Key result
IgA nephropathy is linked to lower ACE2 and higher ACE expression in glomeruli versus controls.
Why the study?
Changes in renal ACE and ACE2 expression observed in diabetic nephropathy may not be specific, necessitating study in IgA nephropathy patients.
Is IgA nephropathy associated with altered renal ACE and ACE2 expression compared to healthy controls?
Case-Control (n=51)
Is IgA nephropathy associated with altered renal ACE and ACE2 expression compared to healthy controls?
p-value: p=<0.01
IgA nephropathy is associated with increased ACE and decreased ACE2 expression in the kidneys, similar to changes seen in diabetic nephropathy.
Supports ACE/ACE2 imbalance as a shared feature in IgA and diabetic nephropathy; leaves open prognostic or therapeutic relevance pending prospective studies.
BACKGROUND: Angiotensin-converting enzyme (ACE)2 forms angiotensin-1-7 which may protect kidney in a counterregulatory manner to angiotensin II. Recent studies revealed increased ACE and decreased ACE2 expression in kidneys of patients with diabetic nephropathy. However, these changes may not be specific for diabetic nephropathy. We studied ACE and ACE2 expression in patients with IgA nephropathy. METHODS: Renal ACE and ACE2 expression was assessed by immunohistochemistry and in situ hybridization in 30 patients with IgA nephropathy and 21 healthy controls. Correlation between ACE and ACE2 expression and levels of various biochemical parameters was also assessed. Gene expression was also assessed in minimal change nephrotic syndrome (MCNS) and membranous nephropathy (MN) as disease controls. RESULTS: Reduced ACE2 expression (p < 0.01) and increased ACE expression in glomeruli (p < 0.001), and reduced ACE2 expression in tubulointerstitium (p < 0.001) were observed in patients with IgA nephropathy compared to healthy controls, although the changes in ACE2 mRNA were not statistically significant. Reduced renal ACE2 expression was also found in MN but not in MCNS. Correlation between renal ACE and ACE2 expression and proteinuria was not observed in IgA nephropathy. CONCLUSION: IgA nephropathy is associated with increased ACE and decreased ACE2 expression in kidneys, as in diabetic nephropathy.
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Mizuiri et al. (2010) conducted a case-control in IgA nephropathy (n=51). IgA nephropathy vs. Healthy controls was evaluated on Renal ACE and ACE2 expression (p=<0.01). IgA nephropathy was associated with reduced ACE2 expression (p<0.01) and increased ACE expression in glomeruli (p<0.001) compared to healthy controls.