Dell'Omo Giulia, Penno Giuseppe, Pucci Laura, Lucchesi Daniela, Del Prato Stefano, Pedrinelli Roberto
Dipartimento Cardio Toracico e Vascolare, Università di Pisa, Italy.
Nephrol Dial Transplant. 2009 Jun;24(6):1864-9. doi: 10.1093/ndt/gfn754. Epub 2009 Jan 28.
Polymorphisms within the gene for transforming growth factor (TGF)-beta-1, a pro-fibrogenic cytokine pathophysiologically involved in hypertension and hypertensive target damage, might modulate the biological activity of the encoded protein. Through that mechanism, they might contribute to microalbuminuria, a marker of subclinical renal damage and a correlate of systemic inflammation and endothelial dysfunction in hypertension, a possibility never before tested. For this reason, we assessed the association of four TGF-beta-1 polymorphic variants (C-509T, Leu(10)-->Pro, Arg(25)-->Pro, Thr(263)-->Ile) with albuminuria in uncomplicated essential hypertensive men, using (circulating active + acid-activatable latent) TGF-beta-1 levels as an indirect index of their in vivo biological activity. Because of the close pathophysiological link of TGF-beta-1 with the renin-angiotensin system, we also tested the behaviour of the angiotensin converting enzyme (ACE) deletion/insertion (D/I) polymorphism.
Albuminuria (three overnight collections), office and 24-h BP, left ventricular mass index (LVMI), BMI, renal function, glucose, lipids, plasma TGF-beta-1 (n = 162, ELISA) were measured in 222 genetically unrelated, never-treated, uncomplicated Caucasian hypertensive men. ACE D/I polymorphisms were analysed by the polymerase chain reaction technique or a 5' nuclease assay with further restriction analysis when required.
Urine albumin levels or microalbuminuria (albuminuria > or =15 microg/min) did not differ by TGF-beta-1 genotypes, but both parameters were more frequent in ACE D/D homozygotes. Plasma TGF-beta-1 was similar across genetic backgrounds and was unrelated to albuminuria. Cardiovascular, renal, metabolic parameters were homogeneously distributed across genotypes.
In contrast to its link with the ACE D/I genotype, microalbuminuria was independent of TGF-beta-1 polymorphism in this group of never-treated, uncomplicated essential hypertensive men.
转化生长因子(TGF)-β1基因内的多态性,这种在高血压及高血压靶器官损害病理生理过程中发挥促纤维化作用的细胞因子,可能会调节其编码蛋白的生物学活性。通过这一机制,它们可能导致微量白蛋白尿,这是亚临床肾损害的一个标志物,也是高血压中全身炎症和内皮功能障碍的一个相关因素,此前从未对此可能性进行过测试。因此,我们评估了4种TGF-β1多态性变体(C-509T、Leu(10)→Pro、Arg(25)→Pro、Thr(263)→Ile)与未经治疗的单纯原发性高血压男性蛋白尿的相关性,使用(循环活性+酸可激活潜伏性)TGF-β1水平作为其体内生物学活性的间接指标。由于TGF-β1与肾素-血管紧张素系统存在密切的病理生理联系,我们还检测了血管紧张素转换酶(ACE)缺失/插入(D/I)多态性的情况。
对222名无亲缘关系、未经治疗的单纯白种人高血压男性测量了蛋白尿(3次夜间收集)、诊室血压和24小时血压、左心室质量指数(LVMI)、体重指数(BMI)、肾功能、血糖、血脂、血浆TGF-β1(n = 162,酶联免疫吸附测定法)。ACE D/I多态性通过聚合酶链反应技术或5'核酸酶测定法进行分析,必要时进行进一步的限制性分析。
尿白蛋白水平或微量白蛋白尿(白蛋白尿≥15微克/分钟)在不同TGF-β1基因型之间无差异,但这两个参数在ACE D/D纯合子中更为常见。血浆TGF-β1在不同遗传背景下相似,且与蛋白尿无关。心血管、肾脏、代谢参数在不同基因型之间分布均匀。
与TGF-β1与ACE D/I基因型的联系不同,在这组未经治疗的单纯原发性高血压男性中,微量白蛋白尿与TGF-β1多态性无关。