Shono Miki, Urushihara Maki, Suga Kenichi, Watanabe Noriko, Saijo Takahiko, Nakagawa Ryuji, Kagami Shoji
Department of Pediatrics, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan.
Clin Exp Nephrol. 2019 Apr;23(4):537-543. doi: 10.1007/s10157-018-1662-3. Epub 2018 Oct 23.
We recently demonstrated that preterm neonates have higher urinary angiotensinogen (AGT) levels than full-term neonates. Here, we tested the hypothesis that enhanced neonatal AGT expression is associated with intrarenal renin-angiotensin system (RAS) status during kidney development.
We prospectively recruited neonates born at our hospital and healthy children with minor glomerular abnormalities between April 2013 and March 2017. We measured neonatal plasma and urinary AGT levels at birth and 1 year later and assessed renal AGT expression in kidney tissues from neonates and healthy children using immunohistochemical (IHC) analysis.
Fifty-four neonates and eight children were enrolled. Although there were no changes in plasma AGT levels, urinary AGT levels were significantly decreased 1 year after birth. Urinary AGT levels at birth were inversely correlated with gestational age, and urinary AGT levels at birth and 1 year later were inversely correlated with estimated glomerular filtration rate 1 year after birth. IHC analysis showed that renal AGT expression in neonates was higher than that in healthy children and inversely correlated with gestational age.
Enhanced AGT expression and urinary AGT excretion may reflect intrarenal RAS activation associated with kidney development in utero.
我们最近证明，早产儿的尿血管紧张素原（AGT）水平高于足月儿。在此，我们检验了一个假设，即新生儿AGT表达增强与肾脏发育过程中的肾内肾素-血管紧张素系统（RAS）状态有关。
我们前瞻性招募了2013年4月至2017年3月在我院出生的新生儿以及患有轻微肾小球异常的健康儿童。我们在出生时和1年后测量了新生儿的血浆和尿AGT水平，并使用免疫组织化学（IHC）分析评估了新生儿和健康儿童肾脏组织中的肾AGT表达。
共纳入54例新生儿和8名儿童。虽然血浆AGT水平没有变化，但出生1年后尿AGT水平显著降低。出生时的尿AGT水平与胎龄呈负相关，出生时和1年后的尿AGT水平与出生1年后的估计肾小球滤过率呈负相关。免疫组织化学分析显示，新生儿肾AGT表达高于健康儿童，且与胎龄呈负相关。
AGT表达增强和尿AGT排泄可能反映了与子宫内肾脏发育相关的肾内RAS激活。
