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RESUMEN La pandemia declarada por la OMS originada por el COVID-19 (enfermedad infecciosa originada por el virus SARS-CoV2), desde su aparición en Wuhan, China en diciembre 2019; esta diseminándose rápidamente y de manera inesperada por todo el mundo originando millones de casos y miles de muertes, afectando más de 120 países y desde el 06 marzo 2020 al Perú, distribuyéndose rápidamente por todo el país, originando crisis y colapso del sistema de servicios de salud, especialmente de las atenciones en emergencia, hospitalizaciones y unidades de cuidados intensivos abarrotadas; sin tener aún un tratamiento específico ni la posibilidad de una vacuna a corto plazo. Se sabe actualmente que COVID-19, es una enfermedad sistémica que puede afectar múltiples órganos y tejidos y que puede ser fatal. El objetivo de esta revisión es mostrar lo descrito en los recientes estudios publicados a nivel mundial incluido nuestro país, que han reportado sus manifestaciones clínicas, esbozando posibles mecanismos de disfunción hepática relacionados a COVID-19 y sus repercusiones, en especial sobre el aparato digestivo; analizando y discutiendo el potencial impacto sobre ellas y las enfermedades del hígado, enunciando las recomendaciones de expertos y organizaciones científicas respecto a medidas de prevención, control y manejo, además de esbozar algunas estrategias de salud pública en nuestro país para la adecuada atención de estos pacientes en tiempos de crisis generalizada.
ABSTRACT The pandemic of COVID-19 (an infectious disease caused by the SARS-CoV2 virus), declared as such by the WHO, is spreading since its appearance in Wuhan (China) in December 2019, rapidly and unexpectedly throughout the world, causing millions of cases and thousands of deaths and has affected more than 120 countries. It was officially acknowledged in Peru on March 6th, 2020, and has spread rapidly throughout the country, causing first the crisis and then the collapse of the healthcare system, especially emergency care, admissions, and overcrowded intensive care units, not having a specific treatment or the foreseeable possibility of a short-term vaccine. COVID-19 is currently known for being a systemic disease that can affect multiple organs and tissues and can be fatal. The goal of this review is to present what has been described in recent studies, published worldwide and including our country, that have reported clinical manifestations, outlining possible mechanisms of liver dysfunction related to COVID-19 and its repercussions, especially on the digestive system. These studies analyze and discuss the potential impact on liver diseases, offering recommendations of experts and scientific organizations regarding prevention, control and management measures, outlining also some public health strategies in our country for the proper care of COVID-19 patients in times of widespread crisis.
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Humans , Pneumonia, Viral/complications , Public Health , Coronavirus Infections/complications , Betacoronavirus , Liver Diseases/virology , Peru/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Pneumonia, Viral/epidemiology , Cost of Illness , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/epidemiology , Pandemics , SARS-CoV-2 , COVID-19 , Liver Diseases/diagnosis , Liver Diseases/physiopathology , Liver Diseases/epidemiologyABSTRACT
ABSTRACT Purpose: Pseudoexfoliation syndrome has been linked to impaired function of the heart and blood vessels. We conducted a study to investigate the role of the renin-angiotensin system in the etiopathogenesis of pseudoexfoliation syndrome. Methods: The subjects were 14 patients with pseudoexfoliation syndrome and 14 healthy controls who underwent cataract extraction. Preoperative 5-ml samples of peripheral venous blood and perioperative aqueous humor were collected from the patients in both groups. Plasma and aqueous humor renin levels were analyzed by an immunoradiometric method, and angiotensin II levels were analyzed by radioimmunassay. SPSS version 16.0 was used for statistical analyses. A p-value <0.05 was considered to indicate a statistically significant difference. Results: The mean ages of the patients in pseudoexfoliation and control groups were 71.7 ± 7.1 and 67.4 ± 9.3 years, respectively (p=0.140). The median aqueous humor renin level was 7.73 pg/ml (4.15-21) in the control group and 11.95 pg/ml (3.75-18.54) in pseudoexfoliation group (p=0.022). There were no differences between the two groups in the plasma renin, plasma angiotensin II, or aqueous humor angiotensin II levels. The correlations between plasma and aqueous humor renin levels and between plasma and aqueous humor angiotensin II levels were examined separately for each group; no significant correlations were observed in pseudoexfoliation group (r=-0.440, p=0.115; r=-0.414, p=0.142) or the control group (r=-0.232, p=0.425; r=0.482, p=0.081). Conclusion: Aqueous humor renin levels are higher in pseudoexfoliation syndrome. The results indicate a probable role of renin-angiotensin system in pseudoexfoliation syndrome. Further studies with larger numbers of cases are needed to clarify the precise association of renin-angiotensin system with the etiopathogenesis of pseudoexfoliation syndrome.
