.930,优于各自单独诊断(Z=2.604,3.851,3.567,均P<0.001)。结论 血清ACE2,TWEAK在ADHD患儿血清中低表达,而CCL5高表达,三者表达水平具有相关性,并且诊断ADHD发生和严重程度具有较高的价值。

Effects of Yinchenhao Decoction on Self-regulation of Renin-angiotensin System by Targeting Angiotensin Converting Enzyme 2 in Bile Duct-ligated Rat Liver

Summary： In order to investigate whether Yinchenhao decoction （YCHD） attenuates hepatic fibro- genesis in the bile duct ligation （BDL） model via recovering and restoring the self-regulation and bal- ance of the renin-angiotensin system （RAS）, 33 specific-pathogen-free （SPF） male Sprague-Dawley rats with common BDL and scission were randomly divided into five groups as follows： G1, the sham group （n=4）; G2, BDL 7-day group （n=5）; G3, BDL＋YCHD 430 mg/mL （n=8）; G4, BDL＋losartan 0.65 mg/mL （ARB group, n=8）; G5, model group （BDL without any treatment, n=8）. YCHD and losartan （10 mL.kgl.day-1） were given by gastric gavage for 16 days following BDL in G3 and G4 groups, respec- tively. The effect of YCHD on liver fibrosis and the detailed molecular mechanisms were assessed by liver function including total bilirubin （TBIL）, direct bilirubin （DBIL）, indirect bilirubin （IDBIL）, alanine aminotransferase （ALT）, and aspartate aminotransferase （AST）. Histological changes were ob-. served by transmission electron microscopy （TEM） and Masson trichrome staining. Western blotting was used to detect the protein expression level of the renin-angiotensin system （RAS） components in- cluding angiotensin converting enzyme （ACE）, angiotensin II type 1 receptor （AT1R）, ACE2, angio- tensin II （Ang II） as well as transforming growth factor 131 （TGF131）. The experimental data were ana- lyzed by principle component analytical method of pattern recognition. The results showed that bio- chemically, serum TBIL, DBIL, IDBIL, ALT and AST levels were markedly increased following BDL as compared with the sham group （P〈0.05）. Serum TBIL, IDBIL and DBIL levels in G3 group were dramatically decreased as compared with G5 and G4 groups （P〈0.05）. Serum AST level in G3 was sig- nificantly lowered than in G5 group （P〈0.05）, but there was no significant difference in ALT among G3, G4 and G5 groups （P〉0.05）. Histologically, livers in G3 group showed less hepatocytes necrosis, less bile duct hyperplasia and less collagen formation than in G4 and G5 groups. The protein expression lev- els of ACE2, ACE, Ang II, AT1R and TGF131 in G2, G3 and G4 groups were significantly higher than in sham group （P〈0.05）, and lower than in G5 group （P〈0.05）. However, the differences among G2, G3 and G4 groups were not significant （P〉0.05）. ACE2 protein expression in G3 group was significantly higher than in G2 group （P〈0.05） and there was no significant difference in comparison with G4 group （P〉0.05）. Moreover, the protein expression of TGF131 in G3 group was significantly lower than in G5 and G4 groups （P〈0.05）. Our findings suggest that the antifibrotic effects of YCHD may be associated with the decreased classical RAS pathway components and TGFI31 downexpression so as to recover and rebuild self-regulation of the RAS by elevating the protein expression of ACE2.

Valsartan Inhibits Angiotensin Ⅱ-induced Proliferation of Vascular Smooth Muscle Cells via Regulating the Expression of Mitofusin 2

Angiotensin Ⅱ (ANGⅡ) plays an important role in the pathogenesis of atherosclerosis by inducing proliferation of vascular smooth muscle cells (VSMCs).In our study,we observed the effects of valsartan on proliferation of cultured VSMCs treated with or without ANGⅡ by cell counting and methyl thiazolyl tetrazolium (MTT) assay,and detected the expression of mitofusin 2 (Mfn2),a newly discovered cell proliferation inhibitor and a related cell proliferation signaling pathway pro-tein by Western blotting.ANGⅡ at a concentration of 10-6 mol/L significantly stimulated VSMCs proliferation,down-regulated the expression of Mfn2 and upregulated the expression of Raf and ERK1/2.Valsartan inhibited such effects of ANGⅡ at concentrations of 10-5 and 10-6 mol/L,but not at 10-7 mol/L.Valsartan had no significant effect on the proliferation of untreated VSMCs.These results suggest that valsartan inhibits ANGⅡ-induced proliferation of VSMCs in vitro via Mfn2-Ras-Raf-ERK/MAPK signaling pathway.

