Huang F1, Guo J2, Zou Z1, Liu J3, Cao B4, Zhang S5, Li H6, Wang W7, Sheng M7, Liu S7, Pan J8, Bao C9, Zeng M10, Xiao H11, Qian G12, Hu X12, Chen Y12, Chen Y12, Zhao Y7, Liu Q7, Zhou H7, Zhu J7, Gao H12, Yang S12, Liu X12, Zheng S12, Yang J12, Diao H12, Cao H12, Wu Y13, Zhao M13, Tan S13, Guo D14, Zhao X15, Ye Y15, Wu W15, Xu Y14, Penninger JM16, Li D17, Gao GF18, Jiang C19, Li L12.
Nat Commun. 2014 May 6;5:3595. doi: 10.1038/ncomms4595
A novel influenza A (H7N9) virus of avian origin emerged in eastern China in the spring of 2013. This virus causes severe disease in humans, including acute and often lethal respiratory failure. As of January 2014, 275 cases of H7N9-infected patients had been reported, highlighting the urgency of identifying biomarkers for predicting disease severity and fatal outcomes. Here, we show that plasma levels of angiotensin II, a major regulatory peptide of the renin-angiotensin system, are markedly elevated in H7N9 patients and are associated with disease progression. Moreover, the sustained high levels of angiotensin II in these patients are strongly correlated with mortality. The predictive value of angiotensin II is higher than that of C-reactive protein and some clinical parameters such as the PaO2/FiO2 ratio (partial pressure of arterial oxygen to the fraction of inspired oxygen). Our findings indicate that angiotensin II is a biomarker for lethality in flu infections.