Angiotensin-converting enzyme is a biologically active substance contained in the human body and is involved in many physiological reactions. In particular, it regulates water-s alt metabolism and controls blood pressure by constricting or expanding blood vessels. Therefore, it is extremely important to control its work, especially for older patients, because it is they who suffer the most from high blood pressure and its sharp fluctuations.
General information about ACE
Angiotensin-converting enzyme is actively involved in metabolism. He does this by influencing the so-called renin-angiotensin system, which is also responsible for regulating blood pressure.
The mechanism of enzyme action is rather complicated. If we describe it in a nutshell, then it consists in influencing the process of converting angiotensin-I into angiotensin-II, which has biologically active properties. In particular, it directly affects the levelblood pressure and contributes to its increase, constricting blood vessels. It is because of its main function of converting one angiotensin to another that the enzyme discussed in the article got its name.
If we talk about where angiotensin-converting enzyme is produced, then there are two main places for its synthesis in the body: lung tissue (the main place of appearance) and renal tubules (in a small amount). After synthesis, the substance is evenly distributed in almost all tissues of the body.
Indications for diagnosing activity
According to the level of angiotensin-converting enzyme activity, experts conclude that there are some diseases, not all of which are related to blood pressure. We can talk about such ailments:
- Sarcoidosis.
- Respiratory diseases such as bronchitis and pulmonary fibrosis.
- Rheumatoid arthritis.
- Chronic liver or kidney disease.
- Amyloidosis.
- Diabetes mellitus and others
In some cases, the analysis is prescribed to monitor the effectiveness of angiotensin-converting enzyme inhibitors. This is quite rare, but for a patient whose he alth may depend on drugs in this group, the analysis becomes a very important diagnostic procedure.
Angiotensin-converting enzyme drugs
ACE inhibitors are the most popular group of medicines that are used forpressure control by people around the world. They are both medicines for emergency therapy ("Captopril") and drugs for the treatment of courses ("Enalapril", "Lizinopril"). The essence of their action is that they slow down the production and effect of ACE on angiotensin-I, preventing it from turning into an active form and, accordingly, preventing an increase in blood pressure.
Preparing for the study
Angiotensin converting enzyme test does not require any major preparation steps. The enzyme is determined in venous blood, so preparation for blood sampling is carried out according to standard recommendations for any such study:
- The patient should only give blood on an empty stomach, and therefore it is recommended that he refrain from eating for 12 hours before traveling to the laboratory for blood sampling.
- It is necessary to exclude smoking and drinking alcohol the day before blood sampling, as these substances can affect the level of the enzyme.
- Stress should be avoided, as the reaction to nervous tension can affect a variety of body functions, for example, increasing the effect of ACE on pressure.
In what cases is the level of ACE increased
When a patient develops the diseases described above (sarcoidosis, respiratory diseases), the amount of angiotensin-converting enzyme in the blood increases significantly. However, sarcoidosis is currently the leading reason for testing.
The exact etiology of the disease is still unclear, but it is known that when sarcoidosis occurs, ACE-producing granulomas begin to appear in the lymph nodes. A significant increase in the level of the enzyme can be recorded and used as a diagnostic sign in identifying the disease.
With significant deviations of the ACE level upwards, the doctor prescribes additional diagnostic procedures to confirm or refute the alleged diagnosis. Therefore, on the basis of only one analysis, it is impossible to say with certainty whether a patient has such a serious disease as sarcoidosis.
Angiotensin-converting enzyme norm
In order to interpret the results of the analysis, it is necessary to know the normal values for the enzyme. Analysis should show results displayed in U/L.
The norms of the enzyme in patients of different age categories are different. The value for children under 12 years old is from 9.4 to 37 units / l. Adolescents 13-16 years old already have a little less active ACE in the blood. For them, the norm is from 9.0 to 33.4 units / l. For adults, values from 6.1 to 26.6 units / l are considered good indicators.
Is a high ACE level always a marker of a serious illness
The answer to this question depends on how much the rate is increased. In the case of sarcoidosis, ACE is increased significantly, since granulomas actively produce it in the body. A slight increase may mean the presence in the body of diseases of the respiratory tract (including bronchitis), rheumatoid arthritis,diabetes and many other diseases. It is important to know that the ACE level is not the only factor by which the doctor concludes the presence of a particular disease.
Any patient whose values of this indicator are too high should undergo additional specific diagnostics. With the help of these studies, doctors make the final diagnosis.
Why the level of enzyme activity can be increased
For a long time, doctors could not pinpoint the reasons why some people have excessively elevated levels of ACE, while others do not have any problems with this enzyme.
However, recent genetic studies in this direction have revealed the gene for angiotensin-converting enzyme. This is the so-called ACE gene, which appears due to a small mutation and causes increased ACE synthesis in the body.
This gene contributes to the appearance of not only high blood pressure in humans, but also many other cardiovascular pathologies. This pathology can appear at any age. However, the researchers are very careful to draw any conclusions from their discovery, as repeated experiments have given very conflicting information.
In particular, some scientists found a dependence of the level of ACE on gender or race, while others did not reveal such a relationship. Therefore, scientists suggest that for more accurate research results, an additional criterion may be required to filter out factors that affect the course of the experiment.
But the difficulties with accurate results do not reduce the hope that soon the reasons for the increase in angiotensin-converting enzyme in the human body will be clarified. Perhaps in the future, gene therapy will help people in the treatment of diseases such as arterial hypertension and angina pectoris. At the present stage, these diseases are treated exclusively with symptomatic therapy. If the causes of the increase in blood levels of ACE can be identified, patients can get rid of their problems with one short course of treatment.