Gasdermin D-mediated hepatocyte pyroptosis expands inflammatory responses that aggravate acute liver failure by upregulating monocyte chemotactic protein 1/CC chemokine receptor-2 to recruit macrophages

BACKGROUND Massive hepatocyte death is the core event in acute liver failure(ALF).Gasdermin D(GSDMD)-mediated pyroptosis is a type of highly inflammatory cell death.However,the role of hepatocyte pyroptosis and its mechanisms of expanding inflammatory responses in ALF are unclear.AIM To investigate the role and mechanisms of GSDMD-mediated hepatocyte pyroptosis through in vitro and in vivo experiments.METHODS The expression of pyroptosis pathway-associated proteins in liver tissues from ALF patients and a hepatocyte injury model was examined by Western blot.GSDMD short hairpin RNA(shRNA)was used to investigate the effects of downregulation of GSDMD on monocyte chemotactic protein 1(MCP1)and its receptor CC chemokine receptor-2(CCR2)in vitro.For in vivo experiments,we used GSDMD knockout mice to investigate the role and mechanism of GSDMD in a D-galactose/lipopolysaccharide(D-Galn/LPS)-induced ALF mouse model.RESULTS The levels of pyroptosis pathway-associated proteins in liver tissue from ALF patients and a hepatocyte injury model increased significantly.The level of GSDMD-N protein increased most obviously(P<0.001).In vitro,downregulation of GSDMD by shRNA decreased the cell inhibition rate and the levels of MCP1/CCR2 proteins(P<0.01).In vivo,GSDMD knockout dramatically eliminated inflammatory damage in the liver and improved the survival of DGaln/LPS-induced ALF mice(P<0.001).Unlike the mechanism of immune cell pyroptosis that involves releasing interleukin(IL)-1βand IL-18,GSDMDmediated hepatocyte pyroptosis recruited macrophages via MCP1/CCR2 to aggravate hepatocyte death.However,this pathological process was inhibited after knocking down GSDMD.CONCLUSION GSDMD-mediated hepatocyte pyroptosis plays an important role in the pathogenesis of ALF,recruiting macrophages to release inflammatory mediators by upregulating MCP1/CCR2 and leading to expansion of the inflammatory responses.GSDMD knockout can reduce hepatocyte death and inflammatory responses,thus alleviating ALF.

Human epidermal growth factor receptor-2 gene amplification in gastric cancer using tissue microarray technology

AIM:To assess human epidermal growth factor receptor-2 (HER2)-status in gastric cancer and matched lymph node metastases by immunohistochemistry (IHC) and chromogenic in situ hybridization (CISH).METHODS:120 cases of primary gastric carcinomas and 45 matched lymph node metastases from patients with full clinicopathological features were mounted onto multiple-punch and single-punch tissue microarrays,respectively,and examined for HER2 overexpression and gene amplification by IHC and CISH.RESULTS:Twenty-four tumors (20%) expressed HER2 immunohistochemically.An IHC score of ≥ 2+ was observed in 20 tumors (16.6%).HER2 amplification was detected by CISH in 19 tumors (15.8%) and in their matched lymph node metastases.A high concordancerate was found between HER2 positivity (as detected by IHC) and HER2 gene amplification (as detected by CISH),since 19 of the 20 IHC positive cases were amplified (95%).All amplified cases had 2+ or 3+ IHC results.Amplification was associated with intestinal phenotype (P < 0.05).No association with grading,staging or survival was found.CONCLUSION:In gastric cancer,HER2 amplification is the main mechanism for HER2 protein overexpression and is preserved in lymph node metastases.

