Varney V A, Warner A, Ghosh A, Nicholas A, Sumar N
Department of Medicine, St Helier Hospital, Wrythe Lane, Carshalton, Surrey SM5 1AA, UK.
J Allergy (Cairo). 2012;2012:258145. doi: 10.1155/2012/258145. Epub 2012 Dec 19.
Circulating angiotensin-II protects the circulation against sudden falls in blood pressure and is generated by the enzymatic action of angiotensin converting enzyme (ACE) on angiotensin-I. The ACE genes have 2 allelic forms, "I" and "D." The "D" genotype has both highest angiotensin-II generation and serum ACE levels compared to "I". 120 patients with IgE-anaphylaxis, 119 healthy controls, and 49 atopics had serum ACE levels, ACE genotype, and renin levels determined. Plasma renin levels were identical for all groups. Serum ACE levels and genotypes were similar for healthy controls (HC) and atopics, but lower in anaphylaxis (P = 0.012), with ACE genotypes also showing increased "I" genes (P = 0.009). This effect was more pronounced in subjects manifesting airway angioedema and cardiovascular collapse (AACVS) than mild cutaneous and respiratory (CRA) symptoms. AACVS was significantly associated with the presence of "I" genes. For "ID" genotype OR is 5.6, 95% CI 1.8 to 17.4, and for "II" genotype OR is 44, 95% CI 5 to 1891 within the anaphylaxis group = 0.001. The results show a difference in the genotype frequency between control and anaphylaxis, suggesting a role for the renin angiotensin system in anaphylaxis manifesting with airway angioedema and cardiovascular collapse.
循环中的血管紧张素-II可保护循环系统免受血压骤降的影响，它是由血管紧张素转换酶（ACE）对血管紧张素-I的酶促作用产生的。ACE基因有两种等位基因形式，即“I”和“D”。与“I”基因型相比，“D”基因型具有最高的血管紧张素-II生成量和血清ACE水平。对120例IgE介导的过敏反应患者、119名健康对照者和49名特应性个体测定了血清ACE水平、ACE基因型和肾素水平。所有组的血浆肾素水平相同。健康对照者（HC）和特应性个体的血清ACE水平和基因型相似，但过敏反应患者的水平较低（P = 0.012），且ACE基因型中“I”基因也有所增加（P = 0.009）。这种效应在表现为气道血管性水肿和心血管虚脱（AACVS）的受试者中比轻度皮肤和呼吸道（CRA）症状更为明显。AACVS与“I”基因的存在显著相关。在过敏反应组中，“ID”基因型的优势比为5.6，95%置信区间为1.8至17.4，“II”基因型的优势比为44，95%置信区间为5至1891（P = 0.001）。结果显示对照组和过敏反应组之间基因型频率存在差异，提示肾素血管紧张素系统在伴有气道血管性水肿和心血管虚脱的过敏反应中起作用。
