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Min J, Cho MH, Bae SP, Shin SH, Ha IS, Cheong HI, Kang HG. A Premature Baby with Severe Oligohydramnios and Hypotension: a Case Report of Renal Tubular Dysgenesis. J Korean Med Sci 2020; 35:e283. [PMID: 32808512 PMCID: PMC7431287 DOI: 10.3346/jkms.2020.35.e283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/14/2020] [Indexed: 11/20/2022] Open
Abstract
Renal tubular dysgenesis (RTD) is a rare fatal disorder in which there is poor development of proximal tubules, leading to oligohydramnios and the Potter sequences. RTD occurs secondary to renin-angiotensin system (RAS) blockade during the early stages of fetal development or due to autosomal recessive mutation of genes in the RAS pathway. A boy born at 33+1 weeks due to cord prolapse was found to be anuric and hypotensive. Pregnancy was complicated by severe oligohydramnios from gestational age 28+4 weeks. Abdominal sonography revealed diffuse globular enlargement of both kidneys with increased cortical parenchymal echogenicity. Infantogram showed a narrow thoracic cage and skull X-ray showed large fontanelles and wide sutures suggestive of ossification delay. Basal plasma renin activity was markedly elevated and angiotensin-converting enzyme was undetectable. Despite adequate use of medications, peritoneal dialysis, and respiratory support, he did not recover and expired on the 23rd day of life. At first, autosomal recessive polycystic kidney disease was suspected, but severe oligohydramnios along with refractory hypotension, anuria, skull ossification delay and high renin levels made RTD suspicious. ACE gene analysis revealed compound heterozygous pathogenic variations of c.1454.dupC in exon 9 and c.2141dupA in exon 14, confirming RTD. Based on our findings, we propose that, although rare, RTD should be suspected in patients with severe oligohydramnios and refractory hypotension.
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Affiliation(s)
- Jeesu Min
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Myung Hyun Cho
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Seong Phil Bae
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Il Soo Ha
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hae Il Cheong
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
- Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Wide River Institute of Immunology, Seoul National University, Seoul, Korea.
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2
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Suessenbach FK, Burckhardt BB. Levels of angiotensin peptides in healthy and cardiovascular/renal-diseased paediatric population-an investigative review. Heart Fail Rev 2020; 24:709-723. [PMID: 31104255 DOI: 10.1007/s10741-019-09797-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The renin-angiotensin-aldosterone system (RAAS) plays a major role in the regulation of blood pressure and homeostasis. Therefore, it is a commonly used target for pharmacotherapy of cardiovascular diseases in adults. However, the efficacy of this pharmacotherapy can only be limitedly derived into children. Comprehensive knowledge of the humoral parameters acting in the paediatric RAAS (e.g. angiotensin I, angiotensin II, angiotensin 1-7, angiotensin III, and angiotensin IV) might facilitate a more effective and rational pharmacotherapy in children. Therefore, this review aims to provide an overview of the maturing RAAS. Out of 925 identified records, 35 publications were classified as relevant. Physiological and pathophysiological concentrations of angiotensin peptides were compiled and categorised according to European Medicines Agency age groups. Age has a major impact on circulating angiotensin I, angiotensin II, and angiotensin 1-7, which is reflected in an age-dependent decrease during childhood. In contrast to data obtained in adults, no gender-related differences in angiotensin levels were identified. The observed increase in peptide concentrations regarding cardiac- and renal-diseased children is influenced by surgical repair, while evidence for a pharmacological impact is conflicting. A comprehensive set of angiotensin I, angiotensin II, and angiotensin 1-7 values from neonates up to adolescents was compiled. Indicating age as a strong effector. However, evidence about potential promising targets of the RAAS like angiotensin III and angiotensin IV is still lacking in children.
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Affiliation(s)
- F K Suessenbach
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitaetsstr. 1, 40225, Dusseldorf, Germany
| | - B B Burckhardt
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University, Universitaetsstr. 1, 40225, Dusseldorf, Germany.
