Recent studies suggest that treatment with angiotensin Ⅱ type 1 (AT1) receptor blockers and lipid lowering agents, namely the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins may have ...Recent studies suggest that treatment with angiotensin Ⅱ type 1 (AT1) receptor blockers and lipid lowering agents, namely the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins may have beneficial effects on renal function independent of lowering actions on blood pressure and cholesterol.^(1,2) However, the renal effects of the combination of AT1 receptor blockers and statins in experimental diabetes are unknown. The aims of the present study were to determine whether valsartan and fluvastatin would lower the expression of nuclear factor kappa B ((NF-κB))and monocyte chemoattractant protein (MCP-1) in the tubulointerstitium and improve renal function and to see whether treatment with a combination of valsartan and fluvastatin would have any extra beneficial effect in streptozotocin (STZ)-induced unilaterally nephrectomized diabetic rats.展开更多
The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospectiv...The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospective analysis of hospitalized adult COVID-19 patients in Wuhan,China,who had definite clinical outcome(dead or discharged)by February 15,2020.Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes.The medical records from 702 patients were screened.Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication,40 patients were receiving ACEI/ARB as part of their regimen,and 61 patients were on antihypertensive medication other than ACEI/ARB.We observed no statistically significant differences in percentages of in-hospital mortality(28%vs.34%,P=0.46),ICU admission(20%vs.28%,P=0.37)or invasive mechanical ventilation(18%vs.26%,P=0.31)between patients with or without ACEI/ARB treatment.Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes.Our findings confirm the lack of an association between chronic receipt of reninangiotensin system antagonists and severe outcomes of COVID-19.Patients should continue previous antihypertensive therapy until further evidence is available.展开更多
Background:Olmesartan,an angiotensin Ⅱ receptor blocker(ARB),is associated with gastrointestinal symptoms resembling sprue-like enteropathy.Some have proposed that enteropathy may be a class effect rather than olmesa...Background:Olmesartan,an angiotensin Ⅱ receptor blocker(ARB),is associated with gastrointestinal symptoms resembling sprue-like enteropathy.Some have proposed that enteropathy may be a class effect rather than olmesartan-specific.We performed a systematic review to identify literature of sprue-like enteropathy for all ARBs.Methods:Case reports,case series and comparative studies of ARBs were searched on PubMed and Embase databases through 21 November 2018 and then assessed.Results:A total of 82 case reports and case series as well as 5 comparative studies,including 248 cases,were selected and analysed.The ARBs listed in the case reports were olmesartan(233 users;94.0%),telmisartan(5 users;2.0%),irbesartan(4 users;1.6%),valsartan(3 users;1.2%),losartan(2 users;0.8%)and eprosartan(1 user;0.4%).The periods between ARB initiation and onset of symptoms ranged from 2 weeks to 13 years.Histologic results were reported in 218 cases,in which 201 cases(92.2%)were villous atrophy and 131 cases(60.1%)were intraepithelial lymphocytosis.Human leucocyte antigen(HLA)testing was performed in 147 patients,among whom 105(71.4%)had HLA-DQ2 or HLA-DQ8 haplotypes.Celiacassociated antibodies were tested in 169 patients,among whom 167(98.8%)showed negative results.Gluten exclusion from the diet failed to relieve symptoms of enteropathy in 127(97.7%)of 130 patients with information.Complete remission of symptoms after discontinuation of ARB was reported in 233(97.4%)of the 239 patients with information.Seven cases(2.8%)reported recurrence of symptoms after restarting olmesartan;rechallenge was not reported for the non-olmesartan ARBs.The retrospective studies conducted worldwide had inconsistent study designs(e.g.differences in periods of study and case definition)and findings.Conclusions:Although enteropathy is rare,clinicians should remain vigilant of this potential adverse event even years after medication initiation.展开更多
文摘Recent studies suggest that treatment with angiotensin Ⅱ type 1 (AT1) receptor blockers and lipid lowering agents, namely the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins may have beneficial effects on renal function independent of lowering actions on blood pressure and cholesterol.^(1,2) However, the renal effects of the combination of AT1 receptor blockers and statins in experimental diabetes are unknown. The aims of the present study were to determine whether valsartan and fluvastatin would lower the expression of nuclear factor kappa B ((NF-κB))and monocyte chemoattractant protein (MCP-1) in the tubulointerstitium and improve renal function and to see whether treatment with a combination of valsartan and fluvastatin would have any extra beneficial effect in streptozotocin (STZ)-induced unilaterally nephrectomized diabetic rats.
基金This work was supported by Major Projects of National Science and Technology on New Drug Creation and Development(Nos.2020ZX09201001 and 2020ZX09201012)Chinese Academy of Medical Sciences(CAMS)Emergency Project of COVID-19(No.2020HY320001).
文摘The possible effects of angiotensin-converting enzyme inhibitors(ACEIs)or angiotensin Ⅱ receptor blockers(ARBs)on COVID-19 disease severity have generated considerable debate.We performed a single-center,retrospective analysis of hospitalized adult COVID-19 patients in Wuhan,China,who had definite clinical outcome(dead or discharged)by February 15,2020.Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes.The medical records from 702 patients were screened.Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication,40 patients were receiving ACEI/ARB as part of their regimen,and 61 patients were on antihypertensive medication other than ACEI/ARB.We observed no statistically significant differences in percentages of in-hospital mortality(28%vs.34%,P=0.46),ICU admission(20%vs.28%,P=0.37)or invasive mechanical ventilation(18%vs.26%,P=0.31)between patients with or without ACEI/ARB treatment.Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes.Our findings confirm the lack of an association between chronic receipt of reninangiotensin system antagonists and severe outcomes of COVID-19.Patients should continue previous antihypertensive therapy until further evidence is available.
文摘Background:Olmesartan,an angiotensin Ⅱ receptor blocker(ARB),is associated with gastrointestinal symptoms resembling sprue-like enteropathy.Some have proposed that enteropathy may be a class effect rather than olmesartan-specific.We performed a systematic review to identify literature of sprue-like enteropathy for all ARBs.Methods:Case reports,case series and comparative studies of ARBs were searched on PubMed and Embase databases through 21 November 2018 and then assessed.Results:A total of 82 case reports and case series as well as 5 comparative studies,including 248 cases,were selected and analysed.The ARBs listed in the case reports were olmesartan(233 users;94.0%),telmisartan(5 users;2.0%),irbesartan(4 users;1.6%),valsartan(3 users;1.2%),losartan(2 users;0.8%)and eprosartan(1 user;0.4%).The periods between ARB initiation and onset of symptoms ranged from 2 weeks to 13 years.Histologic results were reported in 218 cases,in which 201 cases(92.2%)were villous atrophy and 131 cases(60.1%)were intraepithelial lymphocytosis.Human leucocyte antigen(HLA)testing was performed in 147 patients,among whom 105(71.4%)had HLA-DQ2 or HLA-DQ8 haplotypes.Celiacassociated antibodies were tested in 169 patients,among whom 167(98.8%)showed negative results.Gluten exclusion from the diet failed to relieve symptoms of enteropathy in 127(97.7%)of 130 patients with information.Complete remission of symptoms after discontinuation of ARB was reported in 233(97.4%)of the 239 patients with information.Seven cases(2.8%)reported recurrence of symptoms after restarting olmesartan;rechallenge was not reported for the non-olmesartan ARBs.The retrospective studies conducted worldwide had inconsistent study designs(e.g.differences in periods of study and case definition)and findings.Conclusions:Although enteropathy is rare,clinicians should remain vigilant of this potential adverse event even years after medication initiation.
