Angiotensin II plasma levels are linked to disease severity and predict fatal outcomes in H7N9-infected patients

Fengming Huang, Jing Guo, Zhen Zou, Jun Liu, Bin Cao, Shuyang Zhang, Hui Li, Wei Wang, Miaomiao Sheng, Song Liu, Jingcao Pan, Changjun Bao, Mei Zeng, Haixia Xiao, Guirong Qian, Xinjun Hu, Yuanting Chen, Yu Chen, Yan Zhao, Qiang LiuHuandi Zhou, Jindong Zhu, Hainv Gao, Shigui Yang, Xiaoli Liu, Shufa Zheng, Jiezuan Yang, Hongyan Diao, Hongcui Cao, Ying Wu, Min Zhao, Shuguang Tan, Dan Guo, Xiliang Zhao, Yicong Ye, Wei Wu, Yingchun Xu, Josef M. Penninger, Dangsheng Li, George F. Gao, Chengyu Jiang, Lanjuan Li

Research output: Contribution to journalArticlepeer-review

107 Scopus citations


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.

Original languageEnglish (US)
Article number3595
JournalNature communications
StatePublished - May 6 2014
Externally publishedYes

ASJC Scopus subject areas

  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Physics and Astronomy(all)


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