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3
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Soni H, Yakimkova T, Matthews AT, Amartey PK, Read RW, Buddington RK, Adebiyi A. Early onset of renal oxidative stress in small for gestational age newborn pigs. Redox Rep 2020; 24:10-16. [PMID: 30907266 PMCID: PMC6448771 DOI: 10.1080/13510002.2019.1596429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Oxidative stress, a common feature in cardiovascular and renal disease is associated with the causes and consequences of fetal growth restriction. Hence, renal redox status is likely an early determinant of morbidity in small-for-gestational-age (SGA) infants. In this study, we examined renal oxidative stress in naturally-farrowed SGA newborn pigs. METHODS We studied SGA newborn pigs with 52% less body weight and 59% higher brain/liver weight ratio compared with their appropriate-for-gestational-age (AGA) counterparts. RESULTS The kidneys of the SGA newborn pigs weighed 56% less than the AGA group. The glomerular cross-sectional area was also smaller in the SGA group. SGA newborn pigs exhibited increased renal lipid peroxidation, reduced kidney and urine total antioxidant capacity, and increased renal nitrotyrosine immunostaining. Whereas the protein expression level of NADPH oxidase (NOX)2 was unchanged, NOX4 expression was significantly higher in SGA kidneys. The level of serum potassium was lower, but serum sodium and creatinine were similar in SGA compared with AGA newborn pigs. The serum concentrations of C-reactive protein and NGAL, the biomarkers of inflammation and early acute kidney injury were significantly elevated in the SGA group. CONCLUSION Early induction of oxidative stress may contribute to the onset of kidney injury in growth-restricted infants.
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Affiliation(s)
- Hitesh Soni
- a Department of Physiology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Taisiya Yakimkova
- b School of Health Studies , University of Memphis , Memphis , TN , USA
| | - Anberitha T Matthews
- a Department of Physiology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Paul K Amartey
- a Department of Physiology , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Robert W Read
- c Department of Biological Sciences , University of Memphis , Memphis , TN , USA
| | - Randal K Buddington
- a Department of Physiology , University of Tennessee Health Science Center , Memphis , TN , USA.,b School of Health Studies , University of Memphis , Memphis , TN , USA.,d College of Nursing , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Adebowale Adebiyi
- a Department of Physiology , University of Tennessee Health Science Center , Memphis , TN , USA
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4
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Souza LV, Oliveira V, De Meneck F, Grotti Clemente AP, Strufaldi MWL, Franco MDC. Birth Weight and Its Relationship with the Cardiac Autonomic Balance in Healthy Children. PLoS One 2017; 12:e0167328. [PMID: 28095501 PMCID: PMC5240907 DOI: 10.1371/journal.pone.0167328] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/11/2016] [Indexed: 01/13/2023] Open
Abstract
Several studies indicate that the fetal environment plays a significant role in the development of cardiometabolic disease later in life. However, a few studies present conflicting data about the correlation between birth weight and the impairment of cardiac autonomic modulation. The purpose of the present study was to provide further knowledge to elucidate this contradictory relationship. One hundred children aged 5 and 14 years had anthropometric parameters, body composition and blood pressure levels determined. Heart rate variability (HRV) was evaluated by heart rate monitoring, including measurements of both the time and frequency domains. The results showed inverse correlation between the HRV parameters with BMI (RMSSD: P = 0.047; PNN50: P = 0.021; HF: P = 0.041), systolic (RMSSD: P = 0.023; PNN50: P = 0.032) and diastolic (PNN50: P = 0.030) blood pressure levels. On the other hand, there were consistent positive correlations between the HRV parameters and birth weight (RMSSD: P = 0.001; PNN50: P = 0.001; HF: P = 0.002). To determine the effect of birth weight on HRV parameters, we perform multivariate linear regression analysis adjusted for potentially confounding factors (prematurity, gender, age, BMI, physical activity index and SBP levels). These findings were preserved even after adjusting for these confounders. Our results suggested that impaired cardiac autonomic modulation characterized by a reduction in the parasympathetic activity occurs in children with low birth weight. One possible interpretation for these data is that a vagal withdrawal, rather than a sympathetic overactivity, could precede the development of hypertension and other cardiometabolic diseases in children with low birth weight. However, long-term studies should be performed to investigate this possibility.
