Elevated Levels of Circulating Angiotensin Converting Enzyme in Patients with Hepatoportal Sclerosis

Beyazıt, Yavuz; İbi̇ş, Mehmet; Pürnak, Tuğrul; Turhan, Turan; Kekilli, Murat; Kurt, Mevlüt; Sayılır, Abdurrahim; Önal, İbrahi̇m Koral; Turhan, Nesrin; Taş, Adnan; Köklü, Seyfettin; Haznedaroğlu, İbrahim C.

doi:10.1007/s10620-011-1580-7

Cited by 19 publications

(13 citation statements)

References 34 publications

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“…14,15 We verified the importance of the RAS system in portal hypertension due to hepatoportal sclerosis and we reported that the circulating ACE level might have a role in creating vasospasm in microcirculation due to circulating ACE in hepatoportal sclerosis related portal hypertension in our previous study. 8 Corey et al 16 studied the effect of Ang-blocking agents on liver fibrosis in patients with hepatitis C and concluded that less fibrosis was related to the protective role of ACE inhibitors in the patients. Moreover, a review performed by Koh et al 17 stressed some potential benefits of the inhibition of the RAS system in liver injury and fibrosis.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 The role of angiotensin (Ang) has also shown to be implicated in the pathogenesis of liver disorders in some studies. 8,9 Moreover, angiotensin-converting enzyme (ACE), a vital part of the RAS system, is also cogitated as a governing molecule in systemic and portal circulation in some disorders. 8 The first aim of the study is to investigate the role of circulating ACE in the context of RAS in newly diagnosed chronic hepatitis B (CHB) infection.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Moreover, angiotensin-converting enzyme (ACE), a vital part of the RAS system, is also cogitated as a governing molecule in systemic and portal circulation in some disorders. 8 The first aim of the study is to investigate the role of circulating ACE in the context of RAS in newly diagnosed chronic hepatitis B (CHB) infection. Moreover the association between liver fibrosis and serum ACE levels was also investigated.…”

Section: Introductionmentioning

confidence: 99%

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Serum angiotensin-converting enzyme level as a marker of fibrosis in patients with chronic hepatitis B

Pürnak

Beyazıt

Öztaş

et al. 2012

J Renin Angiotensin Aldosterone Syst

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Background and aims: Hepatitis B virus (HBV) infection is a public health problem and affects nearly 350 million people worldwide. The present study was conducted in order to investigate the role of circulating angiotensin-converting enzyme (ACE) in the context of renin-angiotensin-aldosterone in newly diagnosed chronic hepatitis B infection. Moreover the association between liver fibrosis and serum ACE levels was also investigated. Materials and methods:The study was performed on 50 chronic hepatitis B (CHB) patients (24 males, 26 females; median age 39.4 years, range 18-63) and 20 healthy controls. The clinical features of CHB patients including demographics, laboratory and liver biopsy findings were summarized. Serum ACE levels were measured by using commercially available kits. Results: Serum median ACE levels were 48.4 (14-83) U/L and 26.2 (12-48) U/L for the CHB patients and controls, respectively. Serum ACE levels were significantly higher in patients with CHB compared with the control group (p<0.001). Twenty-two patients (44%) had advanced liver fibrosis (Ishak score >2) and 28 patients (56%) had mild liver fibrosis (Ishak score ≤ 2). Mean serum levels of ACE were significantly higher among patients with advanced fibrosis as compared with those without advanced fibrosis (60.3±14.2 U/L vs. 39.0±10.5 U/L, p<0.001). Receiver operating characteristic (ROC) curve analysis suggested that the optimum ACE level cut-off point for advanced fibrosis was 52.5 U/L (sensitivity: 81.8%, specificity: 82.1%, PPV 78.3%, NPV 85.2%, accuracy 82%, AUC: 0.890). Conclusions: Our study showed that elevated circulating ACE levels are commonly observed in CHB patients. This finding was more prominent in patients with advanced fibrosis in liver. When evaluating a patient along with other parameters, the inclusion of ACE levels in the evaluation of CHB patients may grant additional prognostic information.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum angiotensin-converting enzyme level as a marker of fibrosis in patients with chronic hepatitis B

