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Ahmad H, Khan H, Haque S, Ahmad S, Srivastava N, Khan A. Angiotensin-Converting Enzyme and Hypertension: A Systemic Analysis of Various ACE Inhibitors, Their Side Effects, and Bioactive Peptides as a Putative Therapy for Hypertension. J Renin Angiotensin Aldosterone Syst 2023; 2023:7890188. [PMID: 37389408 PMCID: PMC10307051 DOI: 10.1155/2023/7890188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 07/01/2023] Open
Abstract
Hypertension is a major risk factor for heart attack, produce atherosclerosis (hardening of the arteries), congestive heart failure, stroke, kidney infection, blindness, end-stage renal infection, and cardiovascular diseases. Many mechanisms are involved in causing hypertension, i.e., via calcium channels, alpha and beta receptors, and the renin-angiotensin system (RAS). RAS has an important role in blood pressure control and is also involved in the metabolism of glucose, homeostasis, and balance of electrolytes in the body. The components of RAS that are involved in the regulation of blood pressure are angiotensinogen, Ang I (angiotensin I), Ang II (angiotensin II), ACE (angiotensin-converting enzyme), and ACE 2 (angiotensin-converting enzyme 2). These components provide for relevant therapeutic targets for the treatment of hypertension, and various drugs are commercially available that target individual components of RAS. Angiotensin receptor blockers (ARBs) and ACE inhibitors are the most popular among these drugs. ACE is chosen in this review as it makes an important target for blood pressure control because it converts Ang I into Ang II and also acts on the vasodilator, bradykinin, to degrade it into inactive peptides. This review highlights various aspects of blood pressure regulation in the body with a focus on ACE, drugs targeting the components involved in regulation, their associated side effects, and a need to shift to alternative therapy for putative hypertension treatment in the form of bioactive peptides from food.
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Affiliation(s)
- Hafiz Ahmad
- RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras al Khaimah, UAE
- Microbiology and Molecular Division-RAK Hospital, Ras al Khaimah, UAE
| | - Huma Khan
- Faculty of Biotechnology and Applied Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Shabirul Haque
- The Feinstein Institute of Medical Research, Northwell Health, Manhasset, NY, USA
| | - Shameem Ahmad
- Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India
| | - Namita Srivastava
- Faculty of Biotechnology and Applied Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Azhar Khan
- Faculty of Biotechnology and Applied Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
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The Effect of Angiotensin Converting Enzyme (ACE) I/D Polymorphism on Atherosclerotic Cardiovascular Disease and Cardiovascular Mortality Risk in Non-Hemodialyzed Chronic Kidney Disease: The Mediating Role of Plasma ACE Level. Genes (Basel) 2022; 13:genes13071121. [PMID: 35885904 PMCID: PMC9318243 DOI: 10.3390/genes13071121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 02/05/2023] Open
Abstract
The association between angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphisms and plasma ACE levels may allow for the optimization of a preventive intervention to reduce cardiovascular morbidity and mortality in the chronic kidney disease (CKD) population. In this study, we aimed to analyze the association between ACE I/D polymorphism and cardiovascular mortality risk among non-hemodialyzed chronic kidney disease patients. This cross-sectional study examined 70 patients of Javanese ethnic origin with stable CKD who did not receive hemodialysis. ACE I/D polymorphisms, plasma ACE levels, atherosclerotic cardiovascular disease (ASCVD) risk, and cardiovascular mortality risk were investigated. As per our findings, the I allele was found to be more frequent (78.6) than the D allele (21.4), and the DD genotype was less frequent than the II genotype (4.3 vs. 61.4). The ACE I/D polymorphism had a significant direct positive effect on plasma ACE levels (path coefficient = 0.302, p = 0.021). Similarly, plasma ACE levels had a direct and significant positive effect on the risk of atherosclerotic cardiovascular disease (path coefficient = 0.410, p = 0.000). Moreover, atherosclerotic cardiovascular disease risk had a significant positive effect on cardiovascular mortality risk (path coefficient = 0.918, p = 0.000). The ACE I/D polymorphism had no direct effect on ASCVD and cardiovascular mortality risk. However, our findings show that the indirect effects of high plasma ACE levels may be a factor in the increased risk of ASCVD and cardiovascular mortality in Javanese CKD patients.
