ACE inhibitors (ACE inhibitors): mechanism of action, indications, list and selection of drugs. In what situations is it necessary to donate blood for angiotensin-converting enzyme? APF get tested

Some diseases may be asymptomatic and can only be discovered after laboratory tests. allows you to detect such serious illnesses as sarcoidosis and Gaucher disease.

ACE (kininase II) is a substance that affects the regulation of blood pressure, converts the peptide angiotensin I to angiotensin II. If the amount of the latter exceeds the norm, arterial hypertension develops. A powerful vasoconstrictor, angiotensin II, constricts blood vessels and destroys bradykinin (hypotensive, depressive peptide).

Angiotensin-converting enzyme has high biological activity. The main location of the substance is the lung tissue, but it is present in small quantities in all internal organs. No more than 10% of ACE circulates in plasma.

ACE inhibitors are the main means of combating high blood pressure and preventing renal failure in patients with diabetes.

The action of drugs helps to reduce the amount of angiotensin II, thereby providing vasoprotective, cardioprotective and nephroprotective effects. During myocardial infarction, there is a significant increase in the enzyme in the affected ventricles.

A blood test for AFP concentration in most cases is aimed at diagnosing sarcoidosis. In patients with this disease, serum enzyme levels increase by at least 60%.

When is the test prescribed?

A laboratory blood test for angiotensin-converting enzyme is prescribed in the following cases:

Diagnosis of sarcoidosis, neurosarcoidosis (with damage to the central nervous system).
Suspicion of Gaucher disease.
Monitoring the condition in sarcoidosis.
Changes in lung tissue.
Testing the effectiveness of treatment of pulmonary diseases.
Monitoring therapy with ACE inhibitors.

Useful video about sarcoidosis:

Most often, a blood test for ACE is prescribed when diagnosing sarcoidosis. This pathology occurs for unknown reasons and can affect not only an individual organ, but the entire system. The immune cells of a patient with sarcoidosis do not attack foreign microorganisms, but their own tissues and organs. The disease can disappear as suddenly as it appears.

This enzyme converts angiotensin I to angiotensin II, which is the most powerful vasoconstrictor. ACE is produced in large quantities by lung tissues, is synthesized in smaller quantities in the juxtaglomerular apparatus of the kidney (JA) and is detected in small concentrations in almost all tissues of the human body.

Diseases in which blood ACE is increased:

lung pathology (sarcoidosis, bronchitis, pulmonary fibrosis due to tuberculosis, pneumoconiosis);
Gaucher disease;
connective tissue diseases;
rheumatoid arthritis;
cervical lymphadenitis.

Diseases in which ACE can be reduced:

COPD;
terminal stages of lung cancer or tuberculosis.

It should be said that angiotensin-converting enzyme inhibitors are actively used as drugs for:

as an antihypertensive agent for arterial hypertension of various etiologies;
as a prevention of the development of chronic renal failure in patients with diabetic nephropathy;
reducing the likelihood and severity of complications in patients who have suffered a myocardial infarction.

Diseases:

Suspicion of Gaucher disease.
Changes in lung tissue.

Decoding the results of the analysis for ACE

Preparing for analysis

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Angiotensin-converting enzyme is normal (table). Angiotensin converting enzyme is increased or decreased - what does this mean?

Angiotensin-converting enzyme (ACE) is a special enzyme that helps balance water and salt in the body and stabilize blood pressure. In a nutshell, with the help of angiotensin-converting enzyme, if necessary, angiotensin - I converted to angiotensin II. It constricts blood vessels, and low blood pressure returns to normal. Hence the name of this enzyme - angiotensin-converting enzyme. It is produced mainly in the lung tissue, and in smaller quantities in the kidneys. Traces of angiotensin-converting enzyme can be found in all tissues of the human body and, of course, in the blood.

Angiotensin converting enzyme is normal. Explanation of the result (table)

The etymology of sarcoidosis remains unclear to date. It is only known that with this systemic disease, non-caseating granulomas appear in the lymph nodes, lungs, liver and other organs. They cause inflammatory processes and actively produce angiotensin-converting enzyme, which is normally synthesized by epithelial cells of the lung tissue. Sometimes the patient experiences fever, pain in the affected organs, and aching joints. If the eyes are affected, then there is pain in the eyes. But quite often, sarcoidosis can occur without noticeable symptoms and is discovered by chance, for example, during a preventive examination or when visiting a doctor about another disease.

