How is the serum-ACE (angiotensin converting enzyme) levels affected by ACE inhibitors? Can other a

Fråga: How is the serum-ACE (angiotensin converting enzyme) levels affected by ACE inhibitors? Can other antihypertensives affect serum-ACE?

Sammanfattning: "ACE-inhibitors lower serum-ACE enzymatic activity, which is what is actually measured when assessing ""serum-ACE levels"" in suspected or verified sarcoidosis. Diuretic treatment might cause moderate elevation of serum ACE activity, but other antihypertensives do not seem to affect this parameter."

Svar: In 1976 Lieberman described elevation of serum ACE activity in patients with active sarcoidosis (1). Though not specific for the disease, the test is often used in the diagnostic procedure of sarcoidosis, as well as for evaluating the therapeutic response to corticosteroid treatment in this disease. The standard way of measuring serum ACE is through enzymatic activity, with flourimetric detection of an oligopeptide cleavage product (2). Thus, the term "serum-ACE levels" in the scientific literature and medical practice generally refers to a test of enzymatic activity. ACE-inhibitors such as captopril and enalapril interact with the serum-ACE assay and significantly decrease the measured serum-ACE activity (3). Use of serum-ACE measurement as a test for ACE-inhibitor prescription adherence has been suggested (4).

Concerning other antihypertensives, betablockers and calcium channel blockers do not seem to affect serum-ACE activity, whereas some hypertensive patients on diuretics have mildly elevated serum-ACE activity (5).