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Gervasini G, Luna E, Garcia-Pino G, Azevedo L, Mota-Zamorano S, José Cubero J. Polymorphisms in genes involved in vasoactive eicosanoid synthesis affect cardiovascular risk in renal transplant recipients. Curr Med Res Opin 2018; 34:247-253. [PMID: 29022765 DOI: 10.1080/03007995.2017.1391757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Arachidonic acid metabolism by cytochrome P450 (CYP) epoxygenases leads to epoxyeicosatrienoic acids (EETs), which are eicosanoids with vasodilator and anti-inflammatory properties. We aim to determine whether genetic variability in these routes may contribute to cardiovascular (CV) risk in renal transplant recipients. METHODS In a cohort of 355 patients, we determined the presence of two polymorphisms, CYP2C8*3 and CYP2J2*7, known to affect eicosanoid levels. Associations with CV mortality, CV event-free long-term survival and graft survival were retrospectively investigated by logistic regression models. RESULTS CYP2J2*7 showed a statistical trend towards higher CV mortality (p = .06) and lower cardiac or cerebral event-free long-term survival (p = .05), whilst CYP2C8*3 displayed a significant inverse association with the risk of CV event (hazard ratio [HR] = 0.34 [0.15-0.78], p = .01). The association of CYP2J2*7 with CV mortality became significant when the analysis was restrained to 316 patients without a history of CV events prior to transplantation (HR = 15.72 [2.83-91.94], p = .005). In this subgroup of patients both single nucleotide polymorphisms (SNPs) were significantly associated with event-free survival. HR values were 5.44 (1.60-18.51), p = .007 and 0.26 (0.09-0.75), p = .012 for CYP2J2*7 and CYP2C8*3, respectively. CONCLUSIONS Our results show, for the first time to our knowledge, that two SNPs in CYP2C8 and CYP2J2, which synthesize EETs, may modify CV outcomes in renal transplant recipients, a population that is already at a high risk of suffering these events.
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Affiliation(s)
- Guillermo Gervasini
- a Department of Medical and Surgical Therapeutics, Division of Pharmacology , Medical School, University of Extremadura , Badajoz , Spain
| | - Enrique Luna
- b Service of Nephrology, Infanta Cristina University Hospital , Badajoz , Spain
| | - Guadalupe Garcia-Pino
- a Department of Medical and Surgical Therapeutics, Division of Pharmacology , Medical School, University of Extremadura , Badajoz , Spain
| | - Lilia Azevedo
- b Service of Nephrology, Infanta Cristina University Hospital , Badajoz , Spain
| | - Sonia Mota-Zamorano
- a Department of Medical and Surgical Therapeutics, Division of Pharmacology , Medical School, University of Extremadura , Badajoz , Spain
| | - Juan José Cubero
- b Service of Nephrology, Infanta Cristina University Hospital , Badajoz , Spain
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Buraczynska M, Stec A, Filipczak A, Ksiazek A. Association between functional variant of inflammatory system gene (PSMA6) and end-stage kidney disease. Int Urol Nephrol 2016; 48:2083-2087. [PMID: 27671905 PMCID: PMC5099367 DOI: 10.1007/s11255-016-1420-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/12/2016] [Indexed: 12/27/2022]
Abstract
Background The proteasome system is involved in several disorders. The 5′ untranslated region of PSMA6 gene contains a single nucleotide polymorphism (SNP) −8 C/G, associated with diabetes, myocardial infarction and coronary artery disease. Methods We examined 584 patients with end-stage kidney disease (ESKD) and 430 controls. All were genotyped for −8 C/G SNP by polymerase chain reaction and restriction analysis. Results We observed lower frequency of CG + GG genotypes in patients than in controls (20 vs. 42 %, p = 0.0038). The odds ratio of 0.34 (95 % CI 0.26–0.45) suggests association of CG + GG with decreased risk of ESKD. We investigated the association between PSMA6 polymorphism and LVH present in 54 % of patients. There was a significant association of CG + GG genotype with LVH, with over 75 % of CG + GG in patients with LVH. This effect was independent from other common causes of LVH—age (OR 1.12, p = 0.643) and hypertension (OR 1.72, p = 0.422). Conclusion We demonstrated for the first time that PSMA6 polymorphism might be a protective factor for ESKD. On the other hand, CG + GG genotypes are independently related to LVH in ESKD patients.
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Affiliation(s)
- Monika Buraczynska
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-954, Lublin, Poland.
