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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Angiotensin-converting enzyme (ACE) inhibitors are a class of drugs used to treat hypertension (see Table 3.4). The ACE inhibitor group should be considered contraindicated for use during pregnancy because of the risks discussed later (Shotan et al., 1994). Risks associated with ACE inhibitors are second and third trimester events. First trimester exposures do not seem to present a significant risk for congenital anomalies, but this is an unknown area. The risk of severe birth defects was significantly increased (OR = 1.63) among 30 infants whose mothers used ACE-inhibitors in the Swedish Birth Defects Registry (Kallen, 2019).
Immunonutrition Therapy for COVID-19
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Srijan Goswami, Ushmita Gupta Bakshi, Dona Khamaru
The immunotherapeutic effect of vitamin D on ACE-2–angiotensin cascade is an important aspect to consider. Angiotensinogen (AGT), an α2-globulin synthesized by the liver, is a precursor for all types of angiotensin peptide molecules (like angiotensin type-I) with the help of an enzyme called renin (secreted by the kidneys). So, renin helps stimulate the conversion of angiotensinogen to angiotensin type-I (AT1). Again, another enzyme called angiotensin converting enzyme (ACE), secreted by the kidneys and lungs, converts angiotensin type-I to angiotensin type-II. An increased level of angiotensin type-II is particularly known to increase the chances of lung injury. When the concentration of angiotensin type-II increases in circulation, it binds to the angiotensin receptor and stimulates vasoconstriction and increases in pressure, inflammatory processes, and fibrosis. All these factors contribute to lung injury. Vitamin D is known to inhibit excessive secretion of renin from the kidneys, thus minimizing the conversion of angiotensinogen to AT1. A decrease in the level of AT1 means decreased production of angiotensin type-II, and consequently, less binding with the angiotensin receptor, less vasoconstriction, inflammation, fibrosis, and lung injury.
Antioxidant Effects of Peptides
Published in Mesut Karahan, Synthetic Peptide Vaccine Models, 2021
Rümeysa Rabia Kocatürk, Fatmanur Zehra Zelka, Öznur Özge Özcan, Fadime Canbolat
Hypertension is a cardiovascular disease that affects approximately one quarter of the world’s population and is a controllable risk factor that plays a role in related complications. The angiotensin I-converting enzyme (ACE) is a dipeptityl carboxypeptitase and has the role of turning angiotensin I to angiotensin II. Angiotensin II has a general vasoconstriction impact. It plays an important physiological role in controlling blood pressure, liquid, and salt balance in vertebrates (Hartmann and Meisel 2007; Hayes et al. 2016) and peptides that repress the ACE enzyme are potentially assumed as agents that lower the blood pressure (Kannan, Hettiarachchy, and Marshall 2012). Therefore, a great deal of research has been carried out on the peptide production which shows antihypertensive activity from milk, cheese, meat, fish, and a wide variety of plants and algae. However, no correlation has been reported between in vivo antihypertensive effects and the results of in vitro studies investigating the inhibition of ACE enzymes. In this manner, there is no assurance that the result that is taken from ACE inhibition acquired in vitro will have a similar impact in vivo (Majumder and Wu 2013; Miralles, Amigo, and Recio 2018; Ünal, Şener, and Cemek 2018; Girija 2018).
COVID-19 and its long-term impact on the cardiovascular system
Published in Expert Review of Cardiovascular Therapy, 2023
Bejoy Philip, Prerona Mukherjee, Yuti Khare, Pranav Ramesh, Sara Zaidi, Haytham Sabry, Amer Harky
Additionally, this unique relationship with ACE-2 may be the reason for increasingly severe symptoms in those with preexisting cardiovascular disease. Patients with cardiovascular disease are more likely to take ACE inhibitors due to beneficial effects on blood pressure and myocardial remodeling. It has been shown that ACE inhibitor therapy increases the expression of ACE-2 receptors and as this is a functional receptor for SARS-CoV-2 it can theoretically increase viral load [14]. However, a recent randomized controlled trial (n = 659) demonstrated no difference in 30-day mortality in those taking ACE inhibitors or angiotensin receptor blockers compared to those without these medications [15]. Figure 1 provides a general overview of the pathophysiology of SARS-CoV-2 and its cardiovascular sequelae.
Unilateral Multifocal Choroidal Nodules as the Sole Initial Manifestation of Systemic Sarcoidosis – Diagnostic Role of PET–CT Scan
Published in Ocular Immunology and Inflammation, 2023
Gazal Patnaik, Reena Sorokhaibam, Jyotirmay Biswas
Routine blood investigations revealed normal total and differential counts and a raised erythrocyte sedimentation rate. Serum angiotensin converting enzyme level was elevated. Tuberculin skin test/Mantoux test and QuantiFERON TB gold test were also negative. Considering the age, unilateral and unusual presentation, bronchial brush specimens were examined and found to be negative for malignant cells. Cytology study of the bronchoalveolar lavage showed granulomatous inflammation. Magnetic resonance imaging (MRI) scan of brain and orbit was found to be normal. This was followed by a positron emission tomography–computed tomography (PET-CT) scan, which showed two noncalcified nodules in the right middle and lower lobe having mild increased metabolic activity, with metabolically active multiple lymph nodes in the right paratracheal, subcarinal, bilateral hilar, and para-aortic regions (Figure 5).
Assessment of angiotensin converting enzyme gene polymorphism in preeclampsia mothers of Bangladesh
Published in Journal of Obstetrics and Gynaecology, 2021
Md. Bayejid Hosen, Md. Mostafijur Rahman, M. Zakir Hossain Howlader, Yearul Kabir
During normal pregnancy, the renin–angiotensin–aldosterone system (RAAS) augments the plasma levels of renin and aldosterone (Kaur et al. 2005). On the other hand, preeclamptic mothers suffer from suppression of the RAAS system and become highly sensitive to the pressor effects of angiotensin II together with increased vascular resistance during pregnancy (Kim et al. 2004). Angiotensin-converting enzyme (ACE) is an vital circulating enzyme of the RAAS system which catalyses the conversion of angiotensin I to angiotensin II and also degrades bradykinin (Rigat et al. 1990). Thus, ACE plays an important role in blood pressure homeostasis and may influence the occurrence of preeclampsia (Kim et al. 2004). Though different studies provided contradictory results about ACE level during preeclampsia, it was previously reported that a common I/D polymorphism in intron 16 of the ACE gene is said to be linked with different plasma ACE levels, and individuals who are bearing the D allele had higher ACE activities (Rigat et al. 1990). Besides, several studies have indicated that pregnant mothers had higher ACE activity who are carrying the D allele (Mello et al. 2003). A significant association between the D allele and the occurrence of preeclampsia has been shown by Salimi et al. (2011) in Iranian women. The association of D allele with the onset of early preeclampsia has also been reported in Egyptian mothers by Kamha et al. (2013).