Cholangitis of Pancreatitis? Does the Angiotensin-Converting Enzyme Genotype Favor Either?

Cholangitis of Pancreatitis? Does the Angiotensin-Converting Enzyme Genotype Favor Either?Acute cholangitis and pancreatitis are serious complications of gallstones, with considerable morbidity and mortality. Angiotensin-converting enzyme (ACE) is an exopeptidase that is important in regulating blood pressure, metabolizing bradykinin and in maintaining an inflammatory response. To determine whether the ACE genotype determines occurrence of cholangitis or pancreatitis we examined ACE I/D genotypes in 31 patients who had cholangitis, 44 patients with biliary pancreatitis and 157 healthy individuals. The patients had been hospitalized at the Department and Intensive Care Faculty of Medicine, Ege University, Izmir, Turkey. The patients were recalled 4 years later and their prognosis was evaluated. The ACE II genotype was found at a higher frequency in the cholangitis and biliary pancreatitis patients when compared with the healthy subjects (p <0.05). There was no significant difference between cholangitis and biliary pancreatitis cases regarding the genotype and allele distribution (p >0.05). Recurrence of infection occurred more frequently in the patients with the DD genotype, although it was not significant according to the first assessment (p >0.05). The ACE gene polymorphism did not seem to favor development of either cholangitis or pancreatitis.

Angiotensin-Converting Enzyme Genotype and Acute Pancreatitis in Turkey

Angiotensin-Converting Enzyme Genotype and Acute Pancreatitis in TurkeyThe renin-angiotensin system (RAS) has been implicated in the pathogenesis of acute and chronic pancreatitis. Angiotensin-converting enzyme (ACE) is the key enzyme which activates RAS. The ACE intron 16 insertion/ deletion (I/D) polymorphism is associated with ACE activity and is considered to be a risk factor for several inflammatory processes. We investigated this polymorphism in 68 patients with acute pancreatitis (AP) and 157 healthy Turkish control subjects. Patients were evaluated with ultrasonography, abdominal tomography and laboratory markers and grouped by status for diabetes mellitus (DM), hypertension (HT), and both these diseases and by etiology. Genotyping of the I/D polymorphism was performed by polymerase chain reaction (PCR). The DD genotype was more prevalent in healthy controls, however, genotype II was significantly more frequent in AP patients (p <0.05). In severe AP patients, the genotype II frequency was significantly higher than in controls (p <0.05). Acute pancreatitis patients with both DM and HT had lower frequencies of genotype DD and of the D allele, and higher frequencies of genotype II and of the I allele than patients with either DM or HT (p <0.05).