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La actividad de la enzima convertidora de angiotensina ligada al endotelio capilar pulmonar en la lesión pulmonar
S E Orfanos1, A Armaganidis, C Glynos
1Critical Care Department, Evangelismos Hospital, University of Athens Medical School, Greece. stelmar@ath.forthnet.gr
Circulation
|October 18, 2000
Resumen
La actividad de la ectoenzima convertidora de angiotensina (ACE) ligada al endotelio capilar pulmonar y ligada al endotelio pulmonar disminuye en la lesión pulmonar aguda (ALI). Esta reducción sirve como un marcador sensible para la gravedad de la lesión pulmonar y la disfunción endotelial.
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Medicina de cuidados críticos Medicina de cuidados críticos.
- La bioquímica es la bioquímica.
Sus antecedentes:
- La actividad de la ectoenzima convertidora de angiotensina (PCEB-ACE) ligada al endotelium capilar pulmonar es un índice sensible de la lesión pulmonar en modelos animales.
- Las alteraciones en la actividad de la PCEB-ACE pueden indicar una lesión pulmonar aguda (ALI) en humanos.
- La actividad de la PCEB-ACE puede servir como un marcador cuantificable para la disfunción endotelial capilar pulmonar.
Objetivo del estudio:
- Para investigar las alteraciones de la actividad de PCEB-ACE en pacientes con ALI.
- Para determinar si la actividad de la PCEB-ACE se correlaciona con la gravedad de la lesión pulmonar.
- Evaluar la actividad de la PCEB-ACE como un marcador cuantificable de la disfunción endotelial capilar pulmonar.
Principales métodos:
- Se utilizaron técnicas de dilución del indicador para medir la hidrólisis transpulmonar de un sustrato ACE sintético (3H-benzoil-Phe-Ala-Pro).
- Se realizaron mediciones en 33 pacientes en estado crítico con ventilación mecánica con diferentes puntuaciones de lesión pulmonar (LIS).
- Se calcularon los parámetros cinéticos, incluido el Amax/Km, y se correlacionaron con las puntuaciones clínicas (APACHE II, LIS) y el rendimiento cardíaco (CO).
Principales resultados:
- La actividad de PCEB-ACE, indicada por A (max) / K (m), disminuyó temprano en el continuo de IAL.
- La disminución de la actividad de la ECA estaba inversamente relacionada con la puntuación de APACHE II y LIS.
- La hidrólisis disminuyó con el aumento de la potencia cardíaca, con patrones variados observados entre CO y A (max) /K (m).
Conclusiones:
- La actividad de la PCEB-ACE disminuye temprano en la lesión pulmonar aguda.
- La disminución de la actividad PCEB-ACE se correlaciona con la gravedad clínica de la ILA y la enfermedad subyacente.
- La actividad de la PCEB-ACE es un potencial marcador cuantificable para la disfunción endotelial capilar pulmonar en pacientes con ILA.
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