Clinical studyHigh prevalence of polymorphisms of angiotensin-converting enzyme (I/D) and endothelial nitric oxide synthase (Glu298Asp) in patients with systemic sclerosis
Section snippets
Methods
We investigated 73 consecutive Italian patients (62 women, 11 men) with systemic sclerosis who had been referred to the Section of Rheumatology of the Department of Internal Medicine of the University of Florence, Italy. The median age was 62 years (range, 24 to 79 years). The diagnosis of systemic sclerosis was established according to the criteria of the American College of Rheumatology (23). One hundred and twelve control subjects of the same ethnicity, with no history of cardiovascular
Results
The ACE D and eNOS 894T alleles, but not the eNOS –786C allele, were significantly more common in patients with systemic sclerosis than in controls (Table 1). The ACE D allele was associated with about a threefold increase in the risk of systemic sclerosis (OR [DD + ID vs. II] = 3.4; 95% CI: 1.5 to 7.9; P = 0.003), and the eNOS 894T allele with about a doubling in the risk (OR [TT + GT vs. GG] = 1.9; 95% CI: 1.0 to 3.4; P = 0.04).
Forty-one (56%) of 73 patients had both the ACE D and eNOS 894T
Discussion
We found that the ACE D allele and the eNOS 894T allele were associated with an increased risk of systemic sclerosis, but not with the disease subset and clinical features. This suggests the possibility that these alleles affect the incidence, but not the progression and evolution, of the disease.
The ACE D allele affects plasma ACE levels (10), perhaps because the I allele may have a “silencer” effect (27), thereby regulating the production of angiotensin II and the degradation of bradykinin.
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