Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica (LIIM), Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica (LIIM), Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Serviço de Medicina Fetal, Belo Horizonte, MG, Brazil.
J Pediatr (Rio J). 2019 May-Jun;95(3):328-333. doi: 10.1016/j.jped.2018.02.003. Epub 2018 Mar 11.
Posterior urethral valve is the most common lower urinary tract obstruction in male children. A high percentage of patients with posterior urethral valve evolve to end-stage renal disease. Previous studies showed that cytokines, chemokines, and components of the renin-angiotensin system contribute to the renal damage in obstructive uropathies. The authors recently found that urine samples from fetuses with posterior urethral valve have increased levels of inflammatory molecules. The aim of this study was to measure renin-angiotensin system molecules and to investigate their correlation with previously detected inflammatory markers in the same urine samples of fetuses with posterior urethral valve.
Urine samples from 24 fetuses with posterior urethral valve were collected and compared to those from 22 healthy male newborns at the same gestational age (controls). Renin-angiotensin system components levels were measured by enzyme-linked immunosorbent assay.
Fetuses with posterior urethral valve presented increased urinary levels of angiotensin (Ang) I, Ang-(1-7) and angiotensin-converting enzyme 2 in comparison with controls. ACE levels were significantly reduced and Ang II levels were similar in fetuses with posterior urethral valve in comparison with controls.
Increased urinary levels of angiotensin-converting enzyme 2 and of Ang-(1-7) in fetuses with posterior urethral valve could represent a regulatory response to the intense inflammatory process triggered by posterior urethral valve.
后尿道瓣膜是男性儿童中最常见的下尿路梗阻。很大比例的后尿道瓣膜患者会发展为终末期肾病。先前的研究表明，细胞因子、趋化因子和肾素-血管紧张素系统的成分有助于阻塞性尿路疾病中的肾损伤。作者最近发现，后尿道瓣膜胎儿的尿液样本中炎症分子水平升高。本研究旨在测量肾素-血管紧张素系统分子，并探讨它们与在后尿道瓣膜胎儿的相同尿液样本中先前检测到的炎症标志物的相关性。
收集了 24 例后尿道瓣膜胎儿的尿液样本，并与同期 22 例健康男性新生儿（对照组）的尿液样本进行了比较。通过酶联免疫吸附试验测量肾素-血管紧张素系统成分的水平。
与对照组相比，后尿道瓣膜胎儿的尿液中血管紧张素（Ang）I、Ang-（1-7）和血管紧张素转换酶 2 的水平升高。与对照组相比，后尿道瓣膜胎儿的 ACE 水平显著降低，Ang II 水平相似。
后尿道瓣膜胎儿尿液中血管紧张素转换酶 2 和 Ang-（1-7）水平升高可能代表对后尿道瓣膜引发的强烈炎症过程的调节反应。
