ACEI/ARB 对糖尿病肺病的影响

近年来,糖尿病肺部病变越来越受到关注。研究发现糖尿病患者存在肺通气功能障碍、弥散功能障碍,易于发生肺纤维化、合 并感染等。这主要与糖尿病时炎症介质的参与,ACE 基因存在插入多态性,氧化应激损伤和抗氧化失衡等有关。目前研究发现血 管紧张素转换酶抑制剂（ACEI）/ 血管紧张素受体阻滞剂(ARB)对糖尿病肺炎、慢性阻塞性肺疾病、肺间质纤维化等肺损伤有保护 作用,这可能与ACEI具有调节免疫反应、减轻细胞因子水平、抗氧化应激损伤等机制有关。     

血管紧张素转换酶2-血管紧张素1-7-Mas轴对血管作用的研究进展

血管紧张素转换酶2（ACE2）和Mas受体的发现使人们对肾素-血管紧张素（RAS）有了更全面的认识。ACE2可水解血管紧张素Ⅰ和血管紧张素Ⅱ直接或间接生成血管紧张素1-7（Ang 1-7）,并与高血压的形成密切相关。Ang 1-7主要通过Mas受体引起血管舒张、抑制细胞增殖。ACE2-Ang1-7-Mas轴的发现为RAS的研究、高血压等心血管疾病的防治和新药开发提供了新的思路和方向。     

ACE2及其特殊功能

血管紧张素转换酶2（angiotensin—converting enzyme 2,ACE2）是新发现的与血管紧张素转换酶（ACE）相关的羧肽酶,在肾素-血管紧张素系统（rennin-angiotensin system,RAS）中ACE2可以使AngⅡ转换为Ang1-7,从而产生与血管紧张素Ⅱ相反的效应,同时ACE2还可使Ang I转换为Ang1-9。研究发现：ACE2与高血压、SARS以及肾脏、生殖等系统的疾病有着密切的关系。     

蛇毒中的降压组分—血管紧张素转化酶抑制剂

蛇毒中的一些多肽能够竞争性的抑制血管紧张素转化酶,起到降血压的作用,这些多肽波称为血管紧张素转化酶抑制剂(Angiotensin ConvertingEnzyme Iinhibitor——ACEI)。有关 ACEI 的研究和应用,是近年来心血管药物的一大进展,它可用于抗充血性心     

肾素-血管紧张素系统的新调节分子:ACE2

血管紧张素转化酶（angiotensin—converting enzyme,ACE）为含锌的金属蛋白酶,是肾素-血管紧张素系统（renin—angiotensin system,RAS）重要的调节分子。血管紧张素转化酶2（angiotensin—con—verting enzyme2,ACE2）是迄今发现的唯一的ACE同系物（homologue）,它主要分布于睾丸、肾脏和心脏。ACE2可水解血管紧张素Ⅰ（angiotensinⅠ,AngⅠ）和血管紧张素Ⅱ（angiotensinⅡ,AngⅡ）羧基端的1个氨基酸残基,分别形成Ang1-9和有血管舒张作用的Ang1-7。ACE2的生理病理作用还不甚明了,传统的ACE抑制剂不能抑制ACE2的活性。ACE2在心血管、肾脏系统的作用可能与ACE相反．与ACE共同调节心脏、肾脏等脏器的正常功能。     

血管紧张素—（1—7）——肾素血管紧张素系统的新激素

长期以来,血管紧张素－（１－７）「Ａｎｇ－（１－７））」－直被认为是血管紧张素Ⅱ的无生物活性代谢产物。近年的研究证明Ａｎｇ－（１－７）在神经系统和心血管功能调节中起有作用,是血管紧张素系统中一种新的重要激素。     

子宫-胎盘血管紧张素及其受体

子宫－胎盘中存在局部肾素－血管紧张素系统（ｒｅｎｉｎ－ａｎｇｉｏｔｅｎｓｉｎ ｓｙｓｔｅｍ,ＲＡＳ）。血管紧张素的分布较广泛,胎盘合体滋养层、子宫腺体、肌肉和血管壁均可见ＡｎｇⅡ的免疫阳性染色。胎盘主要表达血管紧张素Ⅰ型受体,子宫至少有两种血管紧张素受体亚型,其分布与数量存在种间差异。血管紧张素Ⅰ型受体与Ｇ蛋白偶联,可以激活三种不同的信号途径,Ⅱ型受体能否与Ｇ蛋白偶联及其信号转导途径仍有不同看法。     