Origin and genomic characteristics of SARS-CoV-2 and its interaction with angiotensin converting enzyme type 2 receptors, focusing on the gastrointestinal tract

The emergence of coronavirus disease-2019 induced by a newly identified bcoronavirus, namely severe acute respiratory syndrome coronavirus 2(SARSCoV-2) has constituted a public health emergency. Even though it was considered a zoonotic disease, the virus has also spread among humans via respiratory secretions. The expression and distribution of angiotensin converting enzyme type 2(ACE2) in various human organs might also show other possible infection routes. High ACE2 ribonucleic acid expression has been identified in the gastrointestinal tract(GI) indicating its importance as a possible infection pathway of SARS-CoV-2. ACE2 induces viral entry into the host and most importantly has been found to be associated with the function of the gut. Its deficiency has been implicated in several pathologies such as colorectal inflammation. The renin-angiotensin system(RAS) is an essential regulatory cascade operating both at a local tissue level and at the systemic or circulatory level. The RAS may be important in the pathogenesis of chronic liver disease and is associated with the up-regulation of ACE2. Thus, the aim of this review is firstly, the analysis of some important general and genome characteristics of SARS-CoV-2 and secondly, and most importantly, to focus on the utility of ACE2 receptors in both SARS-CoV-2 replication and pathogenesis, especially in the GI tract.

High levels of serum platelet-derived growth factor-AA and human epidermal growth factor receptor-2 are predictors of colorectal cancer liver metastasis

AIM To develop predictive markers in blood for colorectal cancer liver metastasis.METHODS Twenty colorectal cancer patients were selected and divided into two groups. Group A consisted of 10 patients whose pathological TNM stage was ⅢC(T3-4N2M0), while another 10 patients with synchronous liver metastasis(TNM stage Ⅳ) were recruited for group B. During the surgical procedure, a 10-ml drainage vein(DV) blood sample was obtained from the DV of the tumor-bearing segment prior to the ligation of the DV. At the same time, a 10-ml peripheral vein(PV) blood sample was collected via peripheral venipuncture. The serum levels of 24 molecules that are potentially involved in the mechanism of liver metastasis in both DV blood and PV blood were analyzed by using high-throughput enzyme-linked immunosorbent assay technology.RESULTS Univariate analysis revealed that platelet-derivedgrowth factor AA(PDGFAA) in DV blood(d PDGFAA)(P = 0.001), PDGFAA in PV blood(p PDGFAA)(P = 0.007), and human epidermal growth factor receptor-2 in PV blood(p HER2)(P = 0.001), p MMP7(P = 0.028), pR ANTES(P = 0.013), and pE GF(P = 0.007) were significantly correlated with synchronous liver metastasis. Multivariate analysis identified d PDGFAA(HR = 1.001, P = 0.033) and p HER2(HR = 1.003, P = 0.019) as independent predictive factors for synchronous liver metastasis. Besides, high peripheral HER2 level may also be a risk factor for metachronous liver metastasis, although the difference did not reach statistical significance(P = 0.06). Significant correlations were found between paired DV and PV blood levels for PDGFAA(r = 0.794, P < 0.001), but not for HER2(r = 0.189, P = 0.424).CONCLUSION PDGFAA in tumor drainage and HER2 in PV blood may be useful predictive factors for synchronous liver metastasis of colorectal cancer.

Functional Variant of C-689T in the Peroxisome Proliferator-Activated Receptor-γ2 Promoter is Associated with Coronary Heart Disease in Chinese Nondiabetic Han People

