[肾素-血管紧张素系统成分、ACE2基因rs2106809多态性和RAS阻断剂治疗对新冠肺炎严重程度的影响]。

Q4 Medicine
Z T Zuraeva, O K Vikulova, N M Malysheva, L V Nikankina, N V Zaytceva, O Y Sukhareva, M S Shamhalova, M V Shestakova, N G Mokrysheva
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引用次数: 0

摘要

背景:血管紧张素转换酶2(ACE2)是肾素-血管紧张素系统(RAS)的关键成分,对其作用提供反调节,同时也是严重急性呼吸系统综合征冠状病毒2型进入的受体。提示调节RAS主要成分平衡的因素,包括ACE2基因多态性、RAS阻断剂(ACE抑制剂和血管紧张素受体阻断剂)的治疗,可能会影响COVID-19的严重程度,ACE2基因多态性rs2106809和ACEi/ARBs治疗与新冠肺炎严重程度的关系。材料和方法:该研究包括在内分泌研究中心住院的新冠肺炎患者(n=173),他们被分为中度和重度两组。用ELISA法测定RAS组分,用PCR法鉴定其多态性。采用非参数统计方法进行统计分析;使用Fisher精确检验χ2评估基因型频率分布的差异。结果:两组在年龄、血糖水平和炎症标志物(白细胞、中性粒细胞、IL-6、D-二聚体、C-反应蛋白、铁蛋白和肝酶)方面存在显著差异,这与疾病的严重程度相关。当比较患者的ACE、ACE2、血管紧张素II和ADAM17时,两组之间没有统计学上的显著差异(分别为p=0.544、p=0.054、p=0.836、p=1.0),包括按性别的分布(男性:p=0.695、p=0.726、p=0.824、p=0.512;女性:p=0.873、p=0.196、p=0.150、p=0.937),GG基因型的ACE2基因rs2106809多态性在患者之间也没有差异:男性χ2 1.35,p=0.071,女性χ2 5.28,p=0.024。不同病程严重程度的组之间RAS阻断剂的使用没有显著差异:ACEi组为x2 0.208,p=0.648,ARBs组为x2 1.15,p=0.283。结论:在我们的研究中,RAS成分(ACE、ACE2、AT II、ADAM17)的激活和ACE2基因多态性对新冠肺炎病程严重性的影响尚未得到证实。新冠肺炎病程的严重程度与标准炎症标志物水平相关,表明无论RAS的遗传和功能状态如何,感染都是全身炎症的一般原则。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

[Effect of components of the renin-angiotensin system, rs2106809 polymorphism of the <i>ACE2</i> gene, and therapy with RAS blockers on the severity of COVID-19].

[Effect of components of the renin-angiotensin system, rs2106809 polymorphism of the ACE2 gene, and therapy with RAS blockers on the severity of COVID-19].

Background: Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system (RAS), providing counter-regulation of its effects and, simultaneously, a receptor for the SARS-CoV-2 entering. It is suggested that factors regulating the balance of the major components of RAS, including ACE2 gene polymorphism, therapy with RAS blockers (ACE inhibitors and angiotensin receptor blockers) - may affect the severity of COVID-19.

Aim: The aim of the study was to investigate the effect of RAS components, the relationship of ACE2 gene polymorphism rs2106809 and ACEi/ARBs therapy with the COVID-19 severity.

Materials and methods: The study included patients with COVID-19 hospitalized in Endocrinology research centre (n = 173), who were divided into groups of moderate and severe course. Determination of RAS components was performed by ELISA, identification of polymorphism by PCR. Statistical analysis was performed using nonparametric statistical methods; differences in the distribution of genotype frequencies were assessed using Fisher's exact test χ2.

Results: The groups differed significantly in age, blood glucose levels, and inflammatory markers: leukocytes, neutrophils, IL-6, D-dimer, C-reactive protein, ferritin and liver enzymes, which correlated with the severity of the disease. When comparing patients in terms of ACE, ACE2, angiotensin II, ADAM17 there were no statistically significant differences between the groups (p=0.544, p=0.054, p=0.836, p=1.0, respectively), including the distribution by gender (in men: p=0.695, p=0.726, p=0.824, p=0.512; in women: p=0.873, p=0.196, p=0.150, p=0.937). Analysis of the distribution of AA, AG, and GG genotypes of the rs2106809 polymorphism of the ACE2 gene also revealed no differences between patients: χ2 1.35, p=0.071 in men, χ2 5.28, p=0.244 in women. There were no significant differences in the use of RAS blockers between groups with different course severity: χ2 0.208, p=0.648 for ACEi, χ2 1.15, p=0.283 for ARBs.

Conclusion: In our study, the influence of activation of RAS components (ACE, ACE2, AT II, ADAM17) and ACE2 gene polymorphism on the severity of COVID-19 course was not confirmed. The severity of COVID-19 course correlated with the level of standard inflammatory markers, indicating the general principles of the infection as a systemic inflammation, regardless of the genetic and functional status of the RAS.

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来源期刊
Problemy endokrinologii
Problemy endokrinologii Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
1.40
自引率
0.00%
发文量
59
期刊介绍: Since 1955 the “Problems of Endocrinology” (or “Problemy Endocrinologii”) Journal publishes timely articles, balancing both clinical and experimental research, case reports, reviews and lectures on pressing problems of endocrinology. The Journal is aimed to the most topical issues of endocrinology: to chemical structure, biosynthesis and metabolism of hormones, the mechanism of their action at cellular and molecular level; pathogenesis and to clinic of the endocrine diseases, new methods of their diagnostics and treatment. The Journal: features original national and foreign research articles, reflecting world endocrinology development; issues thematic editions on specific areas; publishes chronicle of major international congress sessions and workshops on endocrinology, as well as state-of-the-art guidelines; is intended for scientists, endocrinologists diabetologists and specialists of allied trade, general practitioners, family physicians and pediatrics.
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