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田小利 人类群体遗传室 北京大学分子医学研究所. 心力衰竭的诱因和病理过程. 高血压,冠心病 遗传,心肌病 瓣膜病,先心病. *. 代偿期. 失代偿期. 恶化期. *. *. *. 死亡. 结构和功能的改变 --- 重塑. 心力衰竭. 心力衰竭可能的发展基础. 激素、药物、 神经递质. 活性肽. 膜受体. 离子通道. 活性肽. 第二信使 Ca 2+. (1). 心律失常. 心 力 衰 竭. 心力 衰竭. 心脏病相关基因. (1). 线粒体活性氧. 目前主要研究的内容. 心力衰竭. 临床诊断 遗传学 通道电生理学
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田小利 人类群体遗传室 北京大学分子医学研究所
心力衰竭的诱因和病理过程 高血压,冠心病 遗传,心肌病 瓣膜病,先心病 * 代偿期 失代偿期 恶化期 * * * 死亡 结构和功能的改变---重塑 心力衰竭
心力衰竭可能的发展基础 激素、药物、 神经递质 活性肽 膜受体 离子通道 活性肽 第二信使 Ca2+ (1) 心律失常 心 力 衰 竭 心力衰竭 心脏病相关基因 (1) 线粒体活性氧
目前主要研究的内容 心力衰竭 临床诊断 遗传学 通道电生理学 神经和信号转导 细胞水平鉴定 动物模型 计算机数字化模拟 3-D结构研究 • 作用机制及早期干预 • 新药靶点及可药性 • 早期诊断标记的可能性 心肌重塑的关键分子
AOGEN Renin ANG I ACE ANG II
Salt/water balance Contraction of VSMC Mitogenic effects Neurotransmitter Hormone-stimulation factor Cardiac output
AII b a g PLC PLD PIP2 PC Shc GTP PA Ras Choline IP3 DAG Grb2 SOS Raf PKC ++ Ca ++ ++ Ca Ca ++ Ca Mek ++ Ca ER Mapk Stats Stats SIE C-myc Jaks C-fos Egr C-Jun
AOGEN Kallikrein Renin Capthepsin G Chymotrypsin ANG I Tonin Chymase Kallikrein ACE Capthesin G Chymotrypsin ANG II
ANG1 perfusion isolated aorta 50 Chymase: 40 Nishimura, 1998 Ang II forming enzyme in vitro 30 %phenylephrine Found, cloned and characterized by Dr. Hidenori Urata 20 10 0 Captopril CV 11974 Cap + Aprot Chymostatin Cap + Chymo Fe Ad Chymase Tian, 1996 ACE Urata, 1990
Angiotensinogen Renin ACE Angiotensinogen Renin AT1 Angiotensin I AT2 ACE Angiotensin II AT1 AT2
Angiotensinogen Kininogen Renin Kallikrein Angiotensin 1 Bradykinin ACE Angiotensin 2 Inactive peptides AS RAS ETS (a1) (AII/AT1) (ET-1/ETA)
Angiotensin 1 Angiotensin II Cell growth. etc. Bradykinin degraded fragments degraded fragments Actiate TGF-β signaling AcSDKP (N-acetyl-Ser-Asp-Lys-Pro)
ACE ACE inhibitor NH2 Extracellular Clinical significance of this pathway is under investigation MKK7 Cytosol CK2 JNK COOH cJun JNK P P cJun P cJun P P cJun cJun P cJun P cJun Nucleus AP-1 Gene expression(ACE, COX-2) Fleming I et al. Physiology. 2005;20:91-5.