Since sarcoidosis can resemble many other diseases in its manifestations, especially those of an infectious nature, it is very important to carry out a correct differentiated diagnosis. For this purpose, an analysis for the content of ACE is prescribed. Blood is drawn from a vein in the morning, on an empty stomach.

If the angiotensin converting enzyme is elevated - what does this mean?

An increase in the level of ACE during diagnosis is indicated if the test results exceed the permissible norm by more than 60%. Although with active sarcoidosis, the angiotensin-converting enzyme may be increased twofold or more. In other lung diseases, the ACE level continues to remain within the established norm. If, after prescribed treatment, the level of angiotensin-converting enzyme begins to gradually decrease, this indicates its effectiveness and is a positive sign, especially for the subsequent prognosis.

A slight increase in the level of angiotensin-converting enzyme can also be observed in the following diseases:

bronchitis - acute or chronic,
amyloidosis,
pulmonary fibrosis in tuberculosis,
rheumatoid arthritis,
fungal infection of the lungs - histoplamosis,
glucosylceramide lipidosis - Gaucher disease,
Melkersson–Rosenthal syndrome,
diabetes,
pneumoconiosis, thyrotoxicosis,
leprosy,
cirrhosis of the liver.

If the angiotensin converting enzyme is low - what does this mean?

There are also diseases in which the level of angiotensin-converting enzyme may be lower than normal. These are chronic obstructive pulmonary diseases and lung cancer or tuberculosis in the last terminal stage. Of course, these diseases have other, more obvious signs, so there is no need to panic if your ACE test result is a little lower than it should be.

Angiotensin converting enzyme (ACE)

The normal level of ACE activity in serum is 8-52 IU/l.

Physiological role of ACE

Angiotensin-converting enzyme is a glycoprotein that is present mainly in the lungs and in small quantities in the brush border epithelium of the proximal tubules of the kidneys, endothelium of blood vessels and blood plasma. ACE, on the one hand, catalyzes the conversion of angiotensin I into one of the most powerful vasoconstrictors - angiotensin II, on the other hand, hydrolyzes the vasodilator bradykinin to an inactive peptide. Therefore, drugs - angiotensin-converting enzyme inhibitors - are effective for lowering blood pressure in patients with hypertension, are used to prevent the development of renal failure in patients with diabetes, and improve the outcomes of patients with myocardial infarction.

An increase in ACE activity in the blood serum is detected in sarcoidosis, acute and chronic bronchitis, pulmonary fibrosis of tuberculous etiology, occupational pneumoconiosis, rheumatoid arthritis, connective tissue diseases, cervical lymphadenitis, Gaucher disease.

Decreased activity can be detected in chronic obstructive pulmonary diseases, advanced stages of lung cancer and tuberculosis.

ACE activity is studied mainly to diagnose sarcoidosis and evaluate the effectiveness of drugs - angiotensin-converting enzyme inhibitors.

To decipher the values of other analysis indicators, you can use our service: deciphering a biochemical blood test online.

Method

Reference values - norm

((APF), blood)

APF blood test

Blood test for ACE: indications and interpretation of results

Some diseases may be asymptomatic and can only be discovered after laboratory tests. An ACE blood test can detect serious illnesses such as sarcoidosis and Gaucher disease.

Angiotensin-converting enzyme: information

ACE inhibitors are the main means of combating high blood pressure and preventing renal failure in patients with diabetes.

A blood test for AFP concentration in most cases is aimed at diagnosing sarcoidosis. In patients with this disease, serum enzyme levels increase by at least 60%. The normal amount of the substance depends on age: in children under 6 years old – 18–90 U/I, 7–14 years old – 25–121 U/I, from 15 to 18 years old – 18–101 U/I. After 18 years, the AFP level stabilizes and is in the range of 9–67 U/I.

When is a blood test prescribed for ACE?

A laboratory blood test for angiotensin-converting enzyme is prescribed in the following cases:

Diagnosis of sarcoidosis, neurosarcoidosis (with damage to the central nervous system).
Suspicion of Gaucher disease.
Monitoring the condition in sarcoidosis.
Changes in lung tissue.
Testing the effectiveness of treatment of pulmonary diseases.
Monitoring therapy with ACE inhibitors.

Pulmonary sarcoidosis is characterized by the formation of benign granulomas (accumulations of immune cells), which increase the concentration of angiotensin-converting enzyme in the blood serum.

