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Study material: Venous blood
Response time (working day): 14
The test is done on an empty stomach: Yes
Home call service: YesAngiotensin-converting enzyme is a key component of the renin-angiotensin system, which is involved in the regulation of blood pressure – through the regulation of circulating blood volume.
The same kinase is an enzyme of the class of hydrolases II, which is located in the cell membrane. 90% of the angiotensin-converting enzyme is in the tissue-bound form, and only a small part circulates freely in the plasma. It is mainly produced in the pulmonary endothelium.
The enzyme participates in the renin-angiotensin-aldosterone reaction cascade. In response to hypovolemia (low blood pressure), the hormone angiotensin I converts to active angiotensin II, which is a vasoconstrictor. Thus, angiotensin-converting enzyme indirectly increases blood pressure. Angiotensin-converting enzyme also inhibits (blocks) bradykinin (kallikrein-kinin system).
Angiotensin-converting enzyme activity is increased in sarcoidosis, a systemic granulomatous disease with lung involvement. In sarcoidosis, angiotensin-converting enzyme is actively produced not only in the lung epithelium, but also in macrophages. Patients with tuberculosis or Hodgkin lymphoma who develop a radiological picture similar to sarcoidosis do not have an increase in the level of angiotensin-converting enzyme, which is an important factor in differential diagnostics.
The activity of angiotensin-converting enzyme increases in direct proportion to the severity of sarcoidosis: in the first stage of the disease, the test is positive in 68% of cases, in the second stage in 86%, and in the third stage in 91%. As the disease progresses towards pulmonary fibrosis, the concentration of angiotensin-converting enzyme also decreases. The enzyme activity also decreases significantly during the period of remission achieved with corticosteroids.
Assessment of angiotensin-converting enzyme activity is also informative after treatment with cytostatics (cytotoxic drugs against tumors and other processes).
Preliminary preparation: the research can be carried out both on an empty stomach and after eating. It is not recommended to conduct research during treatment with angiotensin-converting enzyme inhibitors (captopril, enalapril and others).
Study sample:Venous blood
Elevated angiotensin-converting enzyme activity, along with the presence of pulmonary infiltrates, adenopathy, and granulomas on radiological findings, confirms the diagnostics of sarcoidosis.
A decrease in angiotensin-converting enzyme activity in response to corticosteroid treatment indicates a favorable prognosis for the disease.
In addition to sarcoidosis, increased or decreased angiotensin-converting enzyme activity may be associated with a variety of conditions:
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Approximately 5% of the healthy adult population may have elevated angiotensin-converting enzyme levels.
Increased angiotensin-converting enzyme activity is also observed in other granulomatous diseases, therefore the study is not used in isolation to diagnose sarcoidosis.
Angiotensin-converting enzyme levels in children can be 50% higher than in adults.
Angiotensin-converting enzyme activity is approximately 30% lower in smokers.
Hemolytic and hyperlipemic blood sample - gives wrong results of research
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