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Affiliation(s)
| | - Vanessa Oliveira
- Nephrology Division, Federal University of São Paulo, São Paulo, Brazil
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5
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Shifrin Y, Sadeghi S, Pan J, Jain A, Fajardo AF, McNamara PJ, Belik J. Maternal-pup interaction disturbances induce long-lasting changes in the newborn rat pulmonary vasculature. Am J Physiol Lung Cell Mol Physiol 2015; 309:L1186-98. [PMID: 26342088 DOI: 10.1152/ajplung.00044.2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 09/02/2015] [Indexed: 11/22/2022] Open
Abstract
The factors accounting for the pathological maintenance of a high pulmonary vascular (PV) resistance postnatally remain elusive, but neonatal stressors may play a role in this process. Cross-fostering in the immediate neonatal period is associated with adult-onset vascular and behavioral changes, likely triggered by early-in-life stressors. In hypothesizing that fostering newborn rats induces long-lasting PV changes, we evaluated them at 14 days of age during adulthood and compared the findings with animals raised by their biological mothers. Fostering resulted in reduced maternal-pup contact time when compared with control newborns. At 2 wk of age, fostered rats exhibited reduced pulmonary arterial endothelium-dependent relaxation secondary to downregulation of tissue endothelial nitric oxide synthase expression and tetrahydrobiopterin deficiency-induced uncoupling. These changes were associated with neonatal onset-increased ANG II receptor type 1 expression, PV remodeling, and right ventricular hypertrophy that persisted into adulthood. The pulmonary arteries of adult-fostered rats exhibited a higher contraction dose response to ANG II and thromboxane A2, the latter of which was abrogated by the oxidant scavenger Tempol. In conclusion, fostering-induced neonatal stress induces long-standing PV changes modulated via the renin-angiotensin system.
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Affiliation(s)
- Yulia Shifrin
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and
| | - Sina Sadeghi
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and
| | - Jingyi Pan
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and
| | - Amish Jain
- Department of Paediatrics and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Andres F Fajardo
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and
| | - Patrick J McNamara
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and Department of Paediatrics and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Jaques Belik
- Physiology and Experimental Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; and Department of Paediatrics and Physiology, University of Toronto, Toronto, Ontario, Canada
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6
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Wang KCW, Brooks DA, Summers-Pearce B, Bobrovskaya L, Tosh DN, Duffield JA, Botting KJ, Zhang S, Caroline McMillen I, Morrison JL. Low birth weight activates the renin-angiotensin system, but limits cardiac angiogenesis in early postnatal life. Physiol Rep 2015; 3:3/2/e12270. [PMID: 25649246 PMCID: PMC4393187 DOI: 10.14814/phy2.12270] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Low birth weight (LBW) is associated with increased risk of adult cardiovascular disease and this association may be partly a consequence of early programming of the renin-angiotensin system (RAS). We investigated the effects of LBW on expression of molecules in the RAS and cardiac tissue remodeling. Left ventricular samples were collected from the hearts of 21 days old lambs that were born average birth weight (ABW) and LBW. Cardiac mRNA expression was quantified using real-time RT-PCR and protein expression was quantified using Western blotting. DNA methylation and histone acetylation were assessed by combined bisulfite restriction analysis and chromatin immunoprecipitation, respectively. There were increased plasma renin activity, angiotensin I (ANGI), and ANGII concentrations in LBW compared to ABW lambs at day 20. In LBW lambs, there was increased expression of cardiac ACE2 mRNA, decreased ANGII receptor type 1 (AT1R) protein, and acetylation of histone H3K9 of the AT1R promoter but no changes in AT1R mRNA expression and AT1R promoter DNA methylation. There was no difference in the abundance of proteins involved in autophagy or fibrosis. BIRC5 and VEGF mRNA expression was increased; however, the total length of the capillaries was decreased in the hearts of LBW lambs. Activation of the circulating and local cardiac RAS in neonatal LBW lambs may be expected to increase cardiac fibrosis, autophagy, and capillary length. However, we observed only a decrease in total capillary length, suggesting a dysregulation of the RAS in the heart of LBW lambs and this may have significant implications for heart health in later life.
