title: Association of an insertion polymorphism of angiotensin-converting enzyme gene with the activity of lupus nephritis.
abstract: BACKGROUND
  Lupus nephritis is a common manifestation of systemic lupus erythematosus (SLE). The pathogenesis of lupus nephritis has not been fully understood; however, immunological abnormalities have been considered in the development and activity of lupus nephritis. As angiotensin-converting enzyme (ACE) is implicated in various immunological phenomena, we investigated the correlation between insertion (I)/ deletion (D) polymorphism of the ACE gene and the activity of lupus nephritis.
  
  
  METHODS
  Eighty-four patients with SLE and 100 healthy subjects were enrolled in this study. Following the extraction of genomic DNA from the peripheral blood, the ACE genotype was determined by the polymerase chain reaction. The patients were classified by the histological findings according to the WHO classification. In addition, the activity index and chronicity index were used to assess the severity of renal involvement.
  
  
  RESULTS
  Individuals with II genotype showed a significantly increased activity of lupus nephritis. The allelic frequency was I/D = 0.84/0.16 in patients with WHO class IV renal lesions, and I/D = 0.36/0.64 in those with WHO class I lesions and 0.61/0.39 in patients with WHO class I or WHO class II. The difference in the allelic frequency between patients with WHO class IV and those with WHO class I or WHO class I + WHO class II was statistically significant (p = 0.00016 or p = 0.027, respectively). Moreover, lupus nephritis patients with II genotype showed significantly higher activity index than those with DD genotype (p = 0.0009).
  
  
  CONCLUSIONS
  These results suggest that the insertion polymorphism of the ACE gene may correlate with the activity of lupus nephritis.
authors: First Department of Internal Medicine, Nara Medical University, Japan.
authors: Y
authors: Y
authors: Akai
authors: H
authors: H
authors: Sato
authors: M
authors: M
authors: Iwano
authors: N
authors: N
authors: Kurumatani
authors: H
authors: H
authors: Kurioka
authors: A
authors: A
authors: Kubo
authors: T
authors: T
authors: Yamaguchi
authors: H
authors: H
authors: Shiiki
authors: T
authors: T
authors: Fujimoto
authors: K
authors: K
authors: Dohi
mesh_terms: D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000235:genetics* / Q000473:pathology; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic
chemical_list: D007703:Peptidyl-Dipeptidase A