Description

Angiotensin-converting enzyme (ACE) is an enzyme primarily found in endothelial cells (cells lining blood vessels) and epithelial cells (cells covering the body’s surfaces). It plays a crucial role in the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure, fluid balance, and electrolyte homeostasis.

The main function of ACE is to convert angiotensin I, a relatively inactive precursor peptide, into angiotensin II, a potent vasoconstrictor. Angiotensin II promotes vasoconstriction (narrowing of blood vessels), which increases blood pressure. Additionally, angiotensin II stimulates the release of aldosterone from the adrenal glands, leading to sodium and water retention in the kidneys, further increasing blood volume and pressure.

Measurement of ACE levels in the blood can be used in clinical settings for various purposes:

1. Sarcoidosis diagnosis and monitoring: Elevated ACE levels are often observed in individuals with sarcoidosis, a multisystem inflammatory disorder characterized by the formation of granulomas (small clumps of inflammatory cells). Monitoring ACE levels can aid in the diagnosis and assessment of disease activity in sarcoidosis patients.
2. Granulomatous diseases: Apart from sarcoidosis, ACE levels may be elevated in other granulomatous diseases, such as tuberculosis and histoplasmosis. However, the diagnostic utility of ACE testing in these conditions is less specific compared to sarcoidosis.
3. Hypertension and cardiovascular risk: Some studies suggest a potential association between ACE levels and hypertension, cardiovascular risk, and heart failure. However, ACE levels are not routinely measured for the diagnosis or management of these conditions, as other biomarkers and diagnostic tests are typically used.

It’s important to note that while elevated ACE levels can provide valuable diagnostic information, they are not specific to any one condition and must be interpreted in conjunction with clinical findings, medical history, and other diagnostic tests. Additionally, normal ACE levels do not rule out the presence of certain diseases, as ACE levels can vary among individuals and may be influenced by factors such as age, sex, and medications.