Evaluation of circulating renin-angiotensin system components in pediatric patients with acute leukemia: a pilot study

Abstract

Introduction: Acute leukemia (AL) is the most common cancer of childhood. In recent years, there has been an important advance in the survival rate of these patients. The objective of this study was to assess whether there is an association between the blood levels of Renin Angiotensin System (RAS) molecules in children with acute AL and disease presentation and evolution in pediatric patients. Materials and Methods: This is a cross-sectional study carried out in a group of pediatric patients with AL. We measured blood levels of Angiotensin II (Ang II) and Angiotensin-(1-7) [Ang-(1-7)] by enzyme immunoassay. The Ang-(1-7)/Ang II ratio was calculated as a parameter of the balance between the alternative and classical axes of the RAS. Results: Eleven patients with AL and 20 healthy controls matched by sex and age were included. Patients with AL had significantly higher levels of both peptides when compared with healthy controls (p < 0.05). However, no significant difference was found in the Ang-(1-7)/Ang II ratio between the two groups. A strong and positive correlation was detected between Ang II and Ang-(1-7) levels in patients with AL (r = 0.853; p < 0.0001). There was no significant difference between the levels of Ang II and Ang-(1-7), as well as the Ang-(1-7)/Ang II ratio, the type of AL and clinical outcomes. Conclusion: Both Ang-(1-7) and Ang II seem to be involved in the physiopathology of AL and other molecules of the RAS could be potentially explored for the development of new therapeutic options for AL.