Serum Angiotensin Converting Enzyme in Crohn's Disease, Ulcerative Colitis and Peptic Ulceration

Abstract

Serum angiotensin converting enzyme (ACE) activities were determined in patients with different types of inflammatory disease of the gastrointestinal tract, in patients with peptic ulcer, and in healthy volunteer subjects. ACE activity in serum was measured by its in vitro ability to cleave hippuric acid from the synthetic tripeptide hippuryl-L-histidyl-L-leucine. The hippuric acid so formed was quantified by high performance liquid chromatography and results are expressed as nmol hippuric acid produced/ml plasma/min. ACE activity was 27.4 +/- 7.7 (mean +/- SD, n = 37) in control subjects and was not related to age or sex. Compared to controls, patients with ulcerative colitis had similar ACE values (26.5 +/- 7.7, n = 16) while, surprisingly, there was a significant (p less than 0.01) increase in the enzyme in those with active peptic ulcers (33.8 +/- 8.8, n = 21) irrespective of whether the site of ulceration was gastric or duodenal. In a mixed group of patients with active and inactive Crohn's disease, ACE activity (24.8 +/- 7.2, n = 19) was not different from controls. However, ACE activity was significantly (p less than 0.02) depressed in active Crohn's disease (19.8 +/- 7.3, n = 8) compared to either control subjects or patients with inactive disease (28.4 +/- 6.3, n = 9). There was wide inter-patient variability in ACE levels and hence the diagnostic value of random measurements of this enzyme in Crohn's disease is limited.

Hypercalcaemia due to isolated elevation of 1,25-dihydroxyvitamin D in patients with Crohn’s disease

“…Additionally, an increased ACE inhibitor level is a common feature and a useful therapeutic marker in patients with sarcoidosis and hypercalcaemia 17. However, the significance of elevated ACE levels in patients with Crohn’s disease remains to be determined 18 19. This patient responded adequately to the prednisone treatment; therefore, we did not measure the serum ACE levels.…”

Colon Sarcoidosis Responds to Methotrexate: A Case Report with Review of Literature

“…SACE levels when available are useful as the sensitivity ranges from 58% to 86% and specificity as high as 90% in sarcoidosis [23,24]. In contrast, many studies investigating SACE levels in Crohn's disease found it to be normal or low [23][24][25][26][27][28][29]. Seven of 8 cases reviewed that measured SACE had elevated levels (87.5%).…”