Women aged 20–40 years are most susceptible to this disease. An increase in ACE is observed in 70-80% of diagnostic cases. Symptoms include increased sweating (especially at night), weight loss, regular joint pain, dry cough, shortness of breath, and fatigue. Rashes and erythema (nodular) may appear on the skin.

Gaucher disease is a genetic pathology and is associated with the accumulation of glucocebroside in the tissues of the lungs, liver, kidneys, and bone marrow. Diagnosis of this disease is complicated by the manifestation of various signs and symptoms. Weakness of the limbs, pathological fractures, enlargement of the liver, spleen and disruption of their performance develop. The most accurate method for determining Gaucher disease is a blood test to detect enzymes.

Decoding the results of the analysis for ACE

A slight increase in the concentration of angiotensin-converting enzyme is observed in the following diseases:

Histoplasmosis. Fungal infection of the respiratory system, most often the lungs. Develops in people with reduced immunity and HIV-infected people.
Bronchitis (acute, chronic). An inflammatory process in the bronchi caused by viruses and bacteria.
Rheumatoid arthritis. A disease that affects connective tissues and joints. Rheumatoid damage to the lungs, kidneys, and vasculitis may develop.
Leprosy. Known in ancient times as leprosy. Chronic formation of granulomas on the skin caused by microbacteria. Diagnosing leprosy by external symptoms is quite difficult due to its similarity with other diseases (dermatomyositis, erythema nodosum).
Pulmonary fibrosis. This is the formation of scar tissue due to inflammatory processes in the lungs (tuberculosis, alveolitis, sarcoidosis, pneumonia). For an accurate diagnosis, it is necessary to conduct a comprehensive examination (X-ray, MRI, biopsy).
Cervical lymphadenitis. An inflammatory process in the lymph nodes caused by past viral and infectious diseases.

An increase in angiotensin-converting enzyme occurs in pulmonary sarcoidosis and cardiovascular diseases. AFP inhibitors are prescribed to maintain the functionality of the heart, kidneys and stabilize blood pressure in hypertension.

Reasons for low serum ACE levels may be related to hypothyroidism (endocrine system disease), emphysema, or chronic lung disease.

When decoding a blood test for ACE, it is necessary to take into account the patient’s age. In some cases, an increase in enzyme concentration occurs without the manifestation of any accompanying symptoms and in the absence of disease. To obtain an accurate result, you must follow the rules for preparing and completing the study.

How to prepare for an ACE blood test?

Preparing for analysis

If there are indications for testing the concentration of angiotensin-converting enzyme, the attending physician (phthisiatrician, pulmonologist, therapist, dermatologist) issues a referral for laboratory analysis of blood serum. The test result may be affected by taking medications - ACE inhibitors.

They reduce the real values of the enzyme in plasma: Lisinopril, Captopril, Enelapril, Ramipril, Zofenopril, Cilazapril. Therefore, 7 days before blood sampling, it is necessary to stop taking medications that affect angiotensin II.

48 hours before the test, exclude fatty foods and alcohol from the diet. It is necessary to avoid physical activity and emotional overstimulation. The study is carried out in the morning, on an empty stomach (at least 12 hours after the last meal).

To carry out the analysis, blood is taken from a vein. The analysis time depends on the research method of a particular laboratory. Units of measurement may also differ, so only a doctor can make an accurate diagnosis based on a complete examination of the patient.

Angiotensin-converting enzyme is responsible for regulating blood pressure and changes during pathological processes in various organs. A deviation from the norm in the level of ACE in a blood test indicates the development of the disease.

More information about the disease sarcoidosis can be found in the video.

In what situations is it necessary to donate blood for angiotensin-converting enzyme?

Angiotensin converting enzyme (ACE) is a specific blood enzyme. In minimal quantities it is detected in the epithelium of the kidneys. The main volume of ACE is recorded in the lungs and blood serum. The functions of the enzyme are fully explained by its name: it is “engaged” in the transformation of angiotensin.

The human body contains substances responsible for regulating tension in the walls of blood vessels and pressure indicators. They are called angiotensins. The first, biologically inactive peptide format, angiotensin-I, when interacting with ACE, transforms into angiotensin-II.

This is an important enzyme for the human body, responsible for the process of producing the hormone aldosterone. The latter, in turn, controls the state of mineral metabolism occurring in the body and regulates the contraction of blood vessels.

