Burg M, Menne J, Ostendorf T, Kliem V, Floege J
Division of Nephrology, Medizinische Hochschule, Hannover, Germany.
Clin Nephrol. 1997 Oct;48(4):205-11.
The ACE D- and the ecNOS a-allele have been associated with an adverse prognosis in patients with glomerulonephritis (GN). Using genomic DNA we investigated by RT-PCR whether the two polymorphisms are useful prognostic markers in GN patients. In patients with primary GN (IgA-GN n = 70, membranous GN n = 23, FSGS n = 17, MPGN n = 6) neither the whole group nor disease-specific subgroups exhibited any alterations from the normal ACE genotype distribution. No significant associations were detected between the ACE genotype and the development of hypertension, antihypertensive therapy required, progression rate of the disease, age of diagnosis and the antiproteinuric response to ACE-inhibition. In 40 IgA-GN patients with ESRD no increased prevalence of the D-allele was noted. The distribution of the ecNOS-alleles in the above patients (a-allele 22%, b-allele 78%) was comparable to that of the normal controls. No association with any of the parameters mentioned above were detected in the case of the ecNOS-alleles.
In our Caucasian patients neither the determination of the ACE nor the ecNOS genotype offered any diagnostic or prognostic help.
血管紧张素转换酶（ACE）D等位基因和内皮型一氧化氮合酶（ecNOS）a等位基因与肾小球肾炎（GN）患者的不良预后相关。我们使用基因组DNA通过逆转录聚合酶链反应（RT-PCR）研究这两种多态性是否为GN患者有用的预后标志物。在原发性GN患者中（IgA肾病n = 70，膜性肾病n = 23，局灶节段性肾小球硬化n = 17，膜增生性肾小球肾炎n = 6），无论是整个组还是疾病特异性亚组，ACE基因型分布均未显示与正常情况有任何差异。未检测到ACE基因型与高血压的发生、所需的抗高血压治疗、疾病进展率、诊断年龄以及对ACE抑制的抗蛋白尿反应之间存在显著关联。在40例终末期肾病（ESRD）的IgA肾病患者中，未发现D等位基因的患病率增加。上述患者中ecNOS等位基因的分布（a等位基因22%，b等位基因78%）与正常对照组相当。在ecNOS等位基因方面，未检测到与上述任何参数存在关联。
在我们的白种人患者中，测定ACE基因型和ecNOS基因型均未提供任何诊断或预后帮助。