Objective To investigate the association between the polymorphism of C-689T in the peroxisome proliferator-activated receptor-γ2 （PPARγ2） promoter and coronary heart disease （CHD）. Methods This case-controlled study was conducted in nondiabetic Chinese Han people, which enrolled 455 patients with CHD （cases） and 693 subjects without CHD （controls）. Data of clinical indexes were collected, including height, body weight, waist circumstance, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, smoking, drinking, physical activity, as well as body mass index （BMI）. Fasting blood glucose （FBG）, plasma total cholesterol （TC） and triglyceride （TG） levels were measured. Polymerase chain reaction-restricted fragments length polymorphism （PCR-RFLP） was used to determine the PPARγ2 promoter C-689→T substitution. The genotype distribution of PPARγ2 promoter C-689T, allelic frequency, clinical indexes, and laboratorial measurements were compared between the two groups. The effect of genotype on the risk of CHD was assessed using univariate and multivariate regression model. Results The genotype frequencies of CC, CT and TT in PPARγ2 promoter C-689T were 89.7%, 9.9% and 0.4% in the case group, and 93.1%, 6.6% and 0.3% in the control group, respectively （CC vs. CT＋TT, χ^2= 6.243, P=0.041）. Carriers of -689T allele （n=95） had significantly higher TC level than non-carriers （n=1053） （5.12±1.26 vs. 4.76±1.22 mmol/L, P=0.001）. Male carriers of -689T allele （n=51） were significantly higher in waist circumference, body weight, TC and TG than male non-carriers （n=656） （all P〈0.05）. In subjects whose BMI was over 25 kg/m2, carriers of -689T allele （n=82） had significantly higher levels of waist circumference, BMI, SBP and TC than non-carriers （n=231） （all p〈0.05）. The -689T allele was an independent risk factor for CHD （OR=1.668, 95%CI： 1.031-2.705, P=0.037） after adjusting for age, gender, waist circumference, body weight, BMI, smoking, physical activities, SBP, DBP, FBG, TC and TG level. Conclusion These data support the hypothesis that the -689T allele is associated with an increased risk of CHD, in Chinese Han people and correlates significantly with the profiles of CHD-related risk factors.

FOLLICULO-STELLATE CELLS OF THE RAT ANTERIOR PITUITARY RESPONDED TO ANGIOTENSIN Ⅱ BY INCREASING INTRACELLULAR Ca^(2+) CONCENTRATION

Objective The main purpose of this study was to investigate whether the folliculo stellate cells (FSC) respond to angiotensin(Ang)Ⅱ by increasing intracellular free Ca 2+ concentration ([Ca 2+ ]i),and where the origin of Ca 2+ mobilization is if that has occurred.Methods Pituitary cells in primary culture were prepared from male Wister rats(250g) by a conventional method and cultured in MEM supplemented with 4% normal rat serum.After 2 days in culutre,cells were loaded with 1 μmol/L fura PE3/AM for 1 h and subjected to a Ca 2+ imaging experiment with Quanti Cell 700 system.Excitation wavelengths of 340 and 380 nm were selected by means of a computer controlled filterwheel.Results The [Ca 2+ ]i of FSC in the rat anterior pituitary was elevated by Ang Ⅱ.The elevation of [Ca 2+ ]i of FSC induced by 0.1,1.0,10 and 100 nmol/L Ang Ⅱ was (56.33±6.18)( ±s ),(117.07±36.07),(175.59±40.01) and (216.02±11.52) nmol/L,respectively.The increase of [Ca 2+ ]i of FSC induced by 100 nmol/L Ang Ⅱ was not influenced by the medium without Ca 2+ (0Ca),but significantly suppressed by thapsigargin(TG),an inhibitor of ATPase.The rate of responsive FSC to Ang Ⅱ (100 nmol/L) was 61.84% which was obviously higher than that of pituitary endocrine cells(43.49%).Conclusion The present experiment demonstrates that the FSC in the rat anterior pituitary responds to Ang Ⅱ by increasing [Ca 2+ ]i,which raises the possibility that Ang Ⅱ released from either lactotrophs or gonadotrophs affects FSC through paracrine mechanism.The elevation of [Ca 2+ ]i induced by Ang Ⅱ presents a dosage dependent relation, and is possibly because of the release of Ca 2+ from an intracellular Ca 2+ pool(s).Fashions of Ca 2+ release are relative to the concentration of Ang Ⅱ.The results indicate that Ang Ⅱ functions as a paracrine factor among pituitary cells including FSC.

