Alnahal Alsayed Ahmed, Khalil Usama Ahmed, Diab Magada Alsayed, Zanaty Ali Fahmy
Department of Internal Medicine and Nephrology, Faculty of Medicine, Zagazig University, Egypt.
Saudi J Kidney Dis Transpl. 2012 Sep;23(5):993-9. doi: 10.4103/1319-2442.100881.
A little is known about the behavior of the renin-angiotensin system (RAS) in glomerulo-nephritis (GN), although it is activated in other models of injury. To study renal angiotensin-converting enzyme (ACE) messenger ribonucleic acid (mRNA) gene expression in patients with GN to determine its role in the disease process and other factors that may influence the course of the disease and the prognosis, e.g. treatment with ACE inhibitor (ACEI) drugs, we studied 20 patients with GN allocated to two groups: ten patients received an ACEI drug and ten patients did not receive ACEI in addition to a control group of ten healthy subjects. Routine and special laboratory investigation, histopathological studies and quantitative polymerase chain reaction analysis for renal ACE mRNA were done for both the study and the control groups. There was a statistically significant increase in ACE mRNA gene expression in the GN groups than in control group, but no statistically significant difference in ACE mRNA gene expression between the patients group that received and the group that did not receive ACEI. A significant correlation was found between the ACE mRNA gene expression and the mean blood pressure, serum creatinine, blood urea nitrogen and 24-h urinary protein. In conclusion, a higher level of ACE mRNA gene expression in patients suffering from GN may suggest a role of the RAS in the process of GN, perhaps contributing to glomerular hypertrophy and matrix overproduction. The use of ACEI drugs possibly slows the rate of progression of renal failure and plays a role in controlling the pathophysiology.
尽管肾素 - 血管紧张素系统（RAS）在其他损伤模型中被激活，但关于其在肾小球肾炎（GN）中的行为却知之甚少。为了研究GN患者肾血管紧张素转换酶（ACE）信使核糖核酸（mRNA）基因表达，以确定其在疾病过程中的作用以及可能影响疾病进程和预后的其他因素，例如使用ACE抑制剂（ACEI）药物治疗，我们研究了20例GN患者，分为两组：10例患者接受ACEI药物治疗，10例患者未接受ACEI治疗，另外还有10名健康受试者作为对照组。对研究组和对照组均进行了常规和特殊实验室检查、组织病理学研究以及肾ACE mRNA的定量聚合酶链反应分析。GN组的ACE mRNA基因表达较对照组有统计学意义的增加，但接受ACEI治疗的患者组和未接受ACEI治疗的患者组之间的ACE mRNA基因表达无统计学意义的差异。发现ACE mRNA基因表达与平均血压、血清肌酐、血尿素氮和24小时尿蛋白之间存在显著相关性。总之，GN患者中较高水平的ACE mRNA基因表达可能提示RAS在GN过程中起作用，可能导致肾小球肥大和基质过度产生。使用ACEI药物可能会减缓肾衰竭的进展速度，并在控制病理生理过程中发挥作用。