血管紧张素受体1在血管紧张素Ⅱ诱导人星形胶质细胞老化中的作用

目的通过体外细胞实验研究,探讨血管紧张素受体1在血管紧张素Ⅱ诱导人星形胶质细胞活性氧产生和细胞老化中的作用。方法人星形胶质细胞随机分为三组：血管紧张素Ⅱ＋Cand（坎地沙坦）组和血管紧张素Ⅱ＋tempol组。血管紧张素Ⅱ组是用100nM血管紧张素Ⅱ刺激人星形胶质细胞3天,血管紧张素Ⅱ＋Cand组和血管紧张素Ⅱ＋tempol组先用血管紧张素受体1阻滞剂坎地沙坦（100nM）和氧自由基清除剂tempol（3mM）预处理,再用100nM血管紧张素II刺激人星形胶质细胞3天,利用β半乳糖苷酶染色评估细胞老化。不同剂量（0、1nM、10nM、100nM、1000nM和1000nM＋坎地沙坦）的血管紧张素Ⅱ刺激人星形胶质细胞30min,DHE染色评估细胞内活性氧产生。结果血管紧张素Ⅱ引起人星形胶质细胞DHE染色表达增多和β半乳糖苷酶染色细胞增多。利用血管紧张素受体1阻滞剂坎地沙坦和氧自由基清除剂tempol预处理逆转了血管紧张素Ⅱ引起的星形胶质细胞老化。结论血紧张素Ⅱ是通过血管紧张素受体1和超氧阴离子产生引起星形胶质细胞的老化。     

低氧对肺血管内皮细胞血管紧张素Ⅰ转化功能的影响

急、慢性低氧大鼠肺血管床内皮细胞血管紧张素Ⅰ(AⅠ)转化率显著低于对照组,同时,去内皮细胞组又显著低于急性低氧组;小牛肺内皮细胞在低氧30min后AⅠ转化为血管紧张素Ⅱ(AⅡ)的水平,显著低于常氧组,说明低氧可显著地抑制肺血管内皮细胞的 AⅠ转化功能,提示低氧可使肺血管内皮细胞AⅠ转化功能降低,其程度与缺氧的时间与程度有关。     

肾素 - 血管紧张素 - 醛固酮系统阻滞的研究进展

肾素-血管紧张素-醛固酮系统起初被认为是较简单的神经体液调节机制之一。但是,这一想法随着RAAS阻滞剂:肾素阻滞剂、血管紧张素转换酶抑制剂(ACEI)、AT1受体拮抗剂及盐皮质激素受体拮抗剂的深入研究而受到挑战。因此,RAAS的组成、以上药物发挥作用的具体通路及副作用均得到重新定义。在RAAS阻滞剂的应用过程中,机体肾素水平升高,并刺激肾素原受体(即无活性的肾素前体,PRR),进而对机体造成不良影响。同理,在AT1受体拮抗剂的应用过程中,血浆血管紧张素II的水平升高,并与2型血管紧张素II(AT2)受体结合,进而对机体产生有利作用。此外,随着ACEI及ARB的应用,血管紧张素1-7水平升高,其与Mas受体结合,发挥心脏及肾脏保护的作用,还可通过刺激干细胞发挥组织修复作用。     

硫氧还蛋白系统在COPD抗氧化中的作用研究进展

硫氧还蛋白系统是由硫氧还蛋白（thioredoxin,Trx）,硫氧还蛋白还原酶（thioredoxinreductase,TrxR）和还原型辅酶Ⅱ（NADPH）组成的多功能小分子蛋白系统,广泛表达的硫氧还蛋白作为蛋白质二硫键的还原酶,它参与很多生理过程,并发挥重要生物学功能,包括调节机体的氧化还原反应、抑制细胞凋亡、调节转录因子DNA结合活性以及免疫应答等,其中一重要作用是参与调节细胞氧化还原状态以对抗氧化应激。因此在一些炎症性疾病如慢性阻塞性肺疾病、急性呼吸窘迫综合征、肺间质疾病、哮喘、肺结节病等的发生发展中扮演重要角色,本文对硫氧还蛋白系统在慢性阻塞性肺疾病中的抗氧化作用作一综述。     

氧化应激研究进展及其在缺血性心肌病发病中的作用

缺血性心肌病（ischemic cardiomyopathy,ICM）是指由于长期心肌缺血导致心肌局限性或弥漫性纤维化,从而产生心脏收缩和（或）舒张功能受损,引起心脏扩大或僵硬、充血性心力衰竭、心律失常等一系列临床表现的临床综合症。大量研究表明,ICM的发病机制与氧化应激密切相关。研究和开发新的抗氧化药物,将为缺血性心肌病的防治提供新的方向和途径。     

Eryptosis and oxidative damage in type 2 diabetic mellitus patients with chronic kidney disease