| | - Anna Stec
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-954, Lublin, Poland
| | - Aleksandra Filipczak
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-954, Lublin, Poland
| | - Andrzej Ksiazek
- Department of Nephrology, Medical University of Lublin, Jaczewskiego 8, 20-954, Lublin, Poland
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Cosenso-Martin LN, Vaz-de-Melo RO, Pereira LR, Cesarino CB, Yugar-Toledo JC, Cipullo JP, de Souza Pinhel MA, Souza DRS, Vilela-Martin JF. Angiotensin-converting enzyme insertion/deletion polymorphism, 24-h blood pressure profile and left ventricular hypertrophy in hypertensive individuals: a cross-sectional study. Eur J Med Res 2015; 20:74. [PMID: 26336879 PMCID: PMC4559372 DOI: 10.1186/s40001-015-0166-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/20/2015] [Indexed: 01/19/2023] Open
Abstract
Background The absence of nocturnal blood pressure dipping (ND) identified by 24-h ambulatory blood pressure monitoring (ABPM) correlates with a worse cardiovascular prognosis. The renin–angiotensin system influences blood pressure levels and the occurrence of target organ damage (TOD). Thus, the aim of this study was to correlate the angiotensin-converting enzyme gene (ACE) insertion/deletion (I/D) polymorphism with the 24-h blood pressure profile and TOD in hypertensive individuals. Methods 155 non-diabetic hypertensive individuals on antihypertensive treatment underwent ABPM. Peripheral blood samples were drawn for biochemistry and genetic analysis of the ACE I/D polymorphism by polymerase chain reaction. ND was defined as ≥10 % differences in the mean systolic blood pressure (BP) during wakefulness and sleep. Results There were no differences in clinical or biochemical variables or TOD in respect to ND status, except for higher BP levels during sleep (p < 0.001) in non-dippers. There was significant difference in the prevalence of left ventricular hypertrophy (LVH) between ACE genotypes (II: 13.0 %; ID: 34.1 %; DD: 46.5 %; p value = 0.024) with an increased risk in carriers of the DD genotype (OR = 5.80; IC 95 % 1.50–22.44; p value = 0.011). Carriers of the D allele had higher systolic BP during wakefulness and by ABPM (p < 0.05), higher left ventricular mass (117.3 ± 50.0 vs. 100.3 ± 25.7; p value = 0.017) and higher prevalence of LVH (37.4 vs. 12.5 %; OR = 4.14; 95 % IC: 1.17–14.65; p value = 0.028), compared to the II genotype. Conclusions The DD genotype is associated with a higher prevalence of LVH. The presence of the D allele appears to be associated with higher mean 24-h and wake systolic BP measured by ABPM in hypertensive patients under antihypertensive treatment.
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Affiliation(s)
- Luciana Neves Cosenso-Martin
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - Renan Oliveira Vaz-de-Melo
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - Luana Rocco Pereira
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - Cláudia Bernardi Cesarino
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - Juan Carlos Yugar-Toledo
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | - José Paulo Cipullo
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
| | | | | | - José Fernando Vilela-Martin
- Hypertension Clinic, Internal Medicine Department, State Medical School in São José do Rio Preto (FAMERP) and Hospital de Base, Ave Brig. Faria Lima 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil.
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Association between Angiotensin I-Converting Enzyme Insertion/Deletion Polymorphism and Prognosis of Kidney Transplantation: A Meta-Analysis. PLoS One 2015; 10:e0127320. [PMID: 26000752 PMCID: PMC4441456 DOI: 10.1371/journal.pone.0127320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/13/2015] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Angiotensin I-converting enzyme (ACE) is crucial in the renin-angiotensin-aldosterone system. ACE insertion/deletion (I/D) polymorphism is a common genetic variation of this gene and is associated with several disease phenotypes. However, the results of published studies on the influence of this polymorphism on renal transplantation are inconsistent. Therefore, a meta-analysis was performed to evaluate the association between ACE I/D polymorphism and prognosis of kidney transplantation. METHODS A meta-analysis was performed based on 21 case-control studies from 12 publications (1497 cases and 2029 controls) and 10 studies with quantitative values from 5 publications (814 patients). Pooled odds ratios (ORs) and weighted mean differences (WMDs) with their corresponding 95% confidence intervals (CIs) were used to estimate associations. RESULTS ACE I/D polymorphism was found to be associated with acute rejection (AR) in genotypes DD+ID versus II (OR = 1.62, 95% CI = 1.14-2.29) and with serum creatinine concentration after renal transplantation in genotypes DD versus ID (WMD = 13.12, 95% CI = 8.09-18.16). Stratified analysis revealed that recipients transplanted within a year had higher serum creatinine concentrations in the DD versus ID model. No significant association was found between hypertension and ACE I/D polymorphism. CONCLUSION ACE I/D polymorphism is associated with AR and allograft function after kidney transplantation.
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Reshetnikov EA, Akulova LY, Dobrodomova IS, Dvornyk VY, Polonikov AV, Churnosov MI. The insertion-deletion polymorphism of the ACE gene is associated with increased blood pressure in women at the end of pregnancy. J Renin Angiotensin Aldosterone Syst 2013; 16:623-32. [DOI: 10.1177/1470320313501217] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 05/30/2013] [Indexed: 11/16/2022] Open
Affiliation(s)
- Evgeny A Reshetnikov
- Department of Medical Biological Disciplines, Belgorod National Research University, Russia
| | - Ludmila Y Akulova
- Department of Medical Biological Disciplines, Belgorod National Research University, Russia
| | - Irina S Dobrodomova
- Department of Medical Biological Disciplines, Belgorod National Research University, Russia
| | | | - Alexey V Polonikov
- Department of Biology, Medical Genetics and Ecology, Kursk State Medical University, Russia
| | - Mikhail I Churnosov
- Department of Medical Biological Disciplines, Belgorod National Research University, Russia
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