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Affiliation(s)
- Kimberley C W Wang
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Doug A Brooks
- Mechanisms in Cell Biology and Disease Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Brooke Summers-Pearce
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Larisa Bobrovskaya
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Darran N Tosh
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Jaime A Duffield
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Kimberley J Botting
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Song Zhang
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - I Caroline McMillen
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Janna L Morrison
- Early Origins of Adult Health Research Group, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
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7
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Eiby YA, Lumbers ER, Staunton MP, Wright LL, Colditz PB, Wright IMR, Lingwood BE. Endogenous angiotensins and catecholamines do not reduce skin blood flow or prevent hypotension in preterm piglets. Physiol Rep 2014; 2:2/12/e12245. [PMID: 25538149 PMCID: PMC4332223 DOI: 10.14814/phy2.12245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Endocrine control of cardiovascular function is probably immature in the preterm infant; thus, it may contribute to the relative ineffectiveness of current adrenergic treatments for preterm cardiovascular compromise. This study aimed to determine the cardiovascular and hormonal responses to stress in the preterm piglet. Piglets were delivered by cesarean section either preterm (97 of 115 days) or at term (113 days). An additional group of preterm piglets received maternal glucocorticoids as used clinically. Piglets were sedated and underwent hypoxia (4% FiO2 for 20 min) to stimulate a cardiovascular response. Arterial blood pressure, skin blood flow, heart rate and plasma levels of epinephrine, norepinephrine, angiotensin II (Ang II), angiotensin‐(1–7) (Ang‐(1‐7)), and cortisol were measured. Term piglets responded to hypoxia with vasoconstriction; preterm piglets had a lesser response. Preterm piglets had lower blood pressures throughout, with a delayed blood pressure response to the hypoxic stress compared with term piglets. This immature response occurred despite similar high levels of circulating catecholamines, and higher levels of Ang II compared with term animals. Prenatal exposure to glucocorticoids increased the ratio of Ang‐(1‐7):Ang II. Preterm piglets, in contrast to term piglets, had no increase in cortisol levels in response to hypoxia. Preterm piglets have immature physiological responses to a hypoxic stress but no deficit of circulating catecholamines. Reduced vasoconstriction in preterm piglets could result from vasodilator actions of Ang II. In glucocorticoid exposed preterm piglets, further inhibition of vasoconstriction may occur because of an increased conversion of Ang II to Ang‐(1‐7). This study aimed to determine if immature hormonal control of the cardiovascular system contributes to preterm cardiovascular compromise. Physiological and hormonal responses of preterm piglets to hypoxia are immature compared with term piglets. This is not due to a lack of endogenous catecholamines or angiotensin II, but may be due to the differences in cardiovascular actions of the renin–angiotensin system.
