Angiotensin II plasma levels are linked to disease severity and predict fatal outcomes in H7N9-infected patients

Abstract

A novel influenza A (H7N9) virus of avian origin emerged in eastern China in the spring of 2013. This virus causes severe disease in humans, including acute and often lethal respiratory failure. As of January 2014, 275 cases of H7N9-infected patients had been reported, highlighting the urgency of identifying biomarkers for predicting disease severity and fatal outcomes. Here, we show that plasma levels of angiotensin II, a major regulatory peptide of the renin-angiotensin system, are markedly elevated in H7N9 patients and are associated with disease progression. Moreover, the sustained high levels of angiotensin II in these patients are strongly correlated with mortality. The predictive value of angiotensin II is higher than that of C-reactive protein and some clinical parameters such as the PaO 2 /FiO 2 ratio (partial pressure of arterial oxygen to the fraction of inspired oxygen). Our findings indicate that angiotensin II is a biomarker for lethality in flu infections.

Upregulation of <i>GLE</i>1 and <i>LCP</i>2 Genes in H5N1 Influenza Virus Infected Patients

“…One of the limitations of our study is that a relatively low number of participants were enrolled, because some eligible patients did not agree to sign the informed consent forms during the study period. Therefore, to confirm and extend the results from this study, more patients infected by different influenza A viruses will need to be enrolled, and future studies using established cell lines and animal models (such as Gle1-or Lcp2-knockout mice) challenged with different influenza A viruses should be conducted with methods similar to those reported recently [25]- [27].…”

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

“…Ang-II is an important biomarker that increased with the development of ALF. Ang-II mediates vascular inflammation through the nuclear factor-κB-IL-6 signalling pathway [55,56], and high serum levels of Ang-II appear to be linked to the severity and lethality of infection in some cases [57,58]. The decrease in Ang-II level after Li-ALS treatment could indicate amelioration of the inflammatory response.…”

Influenza virus-induced lung injury: pathogenesis and implications for treatment

“…Moreover, the pulmonary endothelium is one of the major sites of angiotensin-converting enzyme (ACE) production. ACE2, a close homologue of ACE, functions as a negative regulator of the angiotensin system and protects against IAV-induced ARDS [125,126]. Components of the coagulation and fibrinolysis cascades have also been associated with promotion of IAV-induced lung injury [127,128].…”