Angiotensin-converting enzyme 2 receptors,chronic liver diseases,common medications,and clinical outcomes in coronavirus disease 2019 patients

The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the virus responsible for coronavirus disease 2019(COVID-19),enters affected cells through the angiotensin-converting enzyme 2(ACE2)receptor,which is highly expressed in type II alveolar cells,enterocytes,and cholangiocytes.SARS-CoV-2 infection causes fever,dry cough,and breathing difficulty,which can progress to respiratory distress due to interstitial pneumonia,and hepatobiliary injury due to COVID-19 is increasingly recognized.The hepatobiliary injury may be evident at presentation of the disease or develop during the disease progression.The development of more severe clinical outcomes in patients with chronic liver diseases(CLD)with or without cirrhosis infected with SARS-CoV-2 has not been elucidated.Moreover,there is limited data related to common medications that affect the disease severity of COVID-19 patients.Additionally,ACE2 receptor expression of hepatobiliary tissue related to the disease severity also have not been clarified.This review summarized the current situation regarding the clinical outcomes of COVID-19 patients with chronic liver diseases who were treated with common medications.Furthermore,the association between ACE2 receptor expression and disease severity in these patients is discussed.

Serum vascular endothelial growth factor receptor-2 and adropin levels in age-related macular degeneration

AIM： To investigate the serum levels of vascular endothelial growth factor receptor-2（VEGFR-2） and adropin in age-related macular degeneration（AMD）patients.·METHODS： Ninety-eight AMD patients were included in the study. Seventy-eight age- and sex-matched healthy volunteers were recruited as the control group.Fundus florescein angiography and optical coherence tomography were performed to assess the posterior segment details. Serum VEGFR-2 and adropin levels were measured using enzyme-linked immunosorbent assays and compared between the study groups.· RESULTS： AMD group had significantly increased foveal retinal thickness, serum LDL and HDL levels and significantly decreased subfoveal choroidal thickness（P =0.01, 0.047, 0.025 and 〈0.001, respectively）. Serum VEGFR-2level revealed a significant decrease in AMD patients compared to controls（26.48 ±6.44 vs 30.42 ±7.92 ng/m L,P 〈0.001）. There was an insignificant increase in serum adropin level in AMD patients（6.17±3.19 vs 5.79±2.71 ng/m L,P =0.4）. Serum level of VEGFR-2 in AMD patients had a significant negative correlation with foveal retinal thickness（r =-0.226, P =0.025） and a significant positive correlation with subfoveal choroidal thickness（r=0.2, P=0.048）.·CONCLUSION： The current study demonstrated that the decreased serum VEGFR-2 level may be considered in the development of AMD. Adropin does not seem to play a role in the pathogenesis of AMD.

Plasma Levels of Angiotensin-Converting Enzymes 1 and 2 and <i>AGTR</i>2 (T1247G and A5235G) Gene Polymorphisms Are Associated to Breast Cancer Progression

Background: Breast cancer is the most common type of cancer among women. Diagnosed and treated timely, patients may have good prognostics. In Brazil, in 2012, the estimate of new cases was 52,680 and the number of registered deaths in 2012 was 12,852. The Renin-Angiotensin System (RAS) is known for its role in arterial hypertension and in other cardiovascular diseases. Angiotensin-Converting Enzyme 2 (ACE2) is the key to Ang-(1-7) formation, and counterbalances the ACE1/AngII/AGTR1 axis actions. RAS components have complex interactions with different tissues and their actions are not restricted to the cardiovascular system. Recently, the RAS has been associated with different types of cancers and in particular with gynecological cancers. Objectives: Our aim is to investigate possible associations between allelic distribution of two genetic polymorphisms in the AGTR2 receptor with ACEs 1 and 2 plasma levels among women with breast cancer. Patients and Methods: Patients with breast cancer were genotyped for two polymorphisms of the AGTR2 (T1247G and A5235G). Genotyping assays (TaqMan) were performed with genomic DNA extracted from blood cells. ACEs plasma level measurements were conducted in women from the breast-cancer group (N = 53). ACEs were measured in the plasma of these patients using ELISA kits. Results: SNPs genotype distribution is correlated with ACEs plasma levels. ACEs plasma levels are also correlated with clinical variables and ACE2 high levels are associated with better prognostics. Conclusions: Changes in circulating levels of ECA1/AngII ECA2/ Ang-(1-7) determine the magnitude of the inflammatory response that an individual can trigger and the variation in ACE 1 and 2 plasma level measurements in the blood of breast cancer patients suggests an association with the process of mammary carcinogenesis. Thus, the RAS may be associated with the process of mammary carcinogenesis by both genotypic variations of RAS components and by circulating levels of ACEs.

