Highlights
- •ACE concentrations resulted higher in non-ACEIs than ACEIs group
- •ACE levels proved to be higher in zofenopril group than other ACEIs drug
- •We suggested systematically investigating medical drugs prescribed for sarcoidosis patients
ABSTRACT
Background
Angiotensin-converting enzyme (ACE) is an acid glycoprotein that converts angiotensin
I into angiotensin II. It is produced mainly by activated alveolar macrophages and
it resulted elevated in sarcoidosis patients. ACE is the only biomarker mentioned
in WASOG international guidelines for the diagnosis and follow-up of sarcoidosis patients
but its sensitivity and specificity are low. This study aimed to analyze serial measurements
of ACE levels in sarcoidosis patients stratified according to concomitant ACE-inhibitor
therapies (ACEIs).
Subjects and methods
136 serum samples from sarcoidosis patients were retrospectively enrolled in the study.
Serial ACE concentrations were measured once year for each patient. Population were
divided according to radiogical stages and ACEIs.
Results
ACE concentrations resulted higher in non-ACEIs than ACEIs group (p<E-04). This result
was confirmed also stratifying population according to radiological stages particularly
in stage 3 (p=2E-03) or stage 2 of the disease (p<1E-04). Considering ACEIs, serum
ACE levels proved to be higher in sarcoidosis patients treated with zofenopril than
in those treated with perindopril (p=2E-02), enalapril (p=2E-03) or ramipril (p=2E-04).
Patients treated with ACEIs showed a progressive reduction in ACE levels to five years
of follow-up (p=1.3E-02) and the zofenopril group recorded the highest ACE levels
(p<1E-04).
Conclusions
This retrospective study investigated changes in ACE levels in patients with sarcoidosis
treated or not treated with ACEIs. Considering the overall low sensitivity and specificity
of this biomarker, we suggest systematically investigating medical drugs prescribed
for patients with sarcoidosis, in order to optimize the interpretation of ACE in clinical
management.
Keywords
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Article info
Publication history
Published online: April 16, 2020
Accepted:
April 3,
2020
Received in revised form:
April 1,
2020
Received:
March 5,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
