ACE2 EXPRESSION OF HYPERTENSIVE RAT LUNGS GIVEN ACE-I, CCB, AND SWITCHING ACEI TO CCB
Abstract
Latar belakang : Hipertensi merupakan komorbid terbanyak pada COVID-19 dan ACE2 sebagai reseptor yang akan berikatan dengan virus SARS-COV-2, juga berperan dalam regulasi tekanan darah. Penggunaan obat antihipertensi seperti ACE-I atau CCB dapat mempengaruhi ekspresi ACE2. Penggunaan ACE-I selama pandemi menuai pro dan kontra yang memunculkan saran penggantian golongan obat antihipertensi seperti CCB. Tujuan : Mengetahui ekspresi ACE2 jaringan paru tikus setelah induksi hipertensi dan dilanjutkan dengan pemberian ACE-I (kaptopril) atau CCB (amlodipine), dan switching ACE-I menjadi CCB. Metode : Post control group design menggunakan 30 sampel tikus Sprague dawley yang dibagi menjadi 5 kelompok yaitu non-hipertensi, hipertensi, hipertensi + ACE-I, hipertensi + CCB, dan hipertensi + ACE-I switching CCB. Induksi hipertensi menggunakan L-NAME selama 6 minggu dan pengukuran tekanan darah menggunakan metode non-invasif. Pemberian obat antihipertensi diberikan selama 1 minggu. Ekspresi ACE2 diukur menggunakan ELISA kit Elabscience®. Hasil : Ekspresi ACE2 pada kelompok non hipertensi vs hipertensi tidak ditemukan perbedaan bermakna. Ekspresi ACE2 pada kelompok hipertensi dengan pengobatan ACE-I vs CCB ditemukan lebih tinggi pada kelompok CCB (p = 0.042). Ekspresi ACE2 pada kelompok hipertensi dengan pengobatan lebih tinggi dibanding kelompok hipertensi tanpa pengobatan (p = 0.001). Diskusi : Ekspresi ACE2 lebih tinggi pada kelompok dengan pengobatan ACE-I dengan cara menghambat efek Angiotensin II, sehingga kadar ACE2 meningkat sebagai mekanisme kompensasi. Sedangkan CCB akan meningkatkan kadar Angiotensin I dan menurunkan rasio Angiotensin (1-7)/ Angiotensin I dan menurunkan rasio ACE2/ACE Kesimpulan : Ekspresi ACE2 meningkat pada jaringan paru hipertensi dengan pengobatan ACE-I, CCB, dan switching ACE-I menjadi CCB.
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