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Serial investigation of Angiotensin-Converting Enzyme in sarcoidosis patients treated with Angiotensin-Converting Enzyme Inhibitor

  • Miriana d'Alessandro
    Correspondence
    Corresponding author.
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Laura Bergantini
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Anna Perrone
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Paolo Cameli
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Matteo Cameli
    Affiliations
    Department of Cardiovascular Diseases, University of Siena, Italy
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  • Author Footnotes
    # These authors of this publication are members of the European Reference Network for Rare Respiratory Diseases (ERN-LUNG)
    Antje Prasse
    Footnotes
    # These authors of this publication are members of the European Reference Network for Rare Respiratory Diseases (ERN-LUNG)
    Affiliations
    Department of Pulmonology, Hannover Medical School, Hannover, Germany
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  • Dario Plataroti
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Piersante Sestini
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
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  • Author Footnotes
    # These authors of this publication are members of the European Reference Network for Rare Respiratory Diseases (ERN-LUNG)
    Elena Bargagli
    Footnotes
    # These authors of this publication are members of the European Reference Network for Rare Respiratory Diseases (ERN-LUNG)
    Affiliations
    Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences & Neurosciences, Siena University Hospital, Viale Bracci 1, Siena, 53100, Italy
    Search for articles by this author
  • Author Footnotes
    # These authors of this publication are members of the European Reference Network for Rare Respiratory Diseases (ERN-LUNG)
Published:April 16, 2020DOI:https://doi.org/10.1016/j.ejim.2020.04.006

      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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