Hypertension:靶向CXCR4的分子成像——非侵入性诊断醛固酮合成性腺瘤。

2018-01-01 MedSci MedSci原创

原发性醛固酮增多症是引起继发性高血压最常见的原因,并可增加高血压的发病率和死亡率(与普通高血压患者相比)。诊断困难的是鉴别双侧还是单侧发病,因为这决定治疗方案。目前推荐用双侧肾上腺静脉取样进行鉴别诊断,双侧肾上腺静脉取样是一种具有多个缺陷的侵入性检查方法,因此,需要开发一种新的非侵入性的诊断方法。研究人员发现CXCR4(CXC趋化因子受体4)在正常肾上腺合成醛固酮的组织、肾上腺腺瘤相邻的肾上腺皮质

原发性醛固酮增多症是引起继发性高血压最常见的原因,并可增加高血压的发病率和死亡率(与普通高血压患者相比)。诊断困难的是鉴别双侧还是单侧发病,因为这决定治疗方案。目前推荐用双侧肾上腺静脉取样进行鉴别诊断,双侧肾上腺静脉取样是一种具有多个缺陷的侵入性检查方法,因此,需要开发一种新的非侵入性的诊断方法。研究人员发现CXCR4(CXC趋化因子受体4)在正常肾上腺合成醛固酮的组织、肾上腺腺瘤相邻的肾上腺皮质和合成醛固酮的腺瘤(APA)中高表达,并与CYP11B2(醛固酮合成酶)的表达密切相关。相反的是,CSCR4在大多数偶然被发现的非功能性腺瘤多检测不到。利用CXCR4的特异性配体68Ga-pentixafor作CXCR4表达的放射性示踪剂发现,68Ga-pentixafor特异性的高信号的结合至APAs的冰冻切片。研究人员对采用68ga-pentixafor-正电子放射断层照相法的9位原发性醛固酮增多症患者进行深入研究发现,APAs患者肾上腺皮质醛固酮分泌增加的一侧示踪剂摄取量显著增加。利用CXCR4-特异性配体进行醛固酮合成组织进行分子成像,或许可成为检查APAs的非侵入性的特异性方法。原始

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    2018-02-01 feather89
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    2018-01-12 虈亣靌

    谢谢分享.学习了

    0

  6. 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target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Wed Jan 03 08:58:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=274586, encodeId=3b6b2e45864f, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Mon Jan 01 23:46:58 CST 2018, time=2018-01-01, status=1, ipAttribution=), 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    2018-01-03 cmsvly
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GetPortalCommentsPageByObjectIdResponse(id=274554, encodeId=a32b2e4554ea, content=xuexi, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/81d08245657a4a7f9a1ef713c0ec5878/ec4b201a22194a319b1aeb171bc6bb3d.jpg, createdBy=41e02111625, createdName=1581f8c42cm, createdTime=Mon Jan 01 19:30:47 CST 2018, time=2018-01-01, status=1, ipAttribution=)]
    2018-01-03 chenwq09
  8. 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  9. 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    2018-01-01 changjiu

    学习一下谢谢

    0

  10. 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    2018-01-01 1581f8c42cm

    xuexi

    0

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在目前的诊断标准中,原发性醛固酮增多症(PA)有轻度自发醛固酮分泌物的情况可能还未被发现。研究是否缺乏刺激肾素的能力,作为未被发现的自主醛固酮分泌和盐皮质激素受体(MR)激活的一个生物标记。

JCEM:原发性醛固酮增多症的遗传和组织病理学间的异质性

这一病例凸显了在单个原发性醛固酮增多症(PA)患者在组织学、类固醇生成和体细胞突变方面出现的多发性肾上腺皮质腺瘤的复杂的肿瘤异质性。这些发现表明,原发性醛固酮增多症(PA)的并发症状可能涉及多样化的、多功能性的肾上腺腺瘤。

Hypertension:快速筛查原发性醛固酮增多症的新型化学发光免疫分析法!

这种新的测量方法被认为是传统的放射免疫分析法临床上可靠的替代选择,它可以为从大量临床高血压患者中鉴别诊断原发性醛固酮增多症患者提供了更好的通量和成本效益。

Hypertension:原发性醛固酮增多症确诊的新方法!

原发性醛固酮增多症的诊断通常需要至少一次的确认试验。通常情况下,氟氢可的松抑制试验是一个可靠的确认试验,但是此项试验操作十分麻烦。而来自盐水输注试验(SIT)和卡托普利激发试验(CCT)的准确性研究证据提供了相互矛盾的结果。近期,一项发表在杂志Hypertension上的研究前瞻性评估了以氟氢可的松抑制试验为参照标准的SIT和CCT的诊断准确性。此项诊断准确性分析包括135名确诊为原发性醛固酮增多

SCI REP:比较原发性醛固酮增多症患者和原发性高血压患者微血管和大血管的变化!

总之,原发性醛固酮增多症患者相比于原发性高血压患者AVR发生了显著的改变,它可以代表微血管重塑的一个早期和更可靠的指标。