In addition, ACE is a blocker of the bradykinin peptide, which contributes to the expansion of the lumen of the vessel and a sharp drop in blood pressure. Another task of the angiotensin-converting enzyme is to normalize the flow of water and electrolyte metabolism.

An ACE test can be prescribed by the following specialists:

A blood test for ACE is prescribed for the following purposes:

diagnosing sarcoidosis;
in a comprehensive study to differentiate pathologies based on clinical symptoms resembling sarcoidosis;
assessing the progression of an already established disease;
monitoring the course of sarcoidosis;
assessing the effectiveness of prescribed therapy for sarcoidosis.

In addition, research can be carried out:

if a person has clinical symptoms of sarcoidosis. These are identified granulomas in tissues and organs, persistent cough without sputum discharge, redness of the eyes, joint pain, fever, weight loss, enlarged lymph nodes;
in the presence of structural changes in lung tissue identified during chest x-ray;
as monitoring the course of pathology;
during the treatment of sarcoidosis.

How to prepare for analysis

To perform the study, venous blood will be required. The analysis is carried out strictly on an empty stomach. In addition, it is advisable to donate blood for testing in the same laboratory. To get the most reliable results, you must follow the following instructions:

It is necessary to completely exclude fatty foods from the diet at least one day before visiting the laboratory;
You will need to be completely fasted for 8 to 12 hours before blood collection. Dinner should include only easily digestible foods;
completely eliminate the use of ACE inhibitors and renin a week before the date of the expected blood draw. Compliance with this condition requires agreement with the treating doctor. In some cases, discontinuation of ACE inhibitors is not possible. In this case, you must inform the laboratory technician about taking this category of drugs;
It is necessary to avoid physical activity one day before the study, i.e. visiting strength training, swimming pool, etc. forbidden. It is advisable to avoid psycho-emotional stress;
Stop smoking on the day of blood donation.

What can distort the analysis result?

It must be remembered that in childhood and adolescence, as well as in young people (up to the age of twenty), the level of ACE is initially increased. This is considered the norm. In approximately 5% of cases, enzyme activity turns out to be increased for no reason, i.e. There are no symptoms of any disease at all.

Drugs such as nicardipine and triiodothyronine can increase the ACE level in the blood serum. A decrease can be caused by taking ACE inhibitors, magnesium sulfate, propranol and prednisolone.

APF norm

Angiotensin-converting enzyme is present in the blood serum in every person. Acceptable standards depend on the patient’s age:

After a person turns 18–20 years old, the enzyme level stabilizes and remains in the range of 9–67 U/I.

A significant increase in ACE levels causes sarcoidosis to enter the active phase. As a rule, an increase of more than 60% of the norm is fixed at approximately 50 – 80%. At the same time, ACE retains normal values in lung diseases such as tuberculosis and lymphogranulomatosis.

An increase in ACE levels in the blood is typical for sarcoidosis. At the same time, the activity and number of epithelial cells of nodular inflammatory neoplasms (granulomas), which produce huge amounts of the enzyme, increase.

Sarcoidosis is a systemic pathology, the origin of which is unknown to doctors. A characteristic feature of the disease is the formation of non-caseating granulomas. The liver, eyes, lungs, lymph nodes and skin are most often affected.

The disease is diagnosed in most cases between 20 and 40 years. It can occur without any symptoms and is detected completely by accident when a person undergoes a routine chest x-ray.

The clinical picture of the pathology depends on the following factors:

localization and extent of the lesion;
process activity.

The symptoms of sarcoidosis are nonspecific and can be correlated with many diseases. This:

feverish conditions;
general malaise;
weight loss;
enlarged lymph nodes;
joint pain.

When lung tissue is damaged, a person complains of shortness of breath, persistent dry cough, and pain behind the sternum. On the skin (if it is damaged), nodules can form and diffuse infiltrative changes can be observed. With sarcoidosis of the eye, there is a constant burning sensation and redness. Photophobia also develops.

Excessively active production of ACE contributes to an increase in the amount of the enzyme not only in the blood serum, but also in the composition of the cerebrospinal fluid, as well as bronchoalveolar lavage. An increase in ACE in the blood serum of more than 60% has diagnostic significance. This indicates the presence of a significant number of granulomas in the human body.

