[Physiopathology of the acute adverse effects of angiotensin-converting-enzyme inhibitors].
Angiotensin-I-converting-enzyme inhibitors are currently used to treat more than 40 million cardiovascular patients worldwide. These drugs have a variety of acute adverse effects, the nature of which depends on the clinical context, and which include angioedema, anaphylactoid reactions in hemodialysis patients, and severe hypotensive reactions during blood product transfusions. These adverse effects result from a combination of factors affecting the synthesis, metabolism and pharmacological activity of bradykinin and des-arginine9-bradykinin, two powerful vasodilatory and pro-inflammatory peptides. Experimental evidence obtained in our laboratory suggests that acquired, genetic and pharmacological factors can influence the risk of these rare but potentially life-threatening effects.
Adam
Albert
A
Université de Montréal, Faculté de pharmarcie, 2900 boulevard Edouard Montpetit, Montréal, Québec, Canada H3C 3J7.
Désormeaux
Anik
A
Moreau
Marie-Eve
ME
D000208:Acute Disease; D000626:Aminopeptidases / Q000235:genetics / Q000502:physiology; D000707:Anaphylaxis / Q000139:chemically induced; D000799:Angioedema / Q000139:chemically induced; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001920:Bradykinin / Q000031:analogs & derivatives / Q000502:physiology; D004342:Drug Hypersensitivity / Q000209:etiology / Q000503:physiopathology; D020022:Genetic Predisposition to Disease; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D047589:Leukocyte Reduction Procedures; D020641:Polymorphism, Single Nucleotide; D011401:Promoter Regions, Genetic / Q000235:genetics; D018002:Receptors, Bradykinin / Q000502:physiology; D006435:Renal Dialysis; D065227:Transfusion Reaction
D000806:Angiotensin-Converting Enzyme Inhibitors; D018002:Receptors, Bradykinin; C024626:bradykinin, des-Arg(9)-; D000626:Aminopeptidases; C022750:X-Pro aminopeptidase; D001920:Bradykinin