ACE与ACE2在儿童重症肺炎支原体肺炎中的水平变化及预测价值

目的探讨血管紧张素转化酶(ACE)与血管紧张素转化酶2(ACE2)在儿童重症肺炎支原体肺炎(SMPP)中的水平变化,并评估其在预测SMPP临床发展中的价值。方法选择2020年10月至2023年12月在兰州大学第二医院住院的71例普通肺炎支原体肺炎(MPP)患儿(MPP组)、63例重症肺炎支原体肺炎(SMPP)患儿(SMPP组),并选择同期20名健康体检儿童为健康对照组。测定并比较3组儿童血清中ACE与ACE2质量浓度,同时收集MPP组和SMPP组患儿的实验室检查指标结果进行比较及相关性分析,绘制受试者操作特征(ROC)曲线分析比较不同指标单独及联合预测SMPP的价值。结果3组儿童的血清ACE质量浓度中,SMPP组最高、健康对照组最低;血清ACE2质量浓度中,MPP组最高、健康对照组最低(P均<0.008);与MPP组相比,SMPP组白细胞计数、中性粒细胞百分比、C-反应蛋白(CRP)、淀粉样蛋白A、降钙素原、白介素-6(IL-6)、红细胞沉降率、D-二聚体(D-dimer)水平均升高(P<0.001)且与ACE质量浓度呈正相关(P<0.05)、与ACE2质量浓度呈负相关(P<0.05),SMPP组淋巴细胞百分比(LY%)降低(P<0.001)且与ACE2质量浓度呈正相关(P<0.05)、与ACE质量浓度呈负相关(P<0.05),SMPP组乳酸脱氢酶(LDH)水平较高(P<0.05)且与ACE2质量浓度呈负相关(P<0.05)、与ACE质量浓度无相关性(P>0.05),SMPP组单核细胞百分比(MO%)差异既无统计学意义也无相关性(P均>0.05);ROC曲线分析结果显示ACE、ACE2、CRP、D-dimer、LDH及ACE+ACE2联合检测、CRP+D-dimer+LDH联合检测对SMPP均具有预测价值,其中ACE+ACE2联合检测的预测价值最高,其AUC为0.991(95%CI 0.981~1.000)。结论ACE和ACE2水平很可能与SMPP患儿的病情发生、发展有关,可以作为预测SMPP的良好指标。