A slight increase in the ACE value to the permissible level may occur with the following diseases:

Gaucher's disease. Hereditary pathology, accompanied by a lack of enzymes responsible for the breakdown of metabolic reaction products;
amyloidosis. Systemic pathology accompanied by dysfunction of organs;
histoplasmosis. The pathology is a fungal infection of the respiratory system. Most often, the fungus invades lung tissue. Diagnosed mainly in people with reduced immune defense, as well as in the presence of HIV infection;
acute/chronic form of bronchitis. The disease is caused by the penetration of viruses or bacteria into the bronchi;

pulmonary fibrosis of tuberculous origin. The disease is characterized by the formation of fibrous tissue in the lungs, accompanied by a failure of respiratory function;
pneumoconiosis. Irreversible and incurable occupational disease;
connective tissue pathologies, incl. rheumatoid arthritis;
diabetes. Pathology of the endocrine system, characterized by relative or complete insulin deficiency;
thyrotoxicosis. A condition characterized by a persistent increase in thyroid hormones;
Melkerson-Rosenthal syndrome. A neurological disorder accompanied by periodic paralysis and swelling of the face and lips;
psoriasis. Systemic pathology, most often accompanied by skin dermatosis;
alcoholic cirrhosis of the liver. Irreversible damage to liver tissue and death of hepatocytes;
leprosy. Formation of granulomas on the surface of the skin. The disease is of bacterial origin.

Probable reasons for the decline in indicators

The reason for a decrease in ACE levels may be:

obstructive pulmonary disease in chronic form. A progressive disease accompanied by irreversible restriction of air flow into the lungs;
emphysema. Disease of the respiratory tract, which is characterized by pathological expansion of the space of the distal bronchi;
bronchogenic lung cancer. Malignant neoplasm in lung tissue, developing from epithelial cells;

cystic fibrosis. A systemic disease that is inherited. Characterized by damage to the exocrine glands and organs of the respiratory system;
starvation or anorexia. Voluntary refusal to eat;
taking glucocorticoid drugs;
hypothyroidism Endocrine pathology, characterized by a chronic lack of thyroid hormones.

A serum ACE test is a fairly serious blood test that requires careful and, most importantly, professional interpretation. It is also worth noting that the properties of the enzyme have been studied at the proper level by medicine.

There are medications - ACE inhibitors - with which doctors keep blood pressure levels within an acceptable range. The drugs are also used to prevent the possible development of renal failure in patients with diabetes and to eliminate the consequences of myocardial infarction.

The attending physician should decipher the results obtained. Self-diagnosis is unacceptable, since to confirm the disease it is necessary to take into account other data, in particular, the medical history and the results of related tests.

Serum angiotensin converting enzyme

The enzyme, which is normally involved in the regulation of blood pressure, is synthesized in increased quantities by epithelioid granuloma cells in sarcoidosis and is an indicator of disease activity.

ACE, dipeptidyl carboxypeptidase, kinase II.

Serum Angiotensin Converting Enzyme, SACE, ACE, Kinase II, Dipeptidyl Carboxypeptidase, Peptidylpeptide Hydrolase.

Spectrophotometric method with peptide substrate.

What biomaterial can be used for research?

How to properly prepare for research?

Eliminate fatty foods from your diet 24 hours before the test.
Do not eat for 12 hours before the test.
Avoid taking renin inhibitors 7 days before the test.
Avoid physical and emotional stress for 24 hours before the test.
Do not smoke for 30 minutes before the test.

General information about the study

Angiotensin-converting enzyme (ACE) is normally produced in the epithelial cells of the lungs and is detected in small quantities in the blood vessels and kidneys. It promotes the conversion of angiotensin I into the powerful vasoconstrictor angiotensin II, which constricts blood vessels, which causes an increase in blood pressure.

In sarcoidosis, the level of ACE in the blood increases significantly and correlates with the activity of the pathological process. It is believed that in this case, ACE is produced in increased quantities by epithelioid cells of nodular inflammatory formations - granulomas.

Sarcoidosis is a systemic disease of unknown etiology, the characteristic feature of which is the formation of non-caseating granulomas in various organs and tissues. The lymph nodes, lungs, liver, skin, and eyes are mainly affected. The disease is observed more often in older people and is often asymptomatic, being detected during a preventive X-ray examination of the lungs.