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Affiliation(s)
- Yvonne A Eiby
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Eugenie R Lumbers
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
| | - Michael P Staunton
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Layne L Wright
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul B Colditz
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Ian M R Wright
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia Graduate School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Barbara E Lingwood
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
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8
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Rangel M, dos Santos JC, Ortiz PHL, Hirata M, Jasiulionis MG, Araujo RC, Ierardi DF, Franco MDC. Modification of epigenetic patterns in low birth weight children: importance of hypomethylation of the ACE gene promoter. PLoS One 2014; 9:e106138. [PMID: 25170764 PMCID: PMC4149513 DOI: 10.1371/journal.pone.0106138] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 08/03/2014] [Indexed: 12/02/2022] Open
Abstract
There is a growing body of evidence that epigenetic alterations are involved in the pathological mechanisms of many chronic disorders linked to fetal programming. Angiotensin-converting enzyme (ACE) appears as one candidate gene that brings new insights into the epigenetic control and later development of diseases. In this view, we have postulated that epigenetic modifications in the ACE gene might show different interactions between birth weight (BW), blood pressure levels, plasma ACE activity and ACE I/D polymorphism. To explore this hypothesis, we performed a cross-sectional study to evaluate the DNA methylation of 3 CpG sites using pyrosequencing within the ACE gene promoter of peripheral blood leukocytes from 45 LBW children compared with 70 NBW children. Our results have revealed that LBW children have lower methylation levels (P<0.001) in parallel with a higher ACE activity (P = 0.001). Adjusting for prematurity, gender, age, body mass index, and family history of cardiovascular disease did not alter these findings. We have also performed analyses of individual CpG sites. The frequency of DNA methylation was significantly different at two CpG sites (site 1: nucleotide position +555; and site 3: nucleotide position +563). In addition, we have found a significant inverse correlation between degree of DNA methylation and both ACE activity (P<0.001) and systolic blood pressure levels (P<0.001). We also observed that the methylation level was significantly lower in LBW children who are carriers of the DD genotype compared to NBW children with DD genotype (P<0.024). In conclusion, we are able to demonstrate that the hypomethylation in the 3 CpG sites of ACE gene promoter is associated with LBW in 6 to 12 year-old children. The magnitude of these epigenetic changes appears to be clinically important, which is supported by the observation that discrete changes in DNA methylation can affect systolic blood pressure and ACE protein activity levels.
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Affiliation(s)
- Marina Rangel
- Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | | | - Mario Hirata
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Ronaldo C. Araujo
- Biophysics Department, Federal University of São Paulo, São Paulo, Brazil
| | - Daniela Filippini Ierardi
- Ben May Department for Cancer Research, University of Chicago, Chicago, Illinois, United States of America
| | - Maria do Carmo Franco
- Nephrology Division, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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9
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Ajala AR, Almeida SS, Rangel M, Palomino Z, Strufaldi MWL, Puccini RF, Araujo RC, Casarini DE, Franco MCP. Association of ACE gene insertion/deletion polymorphism with birth weight, blood pressure levels, and ACE activity in healthy children. Am J Hypertens 2012; 25:827-32. [PMID: 22647781 DOI: 10.1038/ajh.2012.50] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The human angiotensin-converting enzyme (ACE) gene contains a polymorphism consisting of either an insertion (I) or a deletion (D) of a 287 bp Alu repetitive sequence in intron 16. The potential role of ACE polymorphism in the risk of developing hypertension or other cardiovascular disorders has not been determined in relation to birth weight (BW). METHODS The ACE genotype and plasma ACE activity were determined in 167 children. Among these children, 60 were identified with low BW (LBW), and 107 were of normal BW (NBW). RESULTS ACE activity levels were significantly elevated in LBW children compared with the NBW group (P < 0.001). There was a significant association of the ACE activity with systolic blood pressure (SBP) levels in our population (P < 0.001). Among the ACE genotypes, no significant differences were found with respect to BW (P = 0.136). However, our results revealed that LBW children had a higher D allele frequency than NBW children (P = 0.036). When analyzed by quartiles of SBP or ACE activity, we found a greater frequency of both the LBW children and those carrying the DD genotype in the highest quartiles of these parameters, whereas the NBW children tended to be in the lowest quartile (P < 0.001). Similar results were observed with the heterozygote ID children after categorization by quartiles of both SBP (P < 0.001) and ACE activity (P = 0.004). CONCLUSIONS The ACE I/D polymorphism, especially the DD genotype, can be interpreted as a major factor in association between LBW and high BP levels.
