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Alexander Strizevsky

Publications and source records attributed to Alexander Strizevsky.

2 recordsLinked to original sources

ACE2 activity is increased in monocyte-derived macrophages from prehypertensive subjects.

BACKGROUND: Hypertension is a major risk factor for cardiovascular disease and the renin-angiotensin-aldosterone system (RAAS) plays a central pathophysiological role in its formation. Angiotensin-converting enzyme (ACE) and its homologue ACE2 control the formation of counteracting effectors, angiotensin II (AngII), a potent vasopressor and Ang-(1-7) which has vasodilatory action. It is therefore hypothesized that the balance of the activities of these two enzymes, ACE and ACE2, could be important for the control of blood pressure (BP). METHODS: Monocyte-derived macrophages were isolated from blood samples of normotensives (NT), prehypertensives (preHTN) and untreated hypertensive (HTN) male patients (n = 28, 18 and 11, respectively). The activities of ACE2 were determined by measuring leucine or phenylalanine released following hydrolysis of Ang I and Ang II, respectively. The activity of ACE was measured using a synthetic substrate. RESULTS: The levels of BP were 112.6 +/- 1.4/74.8 +/- 1.2, 128.3 +/- 0.8/78.1 +/- 1.2 and 151.4 +/- 2.7/99.3 +/- 2.4 mmHg in the NT, preHTN and HTN, respectively (P < 0.001). The ACE2-mediated Ang II degrading activity (ACE2-II) was 1201 +/- 241 fmol/min/mg cell protein in NT subjects and was significantly (P < 0.01) increased by 2.4-fold in preHTN. ACE2-II activity in HTN and NT was not significantly different. ACE2-mediated Ang I hydrolysis (ACE2-I) was 85-fold lower than the ACE2-II activity. ACE activity in the human monocyte-derived macrophages (HMDM) averaged 21.6 +/- 3.0 mU/mg cell protein and did not differ among the three groups. CONCLUSIONS: PreHTN subjects have higher ACE2-II activity compared with HTN subjects, suggesting a protective role for ACE2 in the early stage of HTN development, probably by accelerated degradation of the vasopressor AngII.

Adult↗

Fever due to aortitis.

We report a case of vasculitis with predominant aortic involvement. Vasculitis of large vessels has a limited number of tools for diagnosis and follow-up. A 78-year-old woman was referred to the internal medicine department with a 2-month history of fever of unknown origin (FUO), night sweats, weight loss and markedly elevated ESR and CRP. The results of an extended routine investigation found no infection, malignancy, hypersensitivity or autoimmune disorder. The patient did not suffer from claudication; systolic blood pressure difference between arms was 20 mm Hg. Temporal artery biopsies were negative. 2-18F-Fluorine-2-deoxy-D -glucose positron emission tomography (FDG PET) scan imaging demonstrated intense FDG uptake along the aorta and in the brachio-cephalic and carotid arteries consistent with arteritis. A high dose of corticosteroid therapy (1 mg/kg) was instituted with further tapering. The therapy was followed by complete resolution of the symptoms and pathological FDG uptake on repeated FDG PET. Second-line therapy was not added because of positive conversion of Mantaux test followed by rifampicin prophylaxis. FDG PET should be a part of the work-up of FUO when routine investigation fails to determine its etiology. FDG PET is useful both for diagnosis and assessment of response to therapy for large-vessel vasculitis.

Aged↗