The clinical picture of sarcoidosis depends on the duration of the process, the location and extent of the lesion, and the activity of the granulomatous process. Symptoms are often nonspecific: fever, malaise, weight loss, swollen lymph nodes, joint pain. When the lungs are affected, shortness of breath, dry cough, and chest pain occur. Nodular and diffuse-infiltrative changes are possible on the skin. When the eyes are affected - uveitis - there is redness and a burning sensation in the eyes, and photosensitivity. Considering the possible multiple organ damage in sarcoidosis and the similarity of the clinical picture with many diseases of various etiologies (tuberculosis, neoplasms, bacterial and some fungal infections, pneumoconiosis, systemic autoimmune diseases), correct differential diagnosis is very important in making an accurate diagnosis.

Abnormal secretion of ACE leads to an increase in its concentration not only in the blood, but also in the cerebrospinal fluid and bronchoalveolar lavage. An increase in serum ACE level by more than 60% has diagnostic significance. This parameter may correlate with the total number of granulomas in the patient’s body. The specificity of this test is more than 90%, sensitivity%. During the active phase of sarcoidosis, ACE levels may more than double. ACE remains at normal levels in other diseases with lung lesions (tuberculosis, lymphogranulomatosis). During dynamic observation, a decrease in ACE levels during treatment indicates the effectiveness of therapy and is a good prognostic sign.

What is the research used for?

Diagnosis of sarcoidosis;
differential diagnosis of diseases clinically similar to sarcoidosis;
assessment of disease activity;
monitoring the course of sarcoidosis;
evaluation of the effectiveness of treatment of sarcoidosis.

When is the study scheduled?

If there are clinical signs of probable sarcoidosis in older patients: granulomas in organs and tissues, chronic dry cough, red eyes, joint pain, fever, weight loss, swollen lymph nodes;
when changes in the structure of the lungs, similar to sarcoidosis, are detected during an X-ray examination;
when monitoring the course of the disease;
in the treatment of sarcoidosis.

What do the results mean?

Sarcoidosis in the active phase of the disease (50-80% increase in ACE by more than 60%).

A slight increase in ACE is observed in some other diseases:

Gaucher disease (hereditary storage disease)
Amyloidosis
Histoplasmosis (fungal infection of the lungs)
Acute or chronic bronchitis
Pulmonary fibrosis of tuberculous etiology
Pneumoconiosis
Rheumatoid arthritis, connective tissue diseases
Diabetes
Thyrotoxicosis
Melkersson–Rosenthal syndrome (macrocheilitis)
Psoriasis
Alcoholic liver disease, cirrhosis
Leprosy (leprosy)

Chronic obstructive pulmonary disease (COPD)
Emphysema
Bronchogenic lung cancer
Cystic fibrosis
Fasting, anorexia
Taking glucocorticosteroids
Hypothyroidism

What can influence the result?

In children, adolescents and young adults under 20 years of age, ACE levels are normally elevated. In 5% of healthy adults, enzyme activity in the blood can be increased without any signs of disease.
Medicines that increase the level of ACE in the blood: nicardipine, triiodothyronine (T3).
Medicines that reduce the level of ACE in the blood: ACE inhibitors (benazepril, captopril, lisinopril, perindopril, ramipril, fosinopril, cilazapril, enalapril), magnesium sulfate, prednisolone, propranolol.

ACE is not a particularly specific marker of sarcoidosis. An increase in ACE levels without other signs of sarcoidosis activity cannot be a criterion for initiating treatment. Also, a separate increase in ACE is not a reliable sign of sarcoidosis. A normal ACE level in the presence of granulomas in tissues does not exclude sarcoidosis.
The final diagnosis is established based on taking into account all the data from the clinical, laboratory and instrumental examination and the results of pathohistological examination of the granuloma biopsy.

Who orders the study?

Pulmonologist, phthisiatrician, dermatologist.

Fischbach F.T., Dunning M.B. A Manual of Laboratory and Diagnostic Tests, 8th Ed. Lippincott Williams & Wilkins, 2008: 1344 p.
Wilson D. McGraw-Hill Manual of Laboratory and Diagnostic Tests 1st Ed. Normal, Illinois, 2007: p. 40.

