Subclinical endothelial inflammation markers in a family with type I familial hyperaldosteronism caused by a de novo mutation. Marcadores de inflamación endotelial subclínica en una familia con hiperaldosteronismo familiar tipo I por mutación del novo.

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Subclinical endothelial inflammation markers in a family with type I familial hyperaldosteronism caused by a de novo mutation. Marcadores de inflamación endotelial subclínica en una familia con hiperaldosteronismo familiar tipo I por mutación del novo.

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Subclinical endothelial inflammation markers in a family with type I familial hyperaldosteronism caused by a de novo mutation. Marcadores de inflamación endotelial subclínica en una familia con hiperaldosteronismo familiar tipo I por mutación del novo.

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Título: Subclinical endothelial inflammation markers in a family with type I familial hyperaldosteronism caused by a de novo mutation. Marcadores de inflamación endotelial subclínica en una familia con hiperaldosteronismo familiar tipo I por mutación del novo.
Autor: Stehr, Carlos B.; Carvajal, Cristián A.; Lacourt, Patricia; Alcaíno Olivares, Hernán Alejandro; Mellado, Rose Marie; Cattani, Andreína; Mosso, Lorena; Lavandero González, Sergio; Fardella, Carlos E.
Resumen: Background: Type I familial hyperaldosteronism is caused by the presence of a chimaeric gene CYP11B1/CYP11B2 which encodes an enzyme with aldosterone synthetase activity regulated by adernocorticotrophic hormone (ACTH). Therefore, in patients with FH-I is possible to normalize the aldosterone levels with glucocorticoid treatment. Recently it has been shown that aldosterone plays a role in the production of endothelial oxidative stress and subclinical inflammation. Aim: To evaluate subclinical endothelial inflammation markers, like Metalloproteinase 9 (MMP-9) and ultrasensitive C reactive protein (usPCR), before and after glucocorticoid treatment in family members with FH-I caused by a de novo mutation. Patients and menthods: We report three subjects with FH-I in a single family (proband, father and sister). We confirmed the presence of a chimaeric CYP11B1/CYP11B2 gene by long-PCR in all of them. Paternal grandparents were unaffected by the mutation. The proband was a 13 year-old boy with hypertension stage 2 (in agree to The Joint National Committee VII. JNC-VII), with an aldosterone/plasma rennin activity ratio equal to 161. A DNA paternity test confirmed the parental relationship between the grandparents and father with the index case. MMP-9 and usPCR levels were determined by gelatin zymography and nephelometry, respectively. Results: All affected subjects had approxiamately a 50% increase in MMP-9 levels. Only the father had an elevated usPCR. The endothelial inflammation markers returned to normal range after glucocorticoid treatment. Conclusions: We report a family carrying a FH-I caused by a de novo mutation. The elevation of endothelial inflammation markers in these patients and its normalization after glucocorticoid treatment provides new insight about the possible deleterious effect of aldosterone on the endothelium
URI: http://www.captura.uchile.cl/handle/2250/10308
Fecha: 2008-09
Cita del item: REVISTA MEDICA DE CHILE 136(9): 1134-1140


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