Mast cell chymase in the ischemic kidney of severe unilateral renovascular hypertension
| Autor: | Yoshio Konishi, Masahito Imanishi, Michiaki Okumura, Shinji Takai, Mizuo Miyazaki, Hisa Suzuki, Noriyuki Okada, Katsunobu Yoshioka, Takashi Morikawa |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Captopril Arteriosclerosis Kidney Renal Artery Obstruction Plasma renin activity Nephrectomy Renal Veins Renovascular hypertension Renin-Angiotensin System chemistry.chemical_compound Chymases Renal Artery Ischemia Internal medicine Renin–angiotensin system Hyperaldosteronism Renin medicine Humans Mast Cells Aldosterone business.industry Angiotensin II Serine Endopeptidases Smoking Chymase Angiography Digital Subtraction Middle Aged medicine.disease medicine.anatomical_structure Endocrinology Hypertension Renovascular chemistry Nephrology Circulatory system Female Angiotensin I business |
| Zdroj: | American journal of kidney diseases : the official journal of the National Kidney Foundation. 45(3) |
| ISSN: | 1523-6838 |
| Popis: | Chymase degrades angiotensin I (AI) to form angiotensin II (AII), probably constituting a bypass of the renin-angiotensin cascade. Chymase activity increases in some vascular diseases. In the kidney, an increase in chymase activity was reported in an animal model of ischemic kidney of renovascular hypertension (RVH); however, no such evidence has been provided in humans. We treated a 64-year-old patient with severe unilateral RVH and atherosclerosis, for whom removal of the ischemic kidney was the only option. Using immunohistochemical staining, we investigated chymase activity in the removed kidney and associated artery and vein. An increase in chymase activity, together with mast cells infiltrating the interstitium, was observed where interstitial fibrosis was seen. In the renal artery, where severe atherosclerosis was seen, and also in the vein, mast cell infiltration in the adventitia was accompanied by chymase. The captopril test showed an increase in serum aldosterone level, with a concomitant increase in plasma renin activity and decrease in blood pressure. Because the decrease in blood pressure implies a decrease in circulatory AII levels, it is plausible that in this patient, chymase had a role in AII formation in the adrenal gland to stimulate aldosterone secretion. Thus, by means of captopril, AI levels increased, and chymase may have produced AII in loci tissues, which, in turn, stimulated aldosterone secretion. This is the first report of an increase in chymase activity in the interstitium of an ischemic kidney and renal artery and vein in a patient with RVH and atherosclerosis. |
| Databáze: | OpenAIRE |
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