Serum levels of angiotensin converting enzyme 2 in patients with systemic sclerosis

IF 1 Q4 RHEUMATOLOGY Egyptian Rheumatologist Pub Date : 2024-01-05 DOI:10.1016/j.ejr.2023.12.003
Noha A. Azab , Samah A. Mohamed , Mariam Onsy F. Hanna , Wafaa H. Hussein
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Abstract

Background

Systemic sclerosis (SSc) is an autoimmune disorder with fibrosis of the skin and internal organs. Angiotensin-converting enzyme 2 (ACE2) breaks down angiotensin II to the antifibrotic and anti-inflammatory angiotensin (1–7).

Aim of the work

To assess the serum levels of ACE2 in SSc patients and to determine the association between its levels with the clinical features and disease severity.

Patients and methods

Serum from 44 patients with SSc and 35 age and sex matched controls were assayed for ACE2 concentrations by enzyme linked immunosorbent assay. The modified Rodnan skin score (mRSS) was evaluated.

Results

Patients were 41 females and 3 males (F:M 13.7:1) with a mean age of 40.4 ± 11.3 years, and median disease duration of 5 years. Thirty-four patients had limited cutaneous SSc (lcSSc) and 10 had diffuse cutaneous SSc (dcSSc). Interstitial lung disease was present in 30 (68.2 %) patients. The median mRss was 11 (4–35). The antiscleroderma-70 and anticentromere antibodies were positive in 36.4 % and 29 %, respectively. The ACE2 level was significantly lower in SSc (1.02 ng/ml; 0.13–4.25 ng/ml) compared to control (1.57 ng/ml; 0.24–23.69 ng/ml) (p = 0.026) and in females compared to males (0.8; 0.13–4.15 ng/ml vs 3.33; 1.32–4.25 ng/ml) (p = 0.04) while the levels were comparable between lcSSc and dcSSc (p = 0.88). The level was lower in those with telangiectasia (n = 24), (p = 0.048) and in those receiving cyclophosphamide (n = 11), (p = 0.038) compared to those without. There was a non-significant correlation between ACE2 level and mRss (p = 0.16).

Conclusions

Serum ACE2 levels are decreased in patients with SSc and related to telangiectasias and the use of cyclophosphamide.

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系统性硬化症患者血清中的血管紧张素转换酶 2 水平
背景系统性硬化症(SSc)是一种伴有皮肤和内脏器官纤维化的自身免疫性疾病。血管紧张素转换酶 2(ACE2)可将血管紧张素 II 分解为抗纤维化和抗炎的血管紧张素(1-7)。评估系统性硬化症患者血清中 ACE2 的水平,并确定其水平与临床特征和疾病严重程度之间的关系。结果患者中有 41 名女性和 3 名男性(男女比例为 13.7:1),平均年龄为 40.4 ± 11.3 岁,中位病程为 5 年。34名患者患有局限性皮肤鳞状上皮细胞炎(lcSSc),10名患者患有弥漫性皮肤鳞状上皮细胞炎(dcSSc)。30名患者(68.2%)患有间质性肺病。mRss中位数为11(4-35)。36.4% 和 29% 的患者抗硬皮病-70 抗体和抗染色体中心粒抗体呈阳性。与对照组(1.57 纳克/毫升;0.24-23.69 纳克/毫升)相比,SSc 患者的 ACE2 水平(1.02 纳克/毫升;0.13-4.25 纳克/毫升)明显较低(P = 0.026),女性与男性相比(0.8;0.13-4.15 ng/ml vs 3.33;1.32-4.25 ng/ml)(p = 0.04),而 lcSSc 和 dcSSc 的水平相当(p = 0.88)。与没有毛细血管扩张症的人相比,有毛细血管扩张症的人(n = 24)(p = 0.048)和接受环磷酰胺治疗的人(n = 11)(p = 0.038)的水平较低。结论 SSc 患者血清 ACE2 水平降低,与毛细血管扩张和使用环磷酰胺有关。
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来源期刊
Egyptian Rheumatologist
Egyptian Rheumatologist RHEUMATOLOGY-
CiteScore
2.00
自引率
22.20%
发文量
77
审稿时长
39 weeks
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