Serum angiotensin converting enzyme (ACE), blood

Preparing for the study:

7 days before the test, it is recommended to avoid taking ACE inhibitor drugs
24 hours before the test, it is recommended to exclude fatty foods from the diet, as well as physical and emotional stress.
The study must be carried out on an empty stomach
Avoid smoking 30 minutes before the test

Test material: Blood collection

Angiotensin-converting enzyme (ACE) is a glycoprotein that catalyzes the conversion of angiotensin 1 to angiotensin 2, a powerful vasoconstrictor that causes constriction of blood vessels and an increase in blood pressure.

The main sources of ACE are lung tissue, vascular endothelium, and kidney tubules. Angiotensin-converting enzyme activity has been observed to be increased in sarcoidosis, a systemic granulomatous disease that usually affects the lungs. It is believed that the level of ACE reflects the severity of sarcoidosis - 68% of positive results are observed in patients with stage 1 sarcoidosis, 86% in the second and 91% in the third stage of the disease. In 50-80% of patients with active sarcoidosis, the level of angiotensin-converting enzyme is significantly higher than normal (60% or higher). However, ACE may be increased in some other diseases and in up to 5% of the healthy adult population.

Sarcoidosis is a multisystem inflammatory disease, the cause of which is unknown. With sarcoidosis, granulomas are formed - areas of inflammation in the form of nodules, located mainly in the lungs and intrathoracic lymph nodes. In 5% of cases, sacroidosis is asymptomatic. Characteristic clinical manifestations of the disease are fever, lack of appetite, shortness of breath on exertion, cough, chest pain, and occasionally hemoptysis. Dermatological manifestations of sarcoidosis may include the formation of erythema (inflammatory lesions) of the lower extremities, rashes on the cheeks and nose. Ophthalmological symptoms of the disease include granulomatous uveitis (inflammation of the middle choroid), lesions of the conjunctiva and sclera.

A high ACE level along with radiological signs of infiltrates and/or enlarged lymph nodes suggests sarcoidosis. In inactive or chronic sarcoidosis, serum ACE levels may be slightly elevated or normal.

This test allows you to identify and determine the level of angiotensin-converting enzyme in the blood. The test helps diagnose sarcoidosis.

Information regarding the reference values of indicators, as well as the composition of the indicators included in the analysis, may differ slightly depending on the laboratory!

Diagnosis of sarcoidosis
Differential diagnosis of sarcoidosis and other lung diseases
Monitoring the course of sarcoidosis
Evaluation of the effectiveness of sarcoidosis therapy

Sarcoidosis, active stage
Gaucher disease
Rheumatoid arthritis
Amyloidosis
Thyrotoxicosis
Histoplasmosis
Leprosy

Terminal stage lung cancer
Hypothyroidism
Chronic obstructive pulmonary disease - COPD

Biomaterial: Blood serum

Completion time (in the laboratory): 1 w.d. *

Description

Angiotensin-converting enzyme (ACE) is a glycoprotein that is present mainly in the lungs and in small quantities in the brush border epithelium of the proximal tubules of the kidneys, as well as in the endothelium of blood vessels and blood plasma.

ACE, on the one hand, catalyzes the conversion of angiotensin I into one of the most powerful vasoconstrictors - angiotensin II, on the other hand, hydrolyzes the vasodilator bradykinin to an inactive peptide. Therefore, ACE inhibitor drugs are effective for lowering blood pressure in patients with hypertension, are used to prevent the development of renal failure in patients with diabetes, and improve the condition of patients with myocardial infarction.

In clinical practice, ACE activity is studied mainly to diagnose sarcoidosis and evaluate the effectiveness of drugs - ACE inhibitors.

Angiotensin-converting enzyme (ACE) is a glycoprotein that is present mainly in the lungs and in small quantities in the brush border of the epithelium of the lungs.

Indications for use

Diagnosis of sarcoidosis,
Evaluation of the effectiveness of drugs - ACE inhibitors.

Preparing for the study

Blood is drawn on an empty stomach. At least 8 hours should pass between the last meal and blood collection (preferably at least 12 hours). Juice, tea, coffee are not allowed. You can drink water.

Interpretation of results/Information for specialists

Increased activity of angiotensin-converting enzyme: sarcoidosis, acute and chronic bronchitis, pulmonary fibrosis, rheumatoid arthritis, connective tissue diseases, hyperthyroidism, fungal diseases.

Decreased activity of angiotensin-converting enzyme: late stages of lung cancer, tuberculosis.

* The website indicates the maximum possible period for completing the study. It reflects the time it takes to complete the study in the laboratory and does not include the time for delivery of the biomaterial to the laboratory.
The information provided is for reference only and is not a public offer. For up-to-date information, contact the Contractor's medical center or call center.

