title: Role of ACE I/D gene polymorphisms on the effect of ramipril in inflammatory response and myocardial injury in patients undergoing coronary artery bypass grafts.
abstract: BACKGROUND
  Angiotensin-converting enzyme (ACE) inhibitors block angiotensin II formation and release bradykinin, which is effective in the regulation of oxidoinflammatory injury. Some reports denote alterations in the effectiveness of ACE inhibitors in association with ACE insertion/deletion (I/D) gene polymorphisms. This study investigates the effects of ramipril on the oxidoinflammatory cytokines (IL-6, IL-8, TNF-alpha) and TnT (myocardial injury marker) and their alteration in association with ACE I/D gene polymorphisms.
  
  
  METHODS
  The study group (n = 51) patients received ramipril before coronary artery bypass grafting (CABG), while patients not receiving ramipril (n = 51) constituted the controls. TNFα, IL-6, and IL-8 were evaluated using ELISA and TnT by electrochemiluminescence methods before the induction of anesthesia (t1), at the 20th minute following cross-clamping (t2), at the end of the operation (t3), and at the 24th hour from the commencement of anesthesia (t4). Genotyping was performed by PCR.
  
  
  RESULTS
  Differences between the groups were significant at t4 for the TNFα and at t3 for IL-6 (p < 0.05). The TnT levels increased from t2 onward in the control group and were highest in t3. Changes in t3 and t4 values in both groups according to their t1 values were significant (p < 0.05). However, differences between the groups were insignificant (p > 0.05). The IL-6, IL-8, TNFα, and TnT serum levels had no correlation with the ACE I/D gene polymorphism.
  
  
  CONCLUSIONS
  Low cytokine and TnT levels in the study group, especially after cross-clamping, may indicate the protective effect of ramipril from oxidoinflammatory injury. This effect did not appear to be associated with the ACE I/D gene polymorphism.
authors.affiliation: Faculty of Medicine, Department of Medical Biology, Mustafa Kemal University, 31024, Antakya, Hatay, Turkey, meralurhan@hotmail.com.
authors.forename: Meral
authors.initials: M
authors.lastname: Urhan Küçük
authors.forename: Nehir
authors.initials: N
authors.lastname: Sucu
authors.forename: Seyhan
authors.initials: S
authors.lastname: Şahan Firat
authors.forename: Barlas Naim
authors.initials: BN
authors.lastname: Aytaçoğlu
authors.forename: Özden
authors.initials: Ö
authors.lastname: Vezir
authors.forename: Caner
authors.initials: C
authors.lastname: Bozali
authors.forename: Necmiye
authors.initials: N
authors.lastname: Canacankatan
authors.forename: Seval
authors.initials: S
authors.lastname: Kul
authors.forename: Bahar
authors.initials: B
authors.lastname: Tunçtan
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D002316:Cardiotonic Agents / Q000494:pharmacology*; D001026:Coronary Artery Bypass; D005260:Female; D006335:Heart Injuries / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D017257:Ramipril / Q000494:pharmacology*; D020107:Troponin T / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; C508606:CXCL8 protein, human; D002316:Cardiotonic Agents; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D020107:Troponin T; D014409:Tumor Necrosis Factor-alpha; D007703:Peptidyl-Dipeptidase A; D017257:Ramipril