Department of Critical Care Medicine, Shanghai Jiaotong University Affiliated to The Sixth People's Hospital, Shanghai, China.
Lab Invest. 2019 Dec;99(12):1770-1783. doi: 10.1038/s41374-019-0289-7. Epub 2019 Jul 5.
Early pulmonary fibrosis is the leading cause of poor prognosis in patients with acute respiratory distress syndrome (ARDS). However, whether the renin-angiotensin system (RAS) can serve as a therapeutic target is unknown. In this study, an animal model of early pulmonary fibrosis was established via the LPS three-hit regimen. Afterwards, the animals were treated with intraperitoneal injections of Ang-(1-7), AVE0991, or A779 once per day for 20 days. The plasma and BALF AngII levels of the animals were increased, while there were no significant changes in Ang-(1-7) levels in lung tissue after LPS treatment. Furthermore, the AT1R protein levels were significantly increased and the Mas levels were significantly decreased on days 14 and 21. Administration of Ang-(1-7) downregulated LPS-induced AT1R mRNA expression, which was upregulated by A779. The expression of Mas mRNA responded in the opposite direction relative to AT1R. Moreover, LPS caused decreased levels of Mas and E-cadherin and increased AT1R, Vimentin, and Src phosphorylation levels. Ang-(1-7) or AVE0991 blocked these effects but was counteracted by A779 treatment. Our findings suggested that AngII and AT1R levels exhibit opposite dynamic trends during LPS-induced early pulmonary fibrosis, as do Ang-(1-7) and Mas. Ang-(1-7) exerts protective effects against early pulmonary fibrosis, mainly by regulating the balance between AngII and AT1R and between Ang-(1-7) and Mas and by inhibiting Src kinase activation.
早期肺纤维化是急性呼吸窘迫综合征(ARDS)患者预后不良的主要原因。然而,肾素-血管紧张素系统(RAS)是否可以作为治疗靶点尚不清楚。在这项研究中,通过 LPS 三击方案建立了早期肺纤维化的动物模型。之后,动物每天通过腹腔注射 Ang-(1-7)、AVE0991 或 A779 治疗 20 天。动物的血浆和 BALF AngII 水平升高,而 LPS 处理后肺组织中 Ang-(1-7)水平没有明显变化。此外,AT1R 蛋白水平在第 14 天和第 21 天显著升高,Mas 蛋白水平显著降低。Ang-(1-7)下调了 LPS 诱导的 AT1R mRNA 表达,而 A779 则上调了 AT1R mRNA 表达。Mas mRNA 的表达与 AT1R 呈相反的方向。此外,LPS 导致 Mas 和 E-钙黏蛋白水平降低,AT1R、波形蛋白和Src 磷酸化水平升高。Ang-(1-7)或 AVE0991 阻断了这些作用,但 A779 处理则相反。我们的研究结果表明,在 LPS 诱导的早期肺纤维化过程中,AngII 和 AT1R 水平表现出相反的动态趋势,Ang-(1-7)和 Mas 也是如此。Ang-(1-7)对早期肺纤维化具有保护作用,主要通过调节 AngII 和 AT1R 之间以及 Ang-(1-7)和 Mas 之间的平衡,并抑制 Src 激酶的激活。