Angiotensin converting enzyme (ACE, angiotensin converting enzyme)- regulator of the activity of the renin-angiotensin system, which plays a key role in the regulation of blood pressure, water and electrolyte metabolism in humans. In laboratory diagnostics it is mainly used to assess the activity of the disease and diagnose sarcoidosis.

ACE - found mainly in lung tissue. It is found in small quantities in the epithelium of the proximal tubules of the kidneys and vascular endothelium. Currently found in almost all tissues. ACE is involved in the formation of angiotensin II from angiotensin I.
Under the influence of the kidney enzyme renin, the decapeptide, angiotensin I, is cleaved from angiotensinogen. Further, under the action of the ACE enzyme in the blood serum, a dipeptide is cleaved from angiotensin I and a powerful blood pressure regulator is formed, angiotensin II, the excess of which causes essential hypertension. In addition, ACE destroys bradykinin, a low molecular weight peptide that leads to a decrease in blood pressure.

Unlike its predecessor (angiotensin I), angiotensin II has high biological activity. Angiotensin II has a strong vasoactive effect (influence on blood vessels), leading to vasoconstriction and increased blood pressure.

Angiotensin-converting enzyme (ACE) in the blood is a specific enzyme present in small quantities in the epithelial tissue of the kidneys, in the main quantity in the human lungs, and also in the blood serum. The name of the enzyme contains an explanation of its functions. ACE is indeed capable of converting angiotensin to its other form. Regulators of vascular tension and pressure are angiotensins. The first biologically inactive form - angiotensin-I, with the help of ACE, is transformed into angiotensin-II, which performs important functions: it activates the formation of the hormone responsible for the state of mineral metabolism - aldosterone and regulates the contraction of blood vessels. We can say that angiotensin-II is a threat to all hypertensive patients, since it is it that is involved in increasing blood pressure

In addition to the fact that angiotensin-converting enzyme converts angiotensin, it also neutralizes the effect of a peptide that dilates blood vessels and reduces blood pressure - this is bradykinin. ACE is responsible in particular for both water and electrolyte metabolism.

When angiotensin-converting enzyme (ACE) levels in the blood are outside the normal range, it is an indicator of many health problems.

An analysis for angiotensin-converting enzyme (ACE) in the blood is prescribed for diagnosis:

Benign lymphogranulomatosis (Besnier-Böck-Schaumann disease, sarcoidosis) since ACE functions mainly in the lungs.
To adjust therapeutic measures for sarcoidosis.
Adjustments to therapy with ACE inhibitors.
A rare autosomal recessive disease is Gaucher disease, as well as leprosy.

Angiotensin-converting enzyme (ACE) in the blood depends on age and should normally be:

In children from one to 12 years old - no more than 37 units/l.
In older children: from 13 to 16 years old - from 9 to 33.5 units/l.
In people over 16 years of age – from 6 to 26.6 units/l.

Angiotensin-converting enzyme (ACE) in the blood is determined using serum biochemical testing. The analysis is carried out only in the morning, on an empty stomach.

The following factors may influence the results of ACE:

Taking medications containing acetate, chloride, bromide, nitrate, and triiodothyronine can significantly increase ACE levels.
Taking medications such as ramipril, enalapril, perindopril, captopril can significantly reduce ACE levels.

Angiotensin-converting enzyme (ACE) in the blood significantly exceeding normal limits may mean:

Benign lymphogranulomatosis.
Acute course of bronchitis.
Pulmonary fibrosis, tuberculosis.
Arthritis, including rheumatoid.
Lymphadenitis (including cervical).
Mycoses (histoplasmosis).
Gaucher's disease.
Hyperthyroidism is chronic.

Angiotensin-converting enzyme (ACE) in the blood significantly below the normal limit indicates:

Terminal stages of the oncological process.
Lung pathologies (obstruction).
Terminal stage of tuberculosis.

Angiotensin-converting enzyme (ACE) in the blood is certainly a serious analytical study that requires careful and competent interpretation. Despite such serious and alarming previous information, it should be noted that the properties of ACE are quite well studied and drugs - ACE inhibitors - have long been developed, with the help of which medicine controls hypertension, prevents renal failure in diabetics and the consequences of myocardial infarction.

When is the test prescribed?

Diseases:

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