It has been suggested that oxidative stress may participate in the progression of diabetes and its complications. Long-term complications of type 2 diabetes mellitus (T2DM) include retinopathy, atherosclerosis, shortened life span of erythrocytes, nephropathy, and chronic kidney disease (CKD). Oxidative damage has been associated with erythrocyte apoptosis induction in other pathological conditions. Our aim was to study the presence of eryptosis and its possible relationship with oxidative damage in patients with T2DM without CKD (T2DM/CKD(-)) and in patients with T2DM and CKD (T2DM/CKD(+)).Oxidative damage of lipids erythrocytes were increased in diabetic patients. The highest lipoperoxidation was found in T2DM/CKD(+). Likewise, the lower plasma total antioxidant capacity, GSH/GSSG ratio, and GSH in erythrocytes were found in T2DM/CKD(+) patients. A negative correlation was found between plasma total antioxidant capacity and oxidative damage. Phosphatidylserine (PS) externalization was measured in erythrocytes to evaluate eryptosis. Annexin binding in erythrocytes of T2DM/CKD(+) patients was higher than in healthy subjects and T2DM/CKD(-) patients. A positive correlation between lipoperoxidation and PS externalization in erythrocytes was found. This work showed that the erythrocytes of diabetic patients have increased oxidative damage, a reduction of antioxidant systems and more erythrocyte PS externalization. The duration of diabetes and the presence of CKD increase both oxidative damage and eryptosis. It is possible that a longer time of evolution induces an increase in erythrocyte oxidative damage and the consumption of blood antioxidant systems, adding to the osmotic stress in CKD and so contributes to an increase in PS externalization in diabetic patients.     

Oxidative stress and pulmonary fibrosis

Oxidative stress is implicated as an important molecular mechanism underlying fibrosis in a variety of organs, including the lungs. However, the causal role of reactive oxygen species (ROS) released from environmental exposures and inflammatory/interstitial cells in mediating fibrosis as well as how best to target an imbalance in ROS production in patients with fibrosis is not firmly established. We focus on the role of ROS in pulmonary fibrosis and, where possible, highlight overlapping molecular pathways in other organs. The key origins of oxidative stress in pulmonary fibrosis (e.g. environmental toxins, mitochondria/NADPH oxidase of inflammatory and lung target cells, and depletion of antioxidant defenses) are reviewed. The role of alveolar epithelial cell (AEC) apoptosis by mitochondria- and p53-regulated death pathways is examined. We emphasize an emerging role for the endoplasmic reticulum (ER) in pulmonary fibrosis. After briefly summarizing how ROS trigger a DNA damage response, we concentrate on recent studies implicating a role for mitochondrial DNA (mtDNA) damage and repair mechanisms focusing on 8-oxoguanine DNA glycosylase (Ogg1) as well as crosstalk between ROS production, mtDNA damage, p53, Ogg1, and mitochondrial aconitase (ACO2). Finally, the association between ROS and TGF-β1-induced fibrosis is discussed. Novel insights into the molecular basis of ROS-induced pulmonary diseases and, in particular, lung epithelial cell death may promote the development of unique therapeutic targets for managing pulmonary fibrosis as well as fibrosis in other organs and tumors, and in aging; diseases for which effective management is lacking. This article is part of a Special Issue entitled: Fibrosis: Translation of basic research to human disease.     

汉族人群中血管紧张素转换酶抑制剂所致咳嗽与血管紧张素转换酶基因及缓激肽β2受体基因多态性的关系冰

目的：探讨汉族人群中血管紧张素转换酶抑制剂（ACEI）所致咳嗽与血管紧张素转换酶（ACE）基因及缓激肽β2受体（BDK-RB2）基因多态性的关系。方法：应用聚合酶链反应（PCR）方法。检测汉族人群中151例由于服用ACEI引起的咳嗽患者及151例未发生咳嗽的患者的ACEI／D及BDKRB2C／T的多态性,并采用紫外法检测ACE活性。结果：发现ACE基因分布在咳嗽组中II型为47．0％,ID型为42．4％,DD型为10．6％;无咳嗽组分别为39．7％、47．0％、13.3％,两组相比其差异具有统计学意义（P〈0．01）;BDKRB2基因分布在咳嗽组中CC型为21．3％,CT型为50．0％,TT型为28．7％,无咳嗽组分别为22．5％、47．7％、29．8％。两组相比其差异无统计学意义（P〉0．05）;咳嗽组ACE活性水平为[（28．3±10．1）U／L]明显低于无咳嗽组[（40．2±9．4）U／L],两组相比其差异具有统计学意义（P〈0．01）。结论：汉族人群中ACEI所致咳嗽与ACE基因多态性及血清ACE水平有关,BDKRB2C／T与咳嗽间未发现有统计学意义的关联。     

Increases in Endogenous Antioxidant Enzymes During Asbestos Inhalation in Rats

Although the pathogenesis of asbestos-induced pulmonary damage is still not completely understood, an important role has been attributed to active oxygen species. In the present paper we present results of a study investigating the effect of crocidolite asbestos inhalation on different lung antioxidant enzymes in rats. During the development of pulmonary fibrosis induced by crocidolite asbestos, lung superoxide dismutase, catalase and selenium-dependent glutathione peroxidase activities increased, indicating an adaptive response to increased pulmonary oxidant stress. However, this adaptive response obviously is not sufficient to protect the lung from asbestos-induced pulmonary damage. Considering the role of active oxygen species in both the flbrotic process and tumor promotion, it is hypothesized that antioxidants may also protect the lung from chronic asbestos-induced pulmonary damage such as bronchogenic carcinoma.     