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10
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Gao J, Chao J, Parbhu KJK, Yu L, Xiao L, Gao F, Gao L. Ontogeny of angiotensin type 2 and type 1 receptor expression in mice. J Renin Angiotensin Aldosterone Syst 2012; 13:341-52. [PMID: 22526820 DOI: 10.1177/1470320312443720] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the current experiment, we determined angiotensin type 2 receptor (AT2R) and angiotensin type 1 receptor (AT1R) protein expression by western blot analysis in developing normal mice. The results indicate that: (1) in all detected brain regions and in the spinal cord, adult mice exhibited significantly higher AT2R expression and lower AT1R expression in total protein extracts compared to fetuses and neonates; (2) other major organs, including heart, lung, liver and kidney, exhibited the same expression pattern as the brain and spinal cord; (3) reciprocal changes in AT2R and AT1R expression were found in the total protein extracts from the brainstems of mice from one-day prenatal to six weeks of age, and there was a negative correlation between AT2R and AT1R protein expression; (4) in both membrane and cytosolic fractions from the brainstem, adult mice exhibited higher AT2R and lower AT1R expression than did fetuses and neonates; and (5) in the brainstem, there were no significant differences in AT2R and AT1R messenger RNA (mRNA) levels among fetal, neonatal and adult mice. The above results reconfirmed our previous finding in rats that adult animals have higher AT2R and lower AT1R expression compared to fetuses and neonates. These data imply an involvement of AT1R in fetal development and of AT2R in adult function.
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Affiliation(s)
- Juan Gao
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, USA
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11
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Reynolds RM, Walker BR, Phillips DI, Dennison EM, Fraser R, Mackenzie SM, Davies E, Connell JM. Programming of Hypertension. Hypertension 2009; 53:932-6. [DOI: 10.1161/hypertensionaha.109.129320] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Animal models suggest that explanations for the association of low birthweight with adult hypertension may include chronic activation of the hypothalamic-pituitary-adrenal or renin-angiotensin-aldosterone axes. In humans, low birthweight predicts elevated plasma cortisol, but associations with aldosterone have not been reported. We measured aldosterone in serum samples from 205 men and 106 women from 67 to 78 years of age, from Hertfordshire, UK, for whom birthweight was recorded. Participants underwent an overnight low-dose (0.25 mg) dexamethasone suppression test and a low-dose (1 μg) ACTH (corticotropin) stimulation test and were genotyped for the -344 C/T polymorphism of the
CYP11B2
gene encoding aldosterone synthase. Median aldosterone was 6.22 ng/dL (range 0.15 to 38.74) and was higher in men than women (
P
<0.0001). Higher aldosterone levels after both dexamethasone and ACTH stimulation were associated with higher blood pressure (
r
=0.20,
P
=0.001;
r
=0.33,
P
<0.0001, respectively) and with lower birthweight (
r
=−0.16,
P
=0.008;
r
=−0.21,
P
=0.001, respectively). These associations remained significant after adjusting for age, gender, obesity, and genotype. Our findings supplement previous evidence that aldosterone is an important regulator of blood pressure and suggest that factors in early life that retard fetal growth and program activation of the hypothalamic-pituitary-adrenal axis in humans result not only in higher glucocorticoid activity but also in increased mineralocorticoid activity.
