Andrew J Chetwynd, Julien Marro, S. Northey, Daniel J. Hughes, L. Oni
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引用次数: 1
摘要
IgA血管炎(IgAV)是儿童中最常见的血管炎形式,1-2%的患者发展为慢性肾脏疾病。在其他形式的肾小球肾炎中,有强有力的证据支持肾素-血管紧张素-醛固酮系统(RAAS)的作用;然而,缺乏IgAV肾炎的数据。本研究评估了患有IgA血管炎的儿童尿液RAAS成分,包括肾炎(IgAVN)和非肾炎(IgAVwoN)。采用elisa法测定尿肾素、血管紧张素原和醛固酮浓度。共纳入40例患者,IgAVN = 9, IgAVwoN = 17, HC = 14,平均年龄8.3±3.3岁。尿肾素与肾炎无相关性。IgAV组尿血管紧张素原(1.18±1.16 ng/mmol)高于HC组(0.28±0.27 ng/mmol, p = 0.0015), IgAVN组(2.00±1.22 ng/mmol)高于IgAVwoN组(0.74±0.89 ng/mmol, p = 0.0492)和HC组(p = 0.0233)。IgAV组尿醛固酮水平显著高于HC组(73.90±65.22 pg/mmol, p < 0.0001)(1236±1438 pg/mmol);这在IgAVwoN患者中增加最多(1793±1507 pg/mmol;IgAVN 183.30±111.30 pg/mmol, p = 0.0035, HC p < 0.0001)。正如预期的那样,RAAS系统在IgAVN患者中被激活,更令人惊讶的是,甚至在那些没有活动性肾炎的患者中也被激活。需要进一步的研究来充分了解RAAS系统在IgA血管炎中的作用。
Variations in Urinary Renin-Angiotensin-Aldosterone Component Concentrations in Paediatric IgA Vasculitis Nephritis
IgA Vasculitis (IgAV) is the most common form of vasculitis in children, and 1–2% of patients develop chronic kidney disease. In other forms of glomerulonephritis, there is strong evidence to support the role of the renin-angiotensin-aldosterone system (RAAS); however, data are lacking in IgAV nephritis. This study evaluated urinary RAAS components in children with IgA vasculitis, both with nephritis (IgAVN) and without nephritis (IgAVwoN). Urinary concentrations of renin, angiotensinogen and aldosterone were quantified using ELISAs. In total, 40 patients were included: IgAVN n = 9, IgAVwoN n = 17, HC n = 14, with a mean age of 8.3 ± 3.3 years. Urinary renin demonstrated no trend with nephritis. Urinary angiotensinogen was statistically significantly elevated in IgAV (1.18 ± 1.16 ng/mmol) compared to HC (0.28 ± 0.27 ng/mmol, p = 0.0015), and IgAVN (2.00 ± 1.22 ng/mmol) was elevated compared to IgAVwoN (0.74 ± 0.89 ng/mmol, p = 0.0492) and HC (p = 0.0233). Urinary aldosterone levels were significantly elevated in IgAV (1236 ± 1438 pg/mmol) compared to HC (73.90 ± 65.22 pg/mmol, p < 0.0001); this was most increased in IgAVwoN patients (1793 ± 1507 pg/mmol; IgAVN 183.30 ± 111.30 pg/mmol, p = 0.0035, HC p < 0.0001). As expected, the RAAS system is activated in patients with IgAVN and, more surprisingly, even in those without active nephritis. Further studies are needed to fully understand the role of the RAAS system in IgA vasculitis.
期刊介绍:
Journal of International Translational Medicine (JITM, ISSN 2227-6394), founded in 2012, is an English academic journal published by Journal of International Translational Medicine Co., Ltd and sponsored by International Fderation of Translational Medicine. JITM is an open access journal freely serving to submit, review, publish, read and download full text and quote. JITM is a quarterly publication with the first issue published in March, 2013, and all articles published in English are compiled and edited by professional graphic designers according to the international compiling and editing standard. All members of the JITM Editorial Board are the famous international specialists in the field of translational medicine who come from twenty different countries and areas such as USA, Britain, France, Germany and so on.