Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes.
Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes.
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SARS 冠状病毒与其受体的结合会损害胰岛并导致急性糖尿病
DOI：
10.1007/s00592-009-0109-4
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发表时间：
2010-09
影响因子：
3.8
通讯作者：
Guo LM
中科院分区：
文献类型：
--
作者：
Yang JK;Lin SS;Ji XJ;Guo LM
严重急性呼吸综合征（SARS）患者多器官损害是常见的，但其发病机制仍存在争议。本研究旨在探讨SARS冠状病毒受体血管紧张素转换酶2（ACE 2）在不同器官，尤其是胰腺内分泌组织中的表达是否与糖耐量异常有关，并阐明SARS患者糖耐量异常的发病机制。在135例死亡的SARS患者、385例存活的住院SARS患者和19例非SARS肺炎患者中评估了临床变量对生存率的影响。在3年的随访期间，共有39名SARS患者没有糖尿病史，也没有接受过类固醇治疗，他们与39名匹配的健康兄弟姐妹进行了比较。研究了SARS冠状病毒受体ACE2蛋白在人体不同器官中的表达模式。血氧饱和度、血清肌酐、乳酸脱氢酶、肌酸激酶MB同工酶和空腹血糖（FPG）的显著升高是死亡的预测因素，但丙氨酸转氨酶的升高不是死亡的预测因素。在肺、肾、心脏和胰岛中发现了丰富的ACE2免疫染色，但在肝细胞中没有发现。39例随访患者中有20例在住院期间患有糖尿病。3年后，这些患者中只有2人患有糖尿病。与非SARS同胞相比，这些患者的FPG、餐后血糖（PPG）和胰岛素水平无显著差异。SARS的器官受累与ACE 2的表达有关。ACE 2在胰腺内分泌部分表达的定位表明SARS冠状病毒利用ACE 2作为其受体进入胰岛并损伤胰岛，引起急性糖尿病。
Multiple organ damage in severe acute respiratory syndrome (SARS) patients is common; however, the pathogenesis remains controversial. This study was to determine whether the damage was correlated with expression of the SARS coronavirus receptor, angiotensin converting enzyme 2 (ACE2), in different organs, especially in the endocrine tissues of the pancreas, and to elucidate the pathogenesis of glucose intolerance in SARS patients. The effect of clinical variables on survival was estimated in 135 SARS patients who died, 385 hospitalized SARS patients who survived, and 19 patients with non-SARS pneumonia. A total of 39 SARS patients who had no previous diabetes and received no steroid treatment were compared to 39 matched healthy siblings during a 3-year follow-up period. The pattern of SARS coronavirus receptor-ACE2 proteins in different human organs was also studied. Significant elevations in oxygen saturation, serum creatinine, lactate dehydrogenase, creatine kinase MB isoenzyme, and fasting plasma glucose (FPG), but not in alanine transaminase were predictors for death. Abundant ACE2 immunostaining was found in lung, kidney, heart, and islets of pancreas, but not in hepatocytes. Twenty of the 39 followed-up patients were diabetic during hospitalization. After 3 years, only two of these patients had diabetes. Compared with their non-SARS siblings, these patients exhibited no significant differences in FPG, postprandial glucose (PPG), and insulin levels. The organ involvements of SARS correlated with organ expression of ACE2. The localization of ACE2 expression in the endocrine part of the pancreas suggests that SARS coronavirus enters islets using ACE2 as its receptor and damages islets causing acute diabetes.
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影响因子：
64.8
作者：
Li W;Moore MJ;Vasilieva N;Sui J;Wong SK;Berne MA;Somasundaran M;Sullivan JL;Luzuriaga K;Greenough TC;Choe H;Farzan M
通讯作者：
Farzan M
影响因子：
13.8
作者：
Turner AJ;Hiscox JA;Hooper NM
通讯作者：
Hooper NM
影响因子：
7.3
作者：
Hamming, I;Timens, W;van Goor, H
通讯作者：
van Goor, H
影响因子：
20.1
作者：
Donoghue, M;Hsieh, F;Acton, S
通讯作者：
Acton, S
影响因子：
7.3
作者：
Ding, YQ;Wang, HJ;Yao, KT
通讯作者：
Yao, KT