Potential genetic risk factors in angiotensin-converting enzyme-inhibitor-induced angio-oedema.
OBJECTIVE
The pathophysiology of angiotensin-converting enzyme inhibitor (ACEi)-induced angio-oedema remains unclear. We have investigated the impact of ACE insertion/deletion (I/D) polymorphism in combination with serum ACE activity as well as the bradykinin B2 receptor 2/3 and c.C181T polymorphisms.


METHODS
We analysed the ACE I/D as well as bradykinin B2 (2/3 and C181T) receptor polymorphisms in 65 patients with documented episodes of ACEi-induced angio-oedema and 65 patients matched for age and sex being under ACEi treatment without history of angio-oedema. Furthermore, we determined serum ACE activity in 47 of the 65 angio-oedema patients 3 months after the angio-oedema attack and compared these values with 51 healthy individuals (control II).


RESULTS
No risk association was identified between ACE I/D (I-allele: 0.42 vs. 0.41, D-allele: 0.58 vs. 0.59; P= 0.095) or bradykinin B2 receptor polymorphisms and the development of angio-oedema during ACEi treatment. We found a trend of lower serum ACE activity in ACE I/I genotypes in comparison with control II (I/I: 28 +/- 4.5 vs. 33 +/- 1.8 U l(-1); ID: 39 +/- 3.3 vs. 41 +/- 1 U l(-1); DD: 56 +/- 6.7 vs. 52 +/- 1.8 U l(-1); P= 0.9).


CONCLUSIONS
Our data suggest that polymorphism of ACE I/D and the bradykinin B2 receptor polymorphisms are not involved in the development of ACEi-induced angio-oedema when considered individually. Further studies should be carried out to clarify whether a combination of these polymorphisms might be a risk factor for ACEi-induced angio-oedema.
Department of Otorhinolaryngology, Technische Universität München, München, Germany. basmurat@web.de
Murat
M
Bas
Thomas K
TK
Hoffmann
Bernd
B
Tiemann
Vu Thao-Vi
VT
Dao
Christos
C
Bantis
Vera
V
Balz
Hans-Jürgen
HJ
Schultz-Coulon
Thomas
T
Stark
Patrick
P
Schuler
Jens
J
Greve
Katrin
K
Ivens
Henning
H
Bier
Georg
G
Kojda
D000367:Age Factors; D000704:Analysis of Variance; D000799:Angioedema / Q000139:chemically induced* / Q000235:genetics / Q000378:metabolism; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D043782:Receptor, Bradykinin B2 / Q000235:genetics* / Q000378:metabolism; D012307:Risk Factors; D012737:Sex Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D043782:Receptor, Bradykinin B2