Angiotensin-Converting Enzyme Inhibitor-Associated Angioedema: From Bed to Bench

被引:6
作者
Carucci, L. [1 ]
Bova, M. [2 ,3 ]
Petraroli, A. [2 ,3 ]
Ferrara, A. L. [2 ,3 ]
Sutic, A. [4 ]
de Crescenzo, G. [5 ]
Cordisco, G. D. [6 ]
Margaglione, M. [6 ]
Gambardella, J. [7 ]
Spadaro, G. [1 ,2 ,3 ]
Genovese, A. [1 ,2 ,3 ]
Loffredo, S. [2 ,3 ,8 ]
机构
[1] Univ Naples Federico II, Postgrad Program Clin Immunol & Allergy, Naples, Italy
[2] Univ Naples Federico II, Dept Translat Med Sci, Via S Pansini 5, I-80131 Naples, Italy
[3] Univ Naples Federico II, Interdept Ctr Res Basic & Clin Immunol Sci, Via S Pansini 5, I-80131 Naples, Italy
[4] Univ Zagreb, Univ Hosp Dubrava, Div Clin Immunol Allergol & Rheumatol, Dept Internal Med,Sch Med, Zagreb, Croatia
[5] St Anna & San Sebastiano Hosp, Div Clin Immunol & Allergy, Caserta, Italy
[6] Univ Foggia, Dept Clin & Expt Med, Med Genet, Foggia, Italy
[7] Univ Salerno, Dept Med & Surg, Salerno, Italy
[8] CNR, Inst Expt Endocrinol & Oncol G Salvatore, Naples, Italy
关键词
Angiotensin-converting enzyme inhibitor; Angioedema; Vascular endothelial growth factor C; Vascular endothelial growth factor A; Phospholipases A(2); Genetic analysis; C1-inhibitor; Biomarkers; ENDOTHELIAL GROWTH-FACTOR; VASCULAR-PERMEABILITY; HYPERTENSION; DIAGNOSIS; MUTATION; PLASMA;
D O I
10.18176/jiaci.0458
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Angiotensin-converting enzyme inhibitor-associated angioedema (ACEI-AAE) affects 0.1%-0.7% of patients treated with ACEIs. While previous research suggests that angioedema attacks result from increased vascular permeability, the pathogenesis is not completely understood. Objective: This study aimed to describe the clinical, genetic, and laboratory parameters of ACEI-AAE patients and to investigate the role of vascular endothelial growth factors A and C (VEGF-A and VEGF-C), angiopoietins 1 and 2 (Ang1/Ang2), and secretory phospholipase A(2) (sPLA(2)) in the pathogenesis of ACEI-AAE. Methods: The clinical and laboratory data of ACEI-AAE patients were collected from 2 angioedema reference centers. Healthy volunteers and ACEI-treated patients without angioedema were enrolled to compare laboratory parameters. Genetic analyses to detect mutations in the genes SERPING1, ANGPT1, PLG, and F12 were performed in a subset of patients. Results: A total of 51 patients (57% male) were diagnosed with ACEI-AAE. The average time to onset of symptoms from the start of ACEI therapy was 3 years (range, 30 days-20 years). The most commonly affected sites were the lips (74.5%), tongue (51.9%), and face (41.2%). Switching from ACEIs to sartans was not associated with an increased risk of angioedema in patients with a history of ACEI-AAE. VEGF-A, VEGF-C, and sPLA2 plasma levels were higher in ACEI-AAE patients than in the controls. Ang1/2 concentrations remained unchanged. No mutations were detected in the genes analyzed. Conclusions: Our data suggest that sartans are a safe therapeutic alternative in ACEI-AAE patients. Increased concentrations of VEGF-A, VEGF-C, and sPLA(2) in ACEI-AAE patients suggest a possible role of these mediators in the pathogenesis of ACEI-AAE.
引用
收藏
页码:272 / 280
页数:9
相关论文
共 33 条
[1]  
AHMAD S, 1992, J PHARMACOL EXP THER, V260, P1257
[2]   Management of Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema [J].
Al-Khudari, Samer ;
Loochtan, Michael J. ;
Peterson, Edward ;
Yaremchuk, Kathleen L. .
LARYNGOSCOPE, 2011, 121 (11) :2327-2334
[3]   Mutation of the angiopoietin-1 gene (ANGPT1) associates with a new type of hereditary angioedema [J].
Bafunno, Valeria ;
Firinu, Davide ;
D'Apolito, Maria ;
Cordisco, Giorgia ;
Loffredo, Stefania ;
Leccese, Angelica ;
Bova, Maria ;
Barca, Maria Pina ;
Santacroce, Rosa ;
Cicardi, Marco ;
Del Giacco, Stefano ;
Margaglione, Maurizio .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2018, 141 (03) :1009-1017
[4]   Multicenter study of patients with angiotensin-converting enzyme inhibitor-induced angioedema who present to the emergency department [J].
Banerji, Aleena ;
Clark, Sunday ;
Blanda, Michelle ;
LoVecchio, Frank ;
Snyder, Brian ;
Camargo, Carlos A., Jr. .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2008, 100 (04) :327-332
[5]   The Angiotensin-Converting-Enzyme-Induced Angioedema [J].
Bas, Murat .
IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2017, 37 (01) :183-+
[6]   Long-term follow-up of 111 patients with angiotensin-converting enzyme inhibitor-related angioedema [J].
Beltrami, Laura ;
Zanichelli, Andrea ;
Zingale, Lorenza ;
Vacchini, Romualdo ;
Carugo, Stefano ;
Cicardi, Marco .
JOURNAL OF HYPERTENSION, 2011, 29 (11) :2273-2277
[7]   VEGF stimulation of endothelial cell PAF synthesis is mediated by group V 14 kDa secretory phospholipase A2 [J].
Bernatchez, PN ;
Winstead, MV ;
Dennis, EA ;
Sirois, MG .
BRITISH JOURNAL OF PHARMACOLOGY, 2001, 134 (01) :197-205
[8]   Hereditary angioedema with a mutation in the plasminogen gene [J].
Bork, K. ;
Wulff, K. ;
Steinmueller-Magin, L. ;
Braenne, I. ;
Staubach-Renz, P. ;
Witzke, G. ;
Hardt, J. .
ALLERGY, 2018, 73 (02) :442-450
[9]   Angiotensin-converting enzyme inhibitor-induced angioedema: A review of the literature [J].
Brown, Teresa ;
Gonzalez, Jimmy ;
Monteleone, Catherine .
JOURNAL OF CLINICAL HYPERTENSION, 2017, 19 (12) :1377-1382
[10]   Dipeptidyl peptidase IV deficiency increases susceptibility to angiotensin-converting enzyme inhibitor-induced peritracheal edema [J].
Byrd, James Brian ;
Shreevatsa, Ajai ;
Putlur, Pradeep ;
Foretia, Denis ;
McAlexander, Laurie ;
Sinha, Tuhin ;
Does, Mark D. ;
Brown, Nancy J. .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2007, 120 (02) :403-408