Angiotensin converting enzyme 2 and angiotensin (1-7) axis in pulmonary arterial hypertension
EUROPEAN RESPIRATORY JOURNAL
Authors: Sandoval, Julio; Del Valle-Mondragon, Leonardo; Masso, Felipe; Zayas, Nayeli; Pulido, Tomas; Teijeiro, Ricardo; Gonzalez-Pacheco, Hector; Olmedo-Ocampo, Rossana; Sisniega, Carlos; Paez-Arenas, Araceli; Pastelin-Hernandez, Gustavo; Gomez-Arroyo, Jose; Voelkel, Norbert F.
Abstract
Background: In animal models of pulmonary arterial hypertension (PAH), angiotensin-converting enzyme (ACE)2 and angiotensin (Ang)-(1-7) have been shown to have vasodilatory, antiproliferative, antifibrotic and antihypertrophic properties. However, the status and role of the ACE2-Ang(1-7) axis in human PAH is incompletely understood. Methods: We studied 85 patients with a diagnosis of PAH of distinct aetiologies. 55 healthy blood donors paired for age and sex served as controls. Blood samples were obtained from the pulmonary artery in patients with PAH during right heart catheterisation. Peripheral blood was obtained for both groups. Ang (1-7) and -II were measured using zone capillary electrophoresis. Aldosterone, Ang(1-9), AngA and ACE2 were measured using ELISA, and ACE2 activity was determined enzymatically. Results: Of the 85 patients, 47 had idiopathic PAH, 25 had PAH associated with congenital heart disease and 13 had PAH associated with collagen vascular disease. Compared to controls, patients with PAH had a higher concentration of Angil (median 1.03, interquartile range 0.72-1.88 pmol.mL(-1) versus 0.19, 0.10-0.37 pmol.mL(-1); p<0.001) and of aldosterone (88.7, 58.7-132 ng.dL(-1) versus 12.9, 9.55-19.9 ng.dL(-1); p<0.001). Conversely, PAH patients had a lower concentration of Ang(1-7) than controls (0.69, 0474-0.91 pmol.mL(-1) versus 4.07, 2.82-6.73 pmol.mL(-1); p<0.001), and a lower concentration of Ang(1-9) and AngA. Similarly, the ACE2 concentration was higher than in controls (8.7, 5.35-13.2 ng.mL(-1) versus 4.53, 1.47-14.3 ng.mL(-1) ; p=0.011), whereas the ACE2 activity was significantly reduced (1.88, 1.08-2.81 nmol.mL(-1) versus 5.97, 3.1-17.8 nmol.mL(-1); p<0.001). No significant differences were found among the three different aetiological forms of PAH. Conclusions: The AngII-ACE2-Ang(1-7) axis appears to be altered in human PAH and we propose that this imbalance, in favour of AngII, plays a role in the pathogenesis of the severe PAH. Further mechanistic studies are warranted.
Deletion of the transcription factor Prox-1 specifically in the renal distal convoluted tubule causes hypomagnesemia via reduced expression of TRPM6 and NCC
PFLUGERS ARCHIV-EUROPEAN JOURNAL OF PHYSIOLOGY
Authors: Schnoz, Christina; Moser, Sandra; Kratschmar, Denise V.; Odermatt, Alex; Loffing-Cueni, Dominique; Loffing, Johannes
Abstract
The renal distal convoluted tubule (DCT) is critical for the fine-tuning of urinary ion excretion and the control of blood pressure. Ion transport along the DCT is tightly controlled by posttranscriptional mechanisms including a complex interplay of kinases, phosphatases, and ubiquitin ligases. Previous work identified the transcription factor Prox-1 as a gene significantly enriched in the DCT of adult mice. To test if Prox-1 contributes to the transcriptional regulation of DCT function and structure, we developed a novel mouse model (NCCcre:Prox-1(flox/flox)) for an inducible deletion of Prox-1 specifically in the DCT. The deletion of Prox-1 had no obvious impact on DCT structure and growth independent whether the deletion was achieved in newborn or adult mice. Furthermore, DCT-specific Prox-1 deficiency did not alter DCT-proliferation in response to loop diuretic treatment. Likewise, the DCT-specific deletion of Prox-1 did not cause other gross phenotypic abnormalities. Body weight, urinary volume, Na+ and K+ excretion as well as plasma Na+, K+, and aldosterone levels were similar in Prox-1(DCT)(KO) and Prox-1(DCT)(Ctrl) mice. However, Prox-1(DCT)(KO) mice exhibited a significant hypomagnesemia with a profound downregulation of the DCT-specific apical Mg2+ channel TRPM6 and the NaCl cotransporter (NCC) at both mRNA and protein levels. The expression of other proteins involved in distal tubule Mg2+ and Na+ handling was not affected. Thus, Prox-1 is a DCT-enriched transcription factor that does not control DCT growth but contributes to the molecular control of DCT-dependent Mg2+ homeostasis in the adult kidney.