Angiotensinogen (M235T) • Together with ACE-D, associated male LVH • CAD • AT1 (A1166C) • Associated male LVH
ACE (I/D) • Earlier than 1994: tends to associated • Later than 1994: tends to not associated • LVH of man, not woman • Degree, not frequency of LVH • ACEI treatment • QT dispersion, heart rate variability • Exercise-induced LHV
le e cl ic scle ri tr nt ey en a . mu n g er ve rt dn V v Brai Lun Ao R. Sk Ki Li L. rAC E hA CE
SD 110 TGR 100 90 30 80 25 70 60 20 50 15 -10 -9 -8,5 -8 -7,5 10 110 100 5 90 0 80 SD TGR 70 SD 60 TGR 50 -10 -9 -8,5 -8 -7,5 AII (pg/g) ACEI Cardiac AII AI on coronary artery flow
180 3,0 SD-sh 160 2,8 140 TGR-sh ) g / 120 SD-ab 2,6 g m 100 TGR-ab ( 2,4 80 B / 2,2 60 V L 40 2,0 20 1,8 0 b h b h 1,6 s a s a - - - - R R D D LV/B G G S S T T h s h - s R - 8 D G S S T 7 H 6 D P 5 A 4 G % 3 2 1 0 ANF Col3 ) g H m m ( P B S b b a a - - R D G SD-sh T TGR-sh ANF SD-ab TGR-ab Col3 GAPDH
Age > 10 months TGRL1172 TGRL1173 Lisinopril AcSDKP NTGR col1 col3 GAPDH
AcSDKP TGRL1172 TGRL1173 TGF-β NTGR TGF-β ACE TGF-R1 GAPDH TGRL1172 TGRL1173 Lisinopril AcSDKP NTGR Smad2-p Smad2 Smad3 Smad2 Smad4 TGRL1172 TGRL1173 Lisinopril AcSDKP NTGR Smad3-p Col Smad3
Transcriptional machinery CmG H-act Epigenetic modification
Definition of CG island in RAS promoters CG sites TSS 5-UTR ATG 1 kb
ACE启动子区CG岛分析 CTGTCCCTGGCTCCTTCCCTGATCCCACCGCCAGCCTCACCCCACGGTTCCTCCATTGCC CCACCTCCCACTGCGCCGCCGGGCCTCTGCCAGGGTCAAGGGGCTTCCCCCCTCTGGCAG CAGACGCCATGGTGCCGAGGTGGCCTCCACAACCGCCCTGTGCGCCAATAGGACAAGACT GTCCTCCCTCCCCCACACTTGTCACTTTGAGGGACACGTGGATGAGACAGGAAAACACAG GGGAGTGTGGAGACCTGAGGTGACTTGGAGCAAGCCTCTCAACCTGAGCGGCAATTTCTT CATCTGTAAAATGAGGGGGTTGTTCTCATCTCTGAGGCTTTGTGTCGCTCTCAAAGCCTG CTAGCCTCGGGTTCTAGGACTCTGTTGGGATCGTGTGTGATGTTTTCTGCTGAGCGACGG CAGCCTGTGTCCTCGGGGGGAAAGAGGGCAGGCGCTCCAAAGCTCCTGCGCTCTGTGGCT CCCCCTCCCTCGCAGCCCCAAGCCCCAGGTGTGCCGGCCGCCCTGAGCCCCTCCAGCACC TCCCGGAGGCGCCTGCAAGACACCTAAGGTCCCCGCCTCCCTCCTCTCCCCCCCGCCACA CCCCTACCCCCGGCAGGCGACGTCCCCGCCCCTCGACCATGGCCTGGTGAAGAAGCCGGC CAGGCCCGATCAGCCCCATCCCCGCCGCACGAGCGGCGCCTGCGGACAGCTCCTGGGGCC CCGGCCTTGTCACTCCGGAGGCGGGAGGCTCCGGGGGGTCGGGCTGGGAAGATCGAGCCG GAGGCCGCTAGGCTCCCAGGCCCCGGCCGAGGCTGCGCGGCCGCACGGTGGGCAGGCTCG GGTGTTCCGGCAAACTGCCGGGTCCCCATCTTCAAAAGAGAGGAGGCCCTTTCTCCAGCT TCCTCTGCGGGAGCCCGACCCAGCCCCATCCCGCCACCCCCGGGCTGCACCTCGGCCCCT CCCCGGCCCGCGCCCCTGCCCGGGGCGGGCCAGGAACCTCGGCCCGCGCCGCTGGGGACT TTGGAGCGGAGGAGGAAGCGCGGCGGGGCGGGGGCGGGGGTGTGTCGGGTTTTATAACCC GCAGGGCGGCCGCGGCGCAGGAGAAGGGGCAGAGCCGAGCACCGCGCACCGCGTCATGGG
Angiotensinogen Renin ACE AT1a AT2 74 69 87 45 88
甲基化分析的原理 亚硫酸氢钠 CG UG TG 克隆测序 PCR mCG mCG CG 直接测序 CN UN TN
How to quantify methylation C C CG 100% protected = 100% methylation
Methylation of AOG CC CG CC CG SHR WKY
Methylation of ACE (reversal sequence) CC GC CC GC SHR WKY
Met --- ? ? ?
Several signaling pathways are involved in the pathogenesis of heart failure RAS plays a role in cardiac dysfunction through multiple pathways Expression and epigenetic modifications of RAS plays a critical roles in heart failure