葡萄籽原花青素提取物对心肌梗死大鼠肾素-血管紧张素系统及AQP2蛋白表达的影响

目的:探讨葡萄籽原花青素提取物(GSPE)对心肌梗死大鼠肾素血管紧张素-系统及水通道蛋白2(AQP2)表达的影响。方法:将55只无特定病原体(SPF)级Sprague-Dawley(SD)大鼠按照随机数字表法分为健康组、模型组、辛伐他汀组、GSPE低剂量组及GSPE高剂量组,每组11只。除健康组外其余大鼠均采用冠状动脉结扎法制备心肌梗死模型,建模成功后,GSPE低剂量组、高剂量组大鼠分别灌胃100 mg/kg、400 mg/kg葡萄籽原花青素溶液,辛伐他汀组灌胃40 mg辛伐他汀溶液。苏木精-伊红(HE)染色后观察心肌组织形态;末端脱氧核苷酸转移酶介导的原位缺口末端转移酶标记法(TUNEL)检测心肌细胞凋亡;超声心动图监测心功能;放射免疫法检测血管紧张素Ⅱ(AngⅡ)、血浆肾素活性(PRA)、醛固酮水平;免疫印迹法检测心肌组织中AQP2、B细胞淋巴瘤/白血病2号基因(Bcl-2)及半胱天冬氨酸蛋白酶-3(Caspase-3)蛋白水平。结果:与健康组比较,模型组大鼠左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)升高,左心室射血分数(LVEF)和左心室短轴缩短分数(LVFS)降低(P<0.05);与模型组比较,GSPE低剂量组、GSPE高剂量组及辛伐他汀组LVEDD、LVESD降低,LVEF、LVFS升高(P<0.05),GSPE低剂量组、GSPE高剂量组间比较差异有统计学意义,而GSPE高剂量组与辛伐他汀组比较差异无统计学意义(P>0.05)。与健康组比较,模型组大鼠AngⅡ、PRA、醛固酮升高(P<0.05);与模型组比较,GSPE低剂量组、GSPE高剂量组及辛伐他汀组AngⅡ、PRA、醛固酮降低(P<0.05)。健康组、模型组、GSPE低剂量组、GSPE高剂量组及辛伐他汀组的心肌细胞凋亡率分别为(5.11±0.33)%、(46.22±3.97)%、(28.46±3.77)%、(15.42±2.33)%及(16.34±2.57)%,各组比较差异有统计学意义(P<0.05)。与健康组比较,模型组大鼠心肌组织中AQP2、Caspase-3蛋白水平升高,Bcl-2蛋白水平降低(P<0.05);与模型组比较,GSPE低剂量组、GSPE高剂量组、辛代他汀组大鼠心肌组织中AQP2、Caspase-3蛋白水平降低,Bcl-2蛋白水平升高(P<0.05)。结论:GSPE对心肌梗死有保护作用,可改善心功能水平,减少心肌细胞凋亡,其作用机制可能与调控AQP2蛋白表达有关。

ACE2对猪流行性腹泻病毒体外感染传代猪小肠上皮细胞的影响

为探究血管紧张素转换酶2(angiotensin converting enzyme 2,ACE2)在猪流行性腹泻病毒(porcine epidemic diarrhea virus, PEDV)感染仔猪过程中发挥的作用,本研究通过转录组学分析仔猪肠道ACE2在PEDV感染前后表达的变化情况,然后利用猪小肠上皮细胞(porcine intestinal epithelial cells, IPEC-J2细胞)模型,通过RT-qPCR、Western blot检测PEDV感染后ACE2的mRNA、蛋白表达水平的变化。过表达与抑制表达ACE2后通过RT-qPCR、Western blot、TCID50检测PEDV复制水平。结果显示,PEDV感染IPEC-J2后ACE2的mRNA及蛋白表达水平均显著下调,与转录组学结果一致。过表达ACE2组PEDV感染量显著上升,抑制表达ACE2组PEDV感染量显著下降。本研究在细胞水平上验证了ACE2在PEDV感染过程中的作用,即PEDV感染能够使ACE2表达量下降,在IPEC-J2细胞中过表达ACE2能提高PEDV复制水平,抑制ACE2的表达可降低PEDV复制水平。

Loss of human epidermal receptor-2 in human epidermal receptor-2+breast cancer after neoadjuvant treatment:A case report

BACKGROUND Human epidermal receptor-2(HER-2)expression has been reported to be discordant between primary tumor and metastatic tissue.CASE SUMMARY We presented a case diagnosed with the HER-2+breast cancer patient who exhibited changes in the expression of HER-2 receptors on tumour samples from surgical specimens obtained after neoadjuvant treatment(NAT)compared with initial biopsy.The patient underwent a HER-2-targeted therapy consequently,in spite of HER+gene loss.After the surgery,the patient subsequently underwent endocrine therapy and radiotherapy.CONCLUSION Changes in HER-2 expression after NAT should be retested by physicians and pathologists before systemic treatment instead of avoiding further HER-2-targeted therapy,and we will perform immunohistochemical multiple-spot biopsy analyses of other important clinical issues to better define prognosis and tailor subsequent adjuvant therapy.