Pürnak

Beyazıt

Öztaş

et al. 2012

J Renin Angiotensin Aldosterone Syst

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“…During the progression of chronic liver diseases, AT-II is considered to be a potential mediator of portal hypertension. It has been reported that AT-II plasma levels are clinically increased in patients with cirrhosis, and an animal study has shown the elevation of the portal pressure by AT-II administration [37,38].…”

Section: Raas Blockersmentioning

confidence: 99%

Antiangiogenic Therapy for Hepatocellular Carcinoma

Kaji¹,

Yoshiji²

2017

Physiologic and Pathologic Angiogenesis - Signaling Mechanisms and Targeted Therapy

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Angiogenesis plays a pivotal role in many pathological processes, including hepatocellular carcinoma (HCC). This indicates that antiangiogenic agents could be promising candidates for chemoprevention against HCC. Several inhibitors targeting receptor tyrosine kinases (RTKs) for the regulation of tumoral vascularization have been developed and employed in clinical practice, including sorafenib. However, there seem to be several issues for the long-term use of this agent as some patients have experienced adverse effects while taking sorafenib. Therefore, it is desirable for patients with chronic liver diseases to be administered sorafenib as little as possible by combining other safe-to-use antiangiogenic compounds. Various factors, such as renin-angiotensin-aldosterone system (RAAS) and insulin resistance (IR), reciprocally contribute to the promotion of angiogenesis. A blockade of RAAS with an angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin-II (AT-II) receptor blocker (ARB) markedly attenuates HCC in conjunction with the suppression of angiogenesis. Moreover, the IR status has demonstrated direct acceleration in the progression of HCC via the augmentation of tumoral neovascularization. These findings suggest that a combination therapy involving a lower dose of sorafenib with other clinically used agents [e.g., RAAS blockers, insulin sensitizer agents, and branched-chain amino acids (BCAA)] may reduce the adverse effects of sorafenib without attenuating the inhibitory effect against HCC in comparison to a high-dose administration.

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“…Because macrophage could produce ACE for the synthesis of Ang-II [5]. Ang-II increases the production of TNF, IL-1β the infiltration of CD43+ inflammatory cells which are inflammatory proteins [36].…”

Section: The Function Of Local Renin-angiotensin Systems In the Livermentioning

confidence: 99%

Local Renin-Angiotensin System at Liver and Crosstalk with Hepatic Diseases

Taşkın¹,

Güven²

2017

Renin-Angiotensin System - Past, Present and Future

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The systemic renin-angiotensin system mainly regulates blood pressure and maintains kidney function. Recent studies have realized that renin-angiotensin system (RAS) has been found in many tissues, such as heart, liver, and kidney. Although RAS in heart and kidney has been well documented, the RAS in the liver has been evaluated in a few studies. Therefore, this chapter will be assessed it. Based on findings, RAS in the liver has presented almost all of its components, such as angiotensin-I (Ang-I), angiotensin-II (Ang-II), angiotensin-converting enzyme (ACE), angiotensin type-1 receptor (AT1), angiotensin type-2 receptor (AT2), named as classical RAS. Expect these components, the local RAS has had alternative pathway components, including angiotensin-converting enzyme 2 (ACE2) and chymase. Classical RAS has an opposite effect of alternative RAS.Although these local RAS might not be such a crucial for the tissue, it could be a more vital function under pathophysiologic conditions. The chapter the local RAS in the liver the under both physiologic and pathophysiologic conditions is highlighted.

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Elevated Levels of Circulating Angiotensin Converting Enzyme in Patients with Hepatoportal Sclerosis

Cited by 19 publications

References 34 publications

Serum angiotensin-converting enzyme level as a marker of fibrosis in patients with chronic hepatitis B

Serum angiotensin-converting enzyme level as a marker of fibrosis in patients with chronic hepatitis B

Antiangiogenic Therapy for Hepatocellular Carcinoma

Local Renin-Angiotensin System at Liver and Crosstalk with Hepatic Diseases

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