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Affiliation(s)
- Rebecca M. Reynolds
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - Brian R. Walker
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - David I. Phillips
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - Elaine M. Dennison
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - Robert Fraser
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - Scott M. Mackenzie
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - Eleanor Davies
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
| | - John M. Connell
- From the Endocrinology Unit (R.M.R., B.R.W.), Centre for Cardiovascular Sciences, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh; Medical Research Council Resource Centre (D.I.P., E.M.D.), University of Southampton, Southampton; and Glasgow Cardiovascular Research Centre (R.F., S.M.M., E.D., J.M.C.), University of Glasgow, Glasgow, UK
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Miyawaki M, Okutani T, Higuchi R, Yoshikawa N. The plasma angiotensin II level increases in very low-birth weight infants with neonatal chronic lung disease. Early Hum Dev 2008; 84:375-9. [PMID: 18328647 DOI: 10.1016/j.earlhumdev.2007.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Revised: 09/17/2007] [Accepted: 10/07/2007] [Indexed: 11/16/2022]
Abstract
BACKGROUND Angiotensin II (AII) has been reported to play an important role in organ fibrosis, and a local renin-angiotensin-system (RAS) has been demonstrated in the lungs. However, the relationship of the RAS to chronic lung disease of the newborn (CLD) remains obscure. OBJECTIVE To investigate the plasma AII levels throughout the neonatal period in very low-birth weight (VLBW) infants and examine the possible factors that might affect the AII levels. STUDY DESIGN The study includes 20 VLBW infants. Blood samples were collected on days 0, 7, 21 and 35 and plasma AII levels were assayed using an enzyme immunoassay. The data were analyzed by a multiple linear regression analysis with the plasma AII level as the dependent variable and significant factors determined based on a univariate analysis as independent variables. RESULTS The geometric mean of the plasma AII concentrations on days 0, 7, 21 and 35 was 51 pg/mL, 86 pg/mL, 132 pg/mL, and 50 pg/mL, respectively. On day 21, only CLD (p<0.01) had a highly significant association with the plasma AII level. On day 35, birth weight (p<0.05) and CLD (p<0.01) had a highly significant association with the plasma AII level. This analysis confirmed CLD to be the most significant factor associated with plasma AII level on days 21 and 35. CONCLUSION These findings suggest that higher levels of plasma AII in VLBW infants appear to be related to the development of CLD.
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Affiliation(s)
- Masakazu Miyawaki
- Division of Perinatal Medicine, NICU, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan.
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Circulating renin-angiotensin system and catecholamines in childhood: is there a role for birthweight? Clin Sci (Lond) 2008; 114:375-80. [PMID: 17953515 DOI: 10.1042/cs20070284] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There have been only a few reports on the sympathoadrenal and renin-angiotensin systems in children of small gestational age. The purpose of the present study was to investigate plasma levels of ACE (angiotensin-converting enzyme) activity, angiotensin and catecholamines in 8- to 13-year-old children and to determine whether there are correlations between the components of these systems with both birthweight and BP (blood pressure) levels. This clinical study included 66 children (35 boys and 31 girls) in two groups: those born at term with an appropriate birthweight [AGA (appropriate-for-gestational age) group, n=31] and those born at term but with a small birthweight for gestational age [SGA (small-for-gestational age) group, n=35]. Concentrations of angiotensin, catecholamines and ACE activity were determined in plasma. Circulating noradrenaline levels were significantly elevated in SGA girls compared with AGA girls (P=0.036). In addition, angiotensin II and ACE activity were higher in SGA boys (P=0.024 and P=0.050 respectively). There was a significant association of the circulating levels of both angiotensin II and ACE activity with BP levels in our study population. Although the underlying mechanisms that link restricted fetal growth with later cardiovascular events are not fully understood, the findings in the present study support the link between low birthweight and overactivity of both sympathoadrenal and renin-angiotensin systems into later childhood.
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Renal Modulation: The Renin-Angiotensin-Aldosterone System (RAAS). NEPHROLOGY AND FLUID/ELECTROLYTE PHYSIOLOGY: NEONATOLOGY QUESTIONS AND CONTROVERSIES 2008. [PMCID: PMC7152415 DOI: 10.1016/b978-1-4160-3163-5.50013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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