RESUMO Objetivo: A síndrome de pseudo-exfoliação tem sido associada ao comprometimento da função do coração e dos vasos sanguíneos. Foi realizado um estudo para investigar o papel do sistema renina-angiotensina na etiopatogenia da síndrome de pseudo-exfoliação. Métodos: Os sujeitos foram 14 pacientes com síndrome de pseudo-exfoliação e 14 controles saudáveis submetidos à extração de catarata. Amostras pré-operatórias de 5 ml de sangue venoso periférico e humor aquoso perioperatório foram coletadas dos pacientes em ambos os grupos. Os níveis de renina no plasma e humor aquoso foram analisados pelo método imunorradiométrico e os níveis de angiotensina II foram analisados por radioimunoensaio. O SPSS versão 16.0 foi utilizado para análises estatísticas. Considerou-se o valor de p<0,05 para indicar uma diferença estatisticamente significativa. Resultados: A média de idade dos pacientes nos grupos pseudo-exfoliação e controle foi de 71,7 ± 7,1 e 67,4 ± 9,3 anos, respectivamente (p=0,140). O nível médio de renina no humor aquoso foi de 7,73 pg / ml (4,15-21) no grupo controle e 11,95 pg/ml (3,75-18,54) no grupo pseudo-exfoliação (p=0,022). Não houve diferenças entre os dois grupos de renina plasmática, angiotensina II plasmática ou nos níveis de angiotensina II em humor aquoso. As correlações entre os níveis de renina no plasma e no humor aquoso e entre os níveis de angiotensina II no plasma e humor foram examinadas separadamente para cada grupo; n]ao foram observadas correlações significativas no grupo pseudo-exfoliação (r=-0,440, p=0,115; r=-0,414, p=0,142) ou no grupo controle (r=-0,232, p=0,425; r=0,482, p=0,081). Conclusão: Os níveis de renina no humor aquoso são mais elevados na síndrome de pseudo-exfoliação. Os resultados indicam um provável papel do sistema renina-angiotensina na síndrome de pseudo-exfoliação. Novos estudos com maior número de casos são necessários para esclarecer a associação precisa do sistema renina-angiotensina com a etiopatogenia da síndrome de pseudo-exfoliação.
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Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Renin-Angiotensin System , Angiotensin II/analysis , Renin/analysis , Exfoliation Syndrome/etiology , Aqueous Humor/metabolism , Cataract/blood , Cataract Extraction , Prospective Studies , Exfoliation Syndrome/metabolism , Exfoliation Syndrome/blood , Preoperative PeriodABSTRACT
Brain renin-angiotensin system (RAS) is closely associated with many pathophysiological processes of cardiocerebrovascular diseases,including stroke.The activation of the different components in RAS will produce specific biological effects.This article reviews the roles of brain RAS in the pathophysiological processes of ischemic stroke,especially the neuroprotective effect of ACE2/Ang-(1-7)/Mas axis.
