Acute adverse reactions associated with angiotensin-converting enzyme inhibitors: genetic factors and therapeutic implications

Expert Opin Pharmacother. 2005 Sep;6(11):1851-6. doi: 10.1517/14656566.6.11.1851.

Abstract

Angiotensin-converting enzyme inhibitors (ACEIs) have been used in the treatment of various cardiovascular diseases. Despite the therapeutic benefits of ACEIs, there are several reported side effects, including chronic cough, angioedema and anaphylactoid reactions. These adverse events cannot be explained by the vasodilatory effects of this group of medications. Preliminary studies have shown that patients with a history of developing these side effects have a lower activity of an enzyme called aminopeptidase-P. This enzyme has an important role in degrading bradykinin. This defect in enzymatic activity can be partially explained by genetic variation. Using genome-wide screening strategies, the locus (loci), gene(s) and untimely polymorphisms that explain the low enzymatic activity and side effects can be identified.

Publication types

  • Review

MeSH terms

  • Aminopeptidases / genetics
  • Aminopeptidases / metabolism
  • Anaphylaxis / chemically induced*
  • Anaphylaxis / enzymology
  • Anaphylaxis / genetics
  • Angioedema / chemically induced*
  • Angioedema / enzymology
  • Angioedema / genetics
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Bradykinin / metabolism
  • Cough / chemically induced*
  • Cough / enzymology
  • Cough / genetics
  • Humans
  • Lysine Carboxypeptidase / genetics
  • Lysine Carboxypeptidase / metabolism
  • Mutation
  • Peptidyl-Dipeptidase A / metabolism
  • Polymorphism, Genetic

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Aminopeptidases
  • X-Pro aminopeptidase
  • Peptidyl-Dipeptidase A
  • Lysine Carboxypeptidase
  • Bradykinin