Objectives To investigate the levels of angiotensin-converting enzyme (ACE) and anti-angiotensin-converting enzyme antibodies (ACEab) in patients with systemic sclerosis (SSc).
Methods Thirty five patients with systemic sclerosis, age 50,0 ± 11,7 (mean ± SD), range 27–71 years, were included in the study. Duration of disease ranged from 1 to 20 years, means 7,0 ± 5,2. Thirteen pts had diffuse systemic sclerosis (dSSc), twenty two had limited systemic sclerosis (lSSc). Ten healthy subjects were selected as controls. Spectrofluorimetry for detection of ACE and ELISA for ACEab were used.
Results We revealed the two-fold lower levels of ACE in SSc pts compared with controls (0,022 ± 0,021 vs 0,044 ± 0,028; ð = 0,012). There were no differences in ACE values observed between the dSSc and lSSc groups (0,019 ± 0,017 and 0,024 ± 0,024 respectively). The lowest levels of ACE were found in SSc pts treated with inhibitors of ACE (0,013 ± 0,010), but was not statistically different from those of untreated SSc pts. In SSc pts, a positive correlation was detected between the levels of ACE and erythrocyte sedimentation rate (r = 0,505; p = 0,019), fibrinogen (r = 0,578; p = 0,015), titers of antinuclear antibodies (r = 0,529; p = 0,029).
The levels of ACEab in SSc pts were similar to those of the control group (0,180 ± 0,190 and 0,208 ± 0,057, respectively). However, the ACEab levels in pts with dSSc were significantly higher than those in lSSc pts (0,29 ± 0,24 vs 0,14 ± 0,16; p = 0,041). Comparable to lSSc group impaired results were also seen in pts treated with ACE inhibitors (0,1642 ± 0,1093). The ACEab levels positively correlated with ANA titers only in dSSc pts (r = 0,835; p = 0,019). There was no relation between the ACE and ACEab levels neither in SSc pts nor in controls.
Conclusion ACEab can be involved in pathogenesis of SSc and further investigation is needed.
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