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Objective To investigate the relationship between the polymorphisms of angiotensin Ⅱ receptor gene and the risk of primary aldosteronism (PA).Methods Polymerase chain reaction -restriction fragment length polymorphism (PCR -RFLP)was used to examine the 1 1 66A /C polymorphism of AT1 R gene and 1 675A /G poly-morphism of AT2R gene in 85 patients with PA and 1 00 healthy controls.Results There was no significant difference of AT1 R 1 1 66A /C genotypes (AA,AC,CC)and allele (A and C)frequency among patients and controls (χ2 =0.430,P =0.806).There was obvious difference of AT2R 1 675A /G genotypes (AA,AG,GG)and allele (A and G) frequency among two groups (χ2 =6.1 21 ,P =0.01 3).The G allele was higher than A allele in PA group (χ2 =6.767,P =0.009).Conclusion Homogenic mutation of 1 675A /G site in AT2R gene may be one of risk factors of PA.
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Objective To study the effect of long‐acting nitrate on cardiac function and expression of AngⅡreceptor (ATR)subtypes in kidneys of chronic heart failure (CHF)rats after myocardial infarction .Methods Ninety male Wistar rats aged 10 weeks were randomly divided into control group (group A ,n=9) ,sham operation group (group B ,n=8) ,HF model group (group C ,n=9) , low Elantan dose group (group D ,n=9) ,high Elantan dose group (group E ,n=9) ,olmesartan group (group F ,n=9) ,and combined high Elantan dose and olmesartan group (group G ,n=8) .A HF model was established by ligating the left anterior descending artery .The animals received gastric drugs for 6 weeks .Their cardiac function was assyed by ultrasound echocardiography and expressions of AT1 R and AT2 R were detected by RT‐PCR and Western blot ,respectively .Results The PRA and AngⅡexpression levels were significantly higher ,the AT1 R expression level was significantly higher and the AT2 R expression level was significantly lower in group C than in group B (P<0 .01 ,P<0 .05) .The PRA and AngⅡexpression levels were significantly lower ,the AT1 R expression level was significantly lower and the AT2 R expression level was significantly higher in groups E‐G than in group C (P<0 .05 ,P<0 .01) .The receptor expression levels were much higher in group G than in group F (P<0 .05) .Conclusion Long‐term use of long‐acting nitrate can effectively improve cardiac function and protect renal function .
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Angiotensin (Ang Ⅱ),a main effector peptide of the renin-angiotensin system (RAS),mediates a hormonal action in the maintenance of blood pressure and electrolyte levels,and thus fluid homeostasis.Recent studies have implicated that it correlates with tumor growth,angiogenesis,metastasis and it has drawn more and more attention.Many studies show that Ang Ⅱ-AT1R/AT2R play crucial roles in tumor growth,metastasis,invasion and tumor angiogenesis,which are formed new targets for treating malignant tumors.
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Objective To amplify the recombinant adenovirus vector carrying rat angiotensin Ⅱ type 2 receptor (AT2R) gene using human embryonic kidney (HEK) 293A cell lines and to construct a pancreatic islet βcell model overexpressing AT2R by transfecting the adenovirus vector into rat insulinoma (INS-1) cell lines.Methods Recombinant adenovirus vector Ad-G-AT2R-EGFP and control vector Ad-CMV-EGFP were amplified with HEK 293A cells and the titer of the adenovirus was detected .After both adenovirus vectors were transfected into INS-1 cells,AT2R and angiotensin Ⅱtype 1 receptor(AT1R) gene expressions were tested using real-time PCR, Western blotting, immunofluorescence staining and confocal laser-scanning microscopy .Results The titer of amplified Ad-G-AT2R-EGFP and Ad-CMV-EGFP was re-spectively 9 ×109 pfu/ml and 8 ×109 pfu/ml.Transfection of Ad-G-AT2R-EGFP into INS-1 cells induced an increase in AT2R mRNA expression in a dose-dependent manner , and significantly increased AT2R mRNA and protein expression compared with Ad-CMV-EGFP-or mock-transfection.Conclusion The recombinant adenoviral vector carrying AT2R gene is successfully amplified and an INS-1 cell model overexpressing AT2R is constructed by transient transfection , which can contribute to further study of the role of AT2R in pancreatic islet βcells.
