Diverse Responses of Autoantibodies to the Angiotensin II Type 1 Receptor in Primary Aldosteronism
Diverse Responses of Autoantibodies to the Angiotensin II Type 1 Receptor in Primary Aldosteronism
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DOI：
10.1161/hypertensionaha.119.13156
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发表时间：
2019-10-01
期刊：
影响因子：
8.3
通讯作者：
Reincke, Martin
中科院分区：
文献类型：
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作者：
Williams, Tracy Ann;Jaquin, Diana;Reincke, Martin
原发性醛固酮增多症是一种常见的内分泌高血压，主要由单侧醛固酮腺瘤（阿帕）或双侧肾上腺增生（BAH）引起。AT 1 R-Ab（血管紧张素II 1型受体自身抗体）已在高血压相关疾病患者中报告。我们的目的是评估原发性醛固酮增多症（阿帕，n=40和BAH，n=40）患者与原发性高血压（n=40）、先兆子痫（n=23）和血压正常个体（n=25）患者的AT 1 R-Ab水平。使用2种不同的ELISA测量全血清中的AT 1 R-Ab，其给出了对比结果。使用全血清或亲和纯化的抗体，在不存在或存在氯沙坦（一种特异性AT 1 R拮抗剂）的情况下，使用基于功能性细胞的测定来定量AT 1 R（血管紧张素II 1型受体）的活化。来自所有组的血清样品显示不同水平的AT 1 R活化，对氯沙坦的反应不同。BAH患者与阿帕患者相比，显示出较高的氯沙坦非依赖性亲和力分离激动性AT 1 R-Ab水平（P
Primary aldosteronism is a common form of endocrine hypertension mainly caused by a unilateral aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH). AT1R-Abs (autoantibodies to the angiotensin II type 1 receptor) have been reported in patients with disorders associated with hypertension. Our objective was to assess AT1R-Ab levels in patients with primary aldosteronism (APA, n=40 and BAH, n=40) relative to patients with primary hypertension (n=40), preeclampsia (n=23), and normotensive individuals (n=25). AT1R-Abs in whole sera were measured using 2 different ELISAs which gave contrasting results. A functional cell-based assay was used to quantify activation of the AT1R (angiotensin II type 1 receptor) using whole sera or affinity-purified antibodies in the absence or presence of losartan (a specific AT1R antagonist). Serum samples from all groups displayed different levels of AT1R activation with different responses to losartan. Patients with BAH displayed higher losartan-independent affinity-isolated agonistic AT1R-Ab levels compared with patients with APA (P