Niimi T, Tomita H, Sato S, Mori T, Kawaguchi H, Sugiura Y, Matsuda R
2nd Department of Internal Medicine, Nagoya City University Medical School, Nagoya, Japan.
Chest. 1998 Aug;114(2):495-9. doi: 10.1378/chest.114.2.495.
Angiotensin-converting enzyme (ACE) inactivates bradykinin and tachykinins, which are potent bronchoconstrictors and mediators of inflammatory reactions. It has recently been shown that an insertion (I)/deletion (D) polymorphism in the ACE gene accounts for variation in serum ACE level. We investigated bronchial responsiveness in patients with sarcoidosis to determine whether it might be associated with ACE gene polymorphism.
Bronchial responsiveness was assessed in 21 patients with sarcoidosis, 21 patients with asthma, and 18 healthy control subjects. ACE polymorphism was also examined in the 21 patients with sarcoidosis.
Bronchial responsiveness was measured by recording respiratory resistance with continuous inhalation of methacholine from 49 to 25,000 microg/mL in concentration. The ACE genotype was determined using the polymerase chain reaction.
We found a significant increase in bronchial responsiveness in sarcoidosis patients as compared with healthy control subjects (p<0.01). In the sarcoidosis group, patients with the II genotype demonstrated significantly more coughing (p<0.05) and a greater bronchial responsiveness (p<0.05) than did those with DI or DD genotypes.
Patients with sarcoidosis have increased bronchial responsiveness to some extent, the degree apparently depending on the ACE genotype.
血管紧张素转换酶(ACE)可使缓激肽和速激肽失活,而缓激肽和速激肽是强效支气管收缩剂及炎症反应介质。最近研究表明,ACE基因中的插入(I)/缺失(D)多态性可导致血清ACE水平的差异。我们对结节病患者的支气管反应性进行了研究,以确定其是否与ACE基因多态性有关。
对21例结节病患者、21例哮喘患者及18名健康对照者的支气管反应性进行了评估。同时对21例结节病患者的ACE多态性也进行了检测。
通过连续吸入浓度为49至25,000微克/毫升的乙酰甲胆碱来记录呼吸阻力,以此测量支气管反应性。采用聚合酶链反应确定ACE基因型。
我们发现,与健康对照者相比,结节病患者的支气管反应性显著增加(p<0.01)。在结节病组中,与DI或DD基因型患者相比,II基因型患者咳嗽更明显(p<0.05),支气管反应性更高(p<0.05)。
结节病患者在一定程度上支气管反应性增加,其程度显然取决于ACE基因型。