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We determined the relationship between the progression of immunoglobulin A nephropathy (IgAN) and the A1818T polymorphism in intron 2 of Angiotensin II type 2 receptor (AT2R) gene, which might play protective roles in the pathogenesis of IgAN. Patients with biopsy-proven IgAN were recruited from the registry of the Progressive REnal disease and Medical Informatics and gEnomics Research (PREMIER) which was sponsored by the Korean Society of Nephrology. A1818T polymorphism of AT2R gene was analyzed with PCR-RFLP method and the association with the progression of IgAN, which was defined as over 50% increase in baseline serum creatinine level, was analyzed with survival analysis. Among the 480 patients followed for more than 10 months, the group without T allele had significantly higher rates of progression of IgAN than the group with T allele (11.4% vs. 3.9%, p=0.024), although there were no significant differences in the baseline variables such as initial serum creatinine level, the degree of proteinuria, and blood pressure. In the Cox's proportional hazard model, the hazard ratio of disease progression in the patients with T allele was 0.221 (95% confidence interval for Exp(B): 0.052-0.940, p=0.041) compared to that of without T allele. In conclusion, A1818T polymorphism of AT2R gene was associated with the progression of IgAN.
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Humans , Alleles , Creatinine/blood , Disease Progression , Genotype , Glomerulonephritis, IGA/ethnology , Korea , Models, Genetic , Models, Statistical , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Polymorphism, Single Nucleotide , Receptor, Angiotensin, Type 2/genetics , Time Factors , Treatment OutcomeABSTRACT
Objective To examine the expression levels of α1-adrenergie receptor(α1-AR)and angiotensinⅡ reeeptor(ATR)subtypes in left ventricle of rats from adolescent age, middle age,presenium to senium. Methods Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) was used to quantitate the messenger RNA (mRNA) of α1-AR and ATR subtypes in left ventricle in Wistar rats aged 3-months (adolescent age), 12-months (middle age), 18-months (presenium) and 24-months (senium). Results The expression of α1A-AR mRNA was decreased gradually with aging, and the gene expression of α1 D-AR was repressed in middle age and presenium,while the expression of a,B-AR mRNA remained unchanged during senescence. Cardiac AT1R expression was not affected by aging from adolescent age to presenium, but exhibited a remarkable up-regulation in senium There was no significant discrepancies of cardiac AT2R expression among the four different age groups. Conclusions The results suggest that there are considerable changes in mRNA levels of cardiac α1-AR and ATR subtypes with aging. The change of cardiac α1-AR and ATR expression during aging is a protective response for senescence and has an important significance in maintaining normal physiological functions of heart.
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Objective To investigate the effects of angiotensinⅡ (AngⅡ) on the Apelin mRNA and APJ mRNA expression in pulmonary microvascular endothelial ceils (PMVECs) in rats. Methods Pulmonary microvascular endothelial ceils obtained from 24 h old neonatal SD rats were cultured in DMEM liquid culture medium. The 2nd-4th generation PMVECs were inoculated on 6-well plates (5×105). The experiment was performed in two parts. In part Ⅰ different concentration of AngⅡ 0, 10-9, 10-8, 10-7, 10-6mol/L (group Ⅰ- Ⅴ) were added into the PMVECs. The expression of Apelin mRNA and APJ mRNA was determined at 24 h after addition of Ang Ⅱ by RT-PCR. In part Ⅱ the cells were exposed to 10-7 mol/L Ang Ⅱ. The expression of Apelin mRNA and APJ mRNA was determined immediately and at 1, 6, 12, 24, 48 h(group Ⅰ-Ⅵ) after addition of Ang Ⅱ by RT-PCR. Results In part Ⅰ Apelin mRNA expression was significantly higher in group Ⅱ (Ang Ⅱ 10-9 mol/L) but lower in group Ⅲ-Ⅴ (AngⅡ 10-8, 10-7, 10-6 mol/L) than in group Ⅰ (control, Ang Ⅱ 0 mol/L). The APJ mRNA expression was significantly lowered in group Ⅱ-Ⅴ in a dose-dependent manner as compared with control group (group Ⅰ). In partⅡ beth Apelin mRNA and APJ mRNA expression exhibited a bi-phasic response to AngⅡ 10-7 mol/L, increased at first and was then decreasing with time. The Apelin mRNA and APJ mRNA expression reached the peak at 1 h of incubation with Ang Ⅱ respectively. Conclusion Ang Ⅱ decreases both Apelin mRNA and APJ mRNA expression in PMVECs in a dose and time dependent manner. The down-regulation of Apelin mRNA and APJ mRNA expression may be involved in the mechanism of injury to PMVECs.
