Journal
JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
Volume 16, Issue 3, Pages 559-569Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1470320314521086
Keywords
Renin-angiotensin system; inflammatory bowel disease; Crohn's disease; ulcerative colitis; angiotensin II; angiotensin (1-7); angiotensin-converting enzyme; angiotensin-converting enzyme 2
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Introduction: The relationship between intestinal inflammation and circulating components of the renin-angiotensin system (RAS) is poorly understood. Materials and methods: Demographic and clinical data were obtained from healthy controls and patients with inflammatory bowel disease (IBD). Plasma concentrations of the classical RAS components (angiotensin-converting enzyme (ACE) and angiotensin II (Ang II)) and alternative RAS components (ACE2 and angiotensin (1-7) (Ang (1-7))) were analysed by radioimmuno- and enzymatic assays. Systemic inflammation was assessed using serum C-reactive protein (CRP), white cell count, platelet count and albumin, and intestinal inflammation by faecal calprotectin. Results: Nineteen healthy controls (11 female; mean age 38 years, range 23-68), 19 patients with Crohn's disease (11 female; aged 45 years, range 23-76) and 15 patients with ulcerative colitis (6 female; aged 42 years, 26-64) were studied. Circulating classical RAS component levels were similar across the three groups, whereas ACE2 activity and Ang (1-7) concentrations were higher in patients with IBD compared to controls (ACE2: 21.5 vs 13.3 pmol/ml/min, p<0.05; Ang (1-7): 22.8 vs 14.1 pg/ml, p<0.001). Ang (1-7) correlated weakly with platelet and white cell counts, but not calprotectin or CRP, in patients with IBD. Conclusions: Circulating components of the alternative RAS are increased in patients with IBD.
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