The causes of increase and decrease of angiotensin-converting enzyme (ACE)
Last reviewed: 20.11.2021
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Angiotensin converting enzyme (ACE) is a glycoprotein, which is present mainly in the lungs and in small amounts in the brushing of the epithelium of the proximal tubules of the kidneys, the endothelium of the blood vessels and the blood plasma. ACE, on the one hand, catalyzes the conversion of angiotensin I into one of the most potent vasoconstrictors - angiotensin II, on the other hand, hydrolyses the bradykinin vasodilator to an inactive peptide.
Medicines - ACE inhibitors - are successfully used to reduce blood pressure in patients with arterial hypertension, as well as to prevent the development of renal failure in diabetic patients, improve outcomes in patients with myocardial infarction.
Reference values (norm) of activity of angiotensin-converting enzyme (ACE) in blood serum - 8-52 IU / l.
The determination of ACE activity is mainly used to diagnose sarcoidosis (sometimes - to assess the effectiveness of ACE inhibitors). With active pulmonary form of sarcoidosis, an increase in ACE is detected in 85-90% of patients (in the inactive form, only 11%). The more significant the increase in ACE, the greater the prevalence and activity of the process. For the disease, typical leukopenia (in 31% of patients), anemia (in 31%), eosinophilia (in 25%), hypergammaglobulinemia (in 50%), hypercalcemia (in 17%) and hypercalciuria (in 30%).
Increased ACE activity in blood serum is possible with acute and chronic bronchitis, pulmonary fibrosis of the aetiology, occupational pneumoconiosis (in 20% of patients), rheumatoid arthritis, connective tissue diseases, cervical lymphadenitis, Gaucher disease (100%), liver cirrhosis (in 25 %), hyperthyroidism (81%), chronic kidney disease, amyloidosis, type 1 diabetes (more than 24%).
Reduction of ACE activity can be detected in chronic obstructive pulmonary diseases, late stages of lung cancer and tuberculosis.