The role of insertion-deletion polymorphism of the ACE gene in development of arterial hypertension in patients with chronic obstructive pulmonary disease

Inna Krynytska,Khrystyna Maksiv,Mariya Koval,Mariya Marushchak

doi:10.3329/bjms.v19i3.45873

Abstract

Objective. This study aims to establish the role of insertion-deletion polymorphism of the angiotensin-converting enzyme gene in development of arterial hypertension in patients with chronic obstructive pulmonary disease. Materials and Methods: The study group consisted of 96 patients: Group 1 (25 individuals with COPD), Group 2 (23 individuals with AH), Group 3 (28 individuals with COPD and AH). The control group consisted of the 20 healthy subjects. I/D genotypes of ACE were determined by polymerase chain reaction (PCR) amplification. Plasma ACE activity was determined photometrically by a commercially available kit. Results and Discussion: The distribution of polymorphic variants of the ACE gene among COPD-only patients genotype spreading was close to the data obtained in controls. In hypertensive patients, there were fewer ID heterozygotes and more ІІ homozygotes compared to controls. In the COPD+AH category of patients, II genotype was predominant in 7.1% subjects, DD genotype was predominant in 10.0% subjects and the proportion of ID heterozygotes was 17.1% lower compared to controls. The II genotype had a positive relationship with patient age and a negative relationship with body weights and respiratory rates of COPD+AH patients. The ID genotype was associated with increased respiratory rates; however, its correlation with the duration of the disease was negative. Conclusion: The data obtained in the study allow suggesting that polymorphism of the ACE gene doesn’t relate to development of AH in patients with COPD. The highest activity of ACE was found in patients with combination of COPD and AH; maximum findings of ACE activity were seen in patients with DD genotype. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.543-551

Highlights

Chronic obstructive pulmonary disease (COPD) is defined by the American Thoracic Society as a progressive and partially reversible disease of respiratory tract featured by the limitation of airflow that takes place as a result of chronic bronchitis or emphysema[1]
The insertion homozygotes (II) genotype had a positive relationship with patient age and a negative relationship with body weights and respiratory rates of COPD + Arterial hypertension (AH) patients
Our preliminary results suggest a high incidence of COPD combined with AH, since among 143 patients with Stage 2 COPD 28.67% had no comorbidities; in 27.27% of patients, the course of their underlying disease was accompanied by Stage I AH and in 43.36% of patients COPD was associated with other comorbidities[33]

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is defined by the American Thoracic Society as a progressive and partially reversible disease of respiratory tract featured by the limitation of airflow that takes place as a result of chronic bronchitis or emphysema[1]. The role of insertion-deletion polymorphism of the ACE gene in development of arterial hypertension in patients with chronic obstructive pulmonary disease infections are considered as risk factors of COPD4-8. No data for association between gene polymorphism and arterial hypertension in patients with COPD in Ukraine have ever been internationally published.

Results

Conclusion