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Objective To construct the recombinant adenovirus of Angiotensin Ⅱ type 2 receptor (AT2R), and study the effect of AT2R on prevention of neointimal hyperplasia in rat carotid arteries after balloon angioplasty. Methods The recombinant adenovirus of AT2R with green fluorescent protein was constructed by using the method of homogenous recombination in bacteria. AT2R gene was transduced into rat carotid arteries with pAdCMV/AT2R after the reproduction of rat carotid balloon injury restenosis model. The expression and the transfection efficiency of AT2R gene were evaluated by RT-PCR, immunofluorescence staining, and confocal microscope. The intimal/medial area ratio was measured by digital analysis system. Results The titre of purified recombinant adenovirus was 1.5?10 12pfu/ml, and it was proved by PCR. pAdCMV/AT2R transfection efficiency in carotid artery was about 40% at day14, and localized to the neointima, as well as to the media and the adventitia. pAdCMV/AT2R delivered into injured rat carotid arteries significantly up-regulated AT2RmRNA and protein expression in neointima from day 7 to 21 after injury. Compared with pAd-GFP transfection group, pAdCMV/AT2R transfection reduced I/M ratio significantly on day 21(0.78?0.06 vs. 1.36?0.21 respectively, P
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Objective To investigate the effects of angiotensin Ⅱ AT1 receptor antagonist-Candesartan on production of leptin, adiponectin and TNF-? in rat. Methods 20 male Wistar Kyoto rats were randomly divided into vehicle and Candesartan treated groups. The dosage of Candesartan was 10mg?kg~ -1 ?d~ -1 . Food intake and bodyweight were recorded each week. Rats were sacrificed by decapitation after 17 weeks. Epididymal and perirenal fat were collected and weighted. Adipocytes were isolated from epididymal adipose tissue with collagenase. Diameter of adipocyte was evaluated. Blood chemistry, insulin, leptin, adiponectin and TNF-? were assayed. mRNA expressions of leptin, adiponectin and TNF-? of epididymal adipose tissue were assayed with RT-PCR. Results In Candesartan treated group, bodyweight and content of adipose tissue were significantly decreased, and adipocytes shrunk. Blood glucose and insulin levels showed no difference between two groups. Plasma leptin level and leptin mRNA expression in adipose tissue were lower, and plasma adiponectin level as well as adiponectin mRNA expression were higher in Candesartan treated group. Plasma TNF-? level was too low to detect with super sensitive kit, and mRNA expression of TNF? was decreased in Candesartan treated group. Conclusions Angiotensin Ⅱ AT1 receptor antagonist decreases the production of leptin and TNF-?, enhances synthesis as well as release of adiponectin in rat adipose tissue.
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Objective To observe the expression of both type 1 (AT1) and type 2 (AT2) receptors of angiotensin Ⅱ (AngⅡ) in human hypertrophic scars, and to explore theirs role in collagen synthesis of fibroblasts in human hypertrophic scars. Methods The expression of both AT1 and AT2 receptors in fibroblasts of hypertrophic scars was detected with immunohistochemical staining and radioligand receptor binding assay. Collagen synthesis was examined in cultured in vitro fibroblasts of hypertrophic scars by measuring [~3H]proline incorporation into collagenous proteins. Results Positive staining signals of both AT1 and AT2 receptors were found in fibroblasts of hypertrophic scars. Similar results were also got in cultured in vitro fibroblasts of hypertrophic scars, expression level of AT1 and AT2 receptors were 10.69?2.15fmol/10~6cells and 4.9?1.05fmol/10~6cells respectively. In cultured in vitro fibroblasts, AngⅡ may accelerate the collagen synthesis significantly (P