Link Andreas, Lenz Monika, Legner Dominik, Böhm Michael, Nickenig Georg
Klinik für Innere Medizin III, Universität des Saarlandes, Homburg/Saar, Germany.
J Hypertens. 2006 Sep;24(9):1891-8. doi: 10.1097/01.hjh.0000242415.73406.17.
The pathogenesis of atherosclerosis, a chronic inflammatory disease, is influenced by the renin-angiotensin system and especially by angiotensin II subtype 1 (AT1) receptor activation. Although pro-inflammatory properties of angiotensin II as well as anti-inflammatory effects of AT1 receptor antagonists are well known, the underlying mechanisms are poorly understood.
In a prospective double-blind study, patients with hypertension and coronary artery disease were treated with either 40 mg telmisartan (n = 21) or placebo (n = 21) for 12 weeks. General markers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6), and cell adhesion molecules, such as soluble intercellular adhesion molecule (s-ICAM-1) and the leucocyte adhesion molecule soluble-L-selectin (sL-selectin), as well as the lymphocytic expression of the beta2 integrin MAC-1, were assessed before and after treatment. Telmisartan therapy significantly decreased the lymphocyte beta2 integrin MAC-1 expression, whereas hs-CRP, IL-6, s-ICAM and sL-selectin remained unaltered. In-vitro experiments were conducted to clarify the mode of action. Cultured human lymphocytes were stimulated with either angiotensin II or phorbol-12-myristate-13-acetate (PMA)/ionomycin, alone or after pretreatment with telmisartan. Whereas angiotensin II exerted no effect on beta2-integrin MAC-1 expression in lymphocytes, telmisartan dose-dependently inhibited beta2-integrin expression in lymphocytes in the absence or presence of angiotensin II.
The AT1 receptor antagonist telmisartan inhibits the expression of the pro-inflammatory beta2-integrin MAC-1 expression in lymphocytes independently of angiotensin II, suggesting an AT1 receptor-independent atheroprotective effect of this AT1 receptor antagonist.
动脉粥样硬化作为一种慢性炎症性疾病,其发病机制受肾素 - 血管紧张素系统影响,尤其是血管紧张素II 1型(AT1)受体激活。尽管血管紧张素II的促炎特性以及AT1受体拮抗剂的抗炎作用已广为人知,但其潜在机制仍知之甚少。
在一项前瞻性双盲研究中,高血压和冠状动脉疾病患者分别接受40毫克替米沙坦(n = 21)或安慰剂(n = 21)治疗12周。在治疗前后评估炎症的一般标志物,如高敏C反应蛋白(hs-CRP)和白细胞介素-6(IL-6),以及细胞粘附分子,如可溶性细胞间粘附分子(s-ICAM-1)和白细胞粘附分子可溶性L-选择素(sL-选择素),以及β2整合素MAC-1的淋巴细胞表达。替米沙坦治疗显著降低淋巴细胞β2整合素MAC-1表达,而hs-CRP、IL-6、s-ICAM和sL-选择素保持不变。进行体外实验以阐明作用方式。用血管紧张素II或佛波醇-12-肉豆蔻酸酯-13-乙酸酯(PMA)/离子霉素单独或在替米沙坦预处理后刺激培养的人淋巴细胞。血管紧张素II对淋巴细胞中β2整合素MAC-1表达无影响,而替米沙坦在不存在或存在血管紧张素II的情况下均剂量依赖性抑制淋巴细胞中β2整合素表达。
AT1受体拮抗剂替米沙坦独立于血管紧张素II抑制淋巴细胞中促炎β2整合素MAC-1表达,提示该AT1受体拮抗剂具有不依赖于AT1受体的抗动脉粥样硬化作用。