Increases in Endogenous Antioxidant Enzymes During Asbestos Inhalation in Rats

Although the pathogenesis of asbestos-induced pulmonary damage is still not completely understood, an important role has been attributed to active oxygen species. In the present paper we present results of a study investigating the effect of crocidolite asbestos inhalation on different lung antioxidant enzymes in rats. During the development of pulmonary fibrosis induced by crocidolite asbestos, lung superoxide dismutase, catalase and selenium-dependent glutathione peroxidase activities increased, indicating an adaptive response to increased pulmonary oxidant stress. However, this adaptive response obviously is not sufficient to protect the lung from asbestos-induced pulmonary damage. Considering the role of active oxygen species in both the flbrotic process and tumor promotion, it is hypothesized that antioxidants may also protect the lung from chronic asbestos-induced pulmonary damage such as bronchogenic carcinoma.     

Rapamycin attenuates the paraquat-induced pulmonary fibrosis through activating Nrf2 pathway

Oxidative stress is a key regulator of idiopathic pulmonary fibrosis. Paraquat (PQ)-induced pulmonary fibrosis seriously endangers people's health. Rapamycin has been reported to alleviate PQ-induced pulmonary fibrosis, but its underlying mechanism is unclear. The nuclear factor E2-related factor 2 (Nrf2) plays an important regulatory role in the antioxidant therapy of PQ-induced pulmonary fibrosis. In this study, we tried to confirm that rapamycin attenuates PQ-induced pulmonary fibrosis by regulating Nrf2 pathway. In vivo, we proved that rapamycin could inhibit the degree of PQ-induced oxidant stress as well as enhanced the expression of Nrf2. In vitro, rapamycin decreased the upregulated effects of cell death and apoptosis, fibrosis-related factors expression and fibroblast-to-myofibroblast transformation by PQ treatment. In vivo, rapamycin treatment reduced fibrosis degree and the expression of fibrosis-related factors in lung tissues of rat treated PQ. Furthermore, we also found that Nrf2 knockdown reduced the inhibitory effect of rapamycin on PQ-induced pulmonary fibrosis, as well as decreased Nrf2 transfer from the cytoplasm into the nucleus. Our findings demonstrated that the protective effect of rapamycin is associated with the activation of the Nrf2 pathway in pulmonary fibrosis induced by PQ poisoning.     

胶原蛋白肽经由Nrf2信号通路对H2O2诱导的肝细胞氧化损伤的保护作用

目的：氧化应激在肝脏疾病中扮演着重要的角色。胶原蛋白肽是天然的抗氧化剂,其在动物实验中已经被证实有抑制氧化应激的作用。最新研究证实胶原蛋白肽将有可能被应用在肝脏疾病的预防中,但是很少有研究报道其分子作用机制。因此本研究在胶原蛋白肽是对H2O2诱导的正常人的肝细胞系HL7702氧化损伤有保护作用的基础上,并探索其分子作用机制。方法：实验设空白对照组,H2O2模型组,胶原蛋白肽低、中、高剂量组（10,100,200μg/ml）。胶原蛋白肽各组加入相应浓度的药物预处理12 h后,与模型组一起加入300μM H2O2的H2O2共同培养12 h,空白对照组正常培养。细胞毒性是由CCK8和乳酸脱氢酶（LDH）的释放检测。抗氧化试剂盒检测细胞内活性氧的水平,超氧化物歧化酶（SOD）、过氧化氢酶（CAT）活性和丙二醛（MDA）含量的变化。Western blot检测细胞内Nrf2蛋白的表达水平。结果：胶原蛋白肽对H2O2诱导的正常人的肝细胞系HL7702氧化损伤有保护作用。胶原蛋白肽能够及时清除细胞内的活性氧,增加Nrf2的蛋白表达水平,提高超氧化物歧化酶（SOD）、过氧化氢酶（CAT）的活性,减轻脂质过氧化反应,从而保护正常人的肝细胞系HL7702。结论：总之,胶原蛋白肽通过增加Nrf2的蛋白表达水平,提高抗氧化活性,对H2O2诱导损伤的肝细胞发挥保护作用。本研究为胶原蛋白肽的分子作用机制提供了新的证据,